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Truth Squad assigns five ratings to the political statements we review, in descending levels of accuracy:
State Senate 37th District GOP primary
Medicaid expansion is a key point of contention in the Republican primary race between former TV weatherman and state Rep. Greg MacMaster and state Rep. Wayne Schmidt, in a state Senate district that includes the northwestern part of the Lower Peninsula and the eastern portion of the Upper Peninsula. As MacMaster states, he switched his vote to a “no” on Medicaid expansion while Schmidt twice voted for the measure signed into law last September.
|Who:||Greg MacMaster for state Senate||What:||Candidate statements on Medicaid expansion||The Call:||Regular Foul|
“When the expansion was first voted on in the House, I supported it. This wasn’t really Obamacare, we were told. This was Michigan getting its fair share back from Washington...As more facts came to light, my opinion of the bill changed. And, in September, I changed my vote and voted against Obamacare’s Medicaid expansion. I was the only House member to change their vote. I’m proud that I did.
“My heart goes out to those that were laid off or forced to seek employment elsewhere due to the passage of the Medicaid expansion. While I voted 'NO' for it - I'm working diligently to repeal this colossal mistake and disassociate it with the ACA.”
Before this year, Medicaid in Michigan was largely limited to children, parents below the poverty level with dependent children, the elderly and disabled.
Expansion widens that to include the uninsured “working poor,” individuals or families making up to 138 percent of the federal poverty level. More than 320,000 had signed up in Michigan by early July since enrollment began on April 1. That is expected to approach 500,000 within a few years. Under terms of the Affordable Care Act, the federal government is committed to pay the full cost of Medicaid expansion through 2016. Its share would fall to 90 percent by 2020 with states to pay no more than 10 percent after that. Gov. Rick Snyder calculates general fund savings of more than $200 million a year and plans to bank half of that to defray future costs.
A 2013 analysis by the state Senate Fiscal Agency projects that the “crossover point” –where costs exceed savings – could occur anywhere from 2023 to 2036.
MacMaster's statement that he was told Medicaid expansion “wasn't really Obamacare” doesn't square with the facts or the way Obamacare was presented. Medicaid expansion was always a key component of the Affordable Care Act, approved by the U.S. Supreme in June 2012 but with the option for states to opt out of Medicaid expansion that was part of the act. Asked to elaborate on his change of position, MacMaster said he learned after his vote that it could have a “negative effect” on northern Michigan hospitals.
But his assertion that Medicaid expansion cost jobs is not substantiated. A MacMaster campaign spokesperson cited reports of layoffs at hospitals around northern Michigan, including at Mercy Hospital Grayling, which announced in March it is eliminating 24 positions and not replacing 11 other vacant positions.
Hospital CEO Stephanie Riemer-Matuzak said the layoffs were due to a decline in the number of patients receiving services at the hospital. There was also a drop in emergency room visits and outpatient services such as diagnostic testing. But those layoffs were announced before the April 1 enrollment in Medicaid expansion had even begun. McLaren Northern Michigan hospital in Petoskey announced in February it is eliminating 40 jobs, but those layoffs were also announced well in advance of Medicaid expansion enrollment.
|The call:||Regular Foul|
MacMaster’s assertion that Medicaid expansion in Michigan is costing jobs is not substantiated.
|Who:||Rep. Wayne Schmidt|
|What:||Statements on Medicaid expansion issued in September 2013|
|The call:||No Foul|
“We have worked hard in both the House and Senate to craft a program that emphasizes personal responsibility while saving taxpayer money. This will benefit people in Northern Michigan, some of whom currently use expensive emergency room care as their primary source of health care which drives up the cost of healthcare for us all...We are taking every step to ensure that taxpayers are protected and that our most vulnerable families have access to the health care they need.”
Schmidt issued these statements through the Michigan House Republicans about the time of passage of Medicaid expansion. As he noted, those making between 100 percent and 138 percent of the federal poverty level are to contribute up to 2 percent of their income to a health savings account that can be used to pay out-of-pocket expenses.
The plan offers incentives for healthy behavior such as smoking cessation and weight loss. Though the cost of Medicaid expansion is to be paid 100 percent by the federal government through 2016, it is difficult to know with certainty what its cost to the state might be a decade later. Its impact on hospitals long-term is still unknown.
In fiscal 2011, Michigan hospitals had more than $882 million in charity and uncompensated care. Research and interest groups continue to disagree over the impact of Medicaid expansion. Health Affairs, a nonprofit research organization, predicted improved health care outcomes and reduced cost of catastrophic care. The conservative Heritage Foundation warned that Medicaid expansion is part of “unsustainable” growth in entitlement spending. It also warns there is no guarantee federal funding will continue as promised.
|The call:||No Foul|
Schmidt is correct in stating that Michigan's expanded Medicaid asks for personal accountability. For now, its cost is paid by the federal government. Its cost to Michigan a decade or more from now is uncertain.