The Supreme Court, Medicaid Expansion, and MI Health Marketplace

After months of speculation, the U.S. Supreme Court has upheld the constitutionality of the Patient Protection and Affordable Care Act. PPACA was passed by Congress and signed into law by President Obama in March of 2010.

The Supreme Court by a vote of 5-4 upheld the individual mandate ruling that it falls within the taxing authority of Congress. However, the court also overturned a small but significant provision of PPACA ruling that it would be unconstitutional for the federal government to withhold Medicaid funds from states that elect not to participate in the expansion of Medicaid scheduled to begin in 2014.

In Michigan, however, the battle may just be starting over Medicaid expansion and the creation of a health care exchange known as the MI Health Marketplace. No state Republican leaders, including Governor Rick Snyder, have yet committed to moving ahead to add roughly 500,000 uninsured residents to the Medicaid rolls beginning January 1, 2014 despite a federal pledge to pay the full tab in the first two years and 90% of all costs after that. In Michigan, as elsewhere in the nation, Republican leaders have balked at committing to expanding Medicaid citing potential costs.

On the health care exchange front, the future is also uncertain. The Senate passed SB 693 last year to create the MI Health Marketplace, yet despite Governor Snyder’s support to create the exchange the House GOP leadership has not yet decided on a timeframe for either the exchange or the Medicaid expansions. It is unclear whether or not Governor Snyder is willing to create the exchange by executive order or memorandum of understanding as has been done in some other states.

With presumptive Republican presidential nominee Mitt Romney pledging to repeal “Obamacare” on day one, perhaps the only thing we can be sure of is that these issues will be with us at least until Tuesday, November 6^th – Election Day.

posted by PAA Online , Friday, July 6, 2012 2:03 PM
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