Monday, April 29, 2013

State Republicans urged to reform Medicaid to include those with mental disabilities

State Republicans are targets of groups trying to convince them to insert language into an appropriations bill to expand Medicaid under the Patient Protection and Affordable Care Act to cover an estimated 500,000 low-income people in Michigan.

“The Michigan House of Representatives has supported this but the Senate, at this time, is worried about the federal government going to the extreme as far as its authority to cover costs of Medicaid reform,” said Paul Tarr, the former director of legislative affairs for the Michigan Department of Mental Health.

The group, Expand Medicaid, recently was formed to support expansion of Medicaid that provides medical care for those living below the federal poverty line. Expand Medicaid is a coalition of Michigan hospitals, mental health care providers and physicians.

Another coalition, the Michigan Universal Health Care Access Network, is circulating a petition aimed at changing attitudes of GOP lawmakers.

“Governor (Rick) Snyder supports it,” said Tarr, also a legislative liaison for the Department of Community Health. “People (but not enough) on both sides of the aisle support this (Medicaid reform).”

Cuts to general fund support for mental health and substance use disorder services during the past decade have resulted in a lack of access, reduction of services and creation of waiting lists for a person without private insurance or Medicaid.

“Snyder says expanding Medicaid is the best thing to do because it will provide prevention services,” said Tarr.

Some have been against expansion of Medicaid to cover those with mental disabilities because Medicaid reimbursement rates are too low, he added. “(But) the federal government has not reneged on its portion of Medicaid reimbursement but the state has, saying it doesn’t have sufficient funds.”

Tarr said: “In all fairness, the Legislature is looking at this. Lawmakers are waiting to see how this is going to unfold. If the reimbursement rate is below Medicare, then there will be a shortage of doctors.

“It is my belief it will definitely help people with mental and physical disabilities,” said Tarr who helped establish Michigan’s Medicaid system. “In time, I think Michigan will reform Medicaid. I support Medicaid reform and the Senate needs time to let it seep like a good cup of tea.”

Last month, a House subcommittee removed Snyder’s proposed Medicaid expansion from its budget and in mid-April a Senate subcommittee did the same. The bills are SB198 and HB4213.

Lawmakers in the state House and Senate are facing a June 1 self-imposed deadline to finish the state budget.

Some studies have shown, according to Crain’s Detroit Business, that Michigan could save nearly $1 billion in healthcare expenditures if it expands Medicaid to people with incomes up to 138 percent of the federal poverty level.

If lawmakers approve Medicaid expansion, Michigan could receive $2 billion in federal funds during the next decade to finance those, including the mentally ill, who become eligible for Medicaid.

“Expansion represents the best single opportunity to improve access to behavioral health-care services for Michigan’s citizens most in need,” Vizena said.

Jerry Wolffe is the Disability Rights Advocate/writer in residence at MORC Inc., a nonprofit that provides services to 5,100 people with disabilities in Oakland, Macomb, and Wayne counties.