Guest commentary: 10 reasons to expand Medicaid in Michigan

EXPANSION RESULTS: Expanding Medicaid coverage in Michigan would mean 18,000 new jobs in Michigan, argues Mike Vizena. (courtesy photo/used under Creative Commons license)

By Mike Vizena/Michigan Association of Community Mental Health Boards

There are many reasons the Michigan Legislature should follow Gov. Rick Snyder's lead on Medicaid expansion. Let me count the ways:

1. It is simply sensible public policy to tap federal funds already set aside to expand preventive and life-saving health care under Medicaid. Expansion represents the best single opportunity to improve access to behavioral health-care services for Michigan's citizens most in need.

2. Cuts to general fund support for mental health and substance use disorder services over the past decade have resulted in a lack of access, reduction of services and creation of waiting lists for persons without Medicaid. As a result, persons with emerging mental health and substance use disorders are not seen for care, and, instead, end up in emergency room and hospital settings, where their cost of care is 20 times greater.

Far too often these citizens wind up in criminal justice proceedings, or, in some cases, become homeless places where they do not belong and where they will not receive the care they need.

3. Since the tragic Newtown, Conn., massacre, mental health services have taken a much-needed front seat in policy and budget discussions.  Far too often, there is an obvious need for treatment that is not provided due to the waiting lists at many local community mental health service agencies. The governor has proposed increases in mental health funding as a part of the Medicaid expansion proposal. The best way to provide increased support for mental health services in a cost effective manner and to remove barriers to care is to expand Medicaid.

Mike Vizena is executive director of the Michigan Association of Community Mental Health Boards in Lansing.

4. Medicaid expansion would provide coverage options for small businesses and creates a healthier work force that will improve the state’s economic competitiveness. Workers at many small Michigan companies do not get insurance from their employers. Medicaid expansion will cover low-wage working adults.

5. Michigan hospitals now provide more than $880 million a year in uncompensated care to patients who are unable to pay. It is estimated that up to $1,000 of the annual cost of a health insurance premium for a family of four is to cover the bill for this uncompensated care. Expanding Medicaid will reduce this hidden health care tax paid by insured individuals, families and businesses.

6. The governor’s recommendation will help local community hospitals. These hospitals will lose uncompensated care payments from the federal government because more persons should be covered by Medicaid and the health insurance exchange. If the Michigan Legislature does not support Medicaid expansion, lawmakers jeopardize the financial stability of local hospitals across the state.

7. If Michigan's Legislature fails to expand Medicaid coverage, an opportunity to provide health insurance for thousands of hard-working, low-income residents will be lost, while the need and costs will remain.

8. The federal government has pledged to cover the full cost of expansion through 2016, before gradually reducing funding to 90 percent by 2020.

9. Snyder has been extremely clear in his belief the expansion will help protect more than 300, 000 of Michigan's most vulnerable residents in the next year alone; decrease the rate of emergency room visits that drive up health costs for everyone; and save the state millions a year in state spending -- half of which he wants to put in a savings account to offset any future costs.

10. Finally, it is estimated that Medicaid expansion will create 18,000 new health-care jobs and generate $2.1 billion in new economic activity in Michigan.

When Snyder called for expanding Medicaid under the federal Affordable Care Act, he said, "This makes sense for the physical and fiscal health of Michigan." He continued, "expansion will create more access to primary care providers, reduce the burden on hospitals and small businesses, and save precious tax dollars. It also puts Michigan rather than Washington in the driver’s seat in terms of implementation, which allows us to better address Michigan’s specific needs.”

The time is now to call on the Michigan Legislature to support Snyder’s proposals to expand Medicaid coverage in Michigan to families making less than 138 percent of the federal poverty level.

Supporting Medicaid expansion is about helping real people -- our families, neighbors and friends with real needs by tapping the tax dollars we send to Washington. It is a wise investment.