Under the provisions of this legislation, the state would be required to seek a waiver from the federal government to expand coverage for individuals with income up to 133 percent of the poverty level as long as the federal government fully funds the expansion. The bill would also limit Medicaid health care coverage for patients to four years and would institute personal responsibility provisions (i.e. healthy behavior, co-pays, etc.).  The four-year time limit would be prospective from the effective date of this legislation.

During Tuesday’s committee hearings, questions and concerns primarily surrounded the bill’s provision that would limit Medicaid coverage to 48-months for nondisabled adults. Specifically, lawmakers questioned the legality of the cap and whether it would unintentionally increase the number of uninsured when the time limit expires. Committee members also questioned how the state would implement and enforce the healthy behavior requirements and address non-disabled adults facing a chronic and terminal illness after the 48-month limit expired.

On Thursday, Michigan Department of Community Health Director Jim Haveman told committee members the Department could work with the overall premise of the bill but there are a few outstanding concerns. Haveman raised the potential concern that the 48-month threshold would encourage recipients to enroll into Medicaid after, and not before, they are diagnosed with a chronic or long-term illness. He also articulated that the bill did not include an account for the state to pay its required contribution beginning in 2017. Additionally, there were further discussions about on whether the cap would deter the federal government from approving the waiver.

Committee Chairman Shirkey stated the committee will resume discussions on this issue next Tuesday.  A final vote for the bill has not been scheduled.