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What the GOP repeal plan means for 650,000 Michiganders

TaxRebate.org.uk/Flickr Creative Commons
Right now, the Medicaid expansion is a pretty sweet deal for Michigan and the 650,000 people covered under it.

If you're trying to understand what the heck this new Republican health care bill would mean for you, you’re not alone.

Let’s do a quick recap: Medicaid is health insurance for really low income people. Under the Affordable Care Act, states including Michigan expanded their Medicaid programs. Suddenly single adults making $16,600 a year were eligible, or a family of four making about $34,000 a year.

Since then, 650,000 Michiganders have signed up for that Medicaid expansion, called “Healthy Michigan.” Researchers say most of those people didn’t have insurance before this.

And it’s a pretty sweet deal for Michigan, because right now, the federal government is picking up most of the tab.

Under this new proposal, however, things would change. The federal government would say to Michigan and other states: Here’s a flat amount of money, based on how many people are on your Medicaid rolls right now.

“And if you spend more, if you're a more expensive state than medical care inflation going up, then, state, you have to make that up from state dollars,” says Marianne Udow-Phillips, the executive director of the Center for Healthcare Research and Transformation at the University of Michigan.

Basically, if the cost of healthcare goes way up, then Michigan will be left with the bill.

"The state would probably have to make up for much more funding, when new innovations, new drugs come on the market that weren't accounted for, that didn't happen in 2016,” she says.

That could mean that, down the road, states like Michigan may kick people back off Medicaid. 

Kate Wells is a Peabody Award-winning journalist currently covering public health. She was a 2023 Pulitzer Prize finalist for her abortion coverage.
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