On Thursday, the full House voted to expand Medicaid health care coverage for individuals with income up to 133 percent of the federal poverty level.

The final bill (House Bill 4714, H-3) did not include the provision that prospectively limits non-disabled adults to 48-months of coverage. However, the substitute version of the bill would require recipients in the expanded population who exceed 48 months to contribute between 3 to 7 percent of their annual income to their coverage or purchase private insurance through the federal health insurance exchange.

Additionally, the bill stipulates that in order for Michigan to participate the federal government must fully fund the expansion program or the savings from the expansion must cover the state match. The Michigan Department of Community Health (MDCH) would be required to post reports on the savings gleaned from the expansion program.

In addition to seeking the federal waiver, the MDCH would create incentives for health plans to meet improvement goals, providers to achieve quality and cost targets, and healthy behavior outcomes for recipients.  The bill would also create health savings accounts requiring recipients to contribute up to 5 percent of their annual income to their coverage through co-pays, deductibles, premiums, etc. and institute abuse and fraud initiatives.

If the federal waiver is not approved by December 31, 2015, the MDCH would have to notify enrollees that the expanded program would be terminated on April 30, 2016.

The bill now heads to the Senate for consideration where it is expected to move before the Legislature adjourns for its summer recess next week.