There was a lot of criticism of President Obama for devoting so much time to his health care plan during his first year and a half in office. Some felt he should have also tried to get through a massive job creation plan, or a program to rebuild the nation’s infrastructure. However, he did succeed at getting what we now call “Obamacare” passed, and it is now transforming medical coverage.

For as long as I can remember, the Republican Party has stood for local control. They don’t like Washington telling the states what to do. When Democrats have been in control in Lansing, they didn’t like the state meddling in local matters. Today, this continues to be true in one sense.

It’s clear that the Republicans running our legislature don’t like the federal government setting health care policy for the states. That’s why they’ve refused for two years to establish a state registry to help match Michiganders who will now need to buy health insurance with various private care providers.

Basically, those running our legislature want to pretend that the Affordable Care Act is going away soon. Never mind that the U.S. Supreme Court ruled that it was fully constitutional. Never mind that the last presidential election was fought largely on that issue, and President Obama was decisively reelected.

They so hate higher levels of government telling lower levels what to do, that they refused to create a health care registry, even though this means that Washington will create one for us anyway, and we will lose millions as a result.

Well, you might figure that if the Republicans believe this that strongly, they’d be against meddling with employment policies set by local units of government.  But you’d be wrong. At least, that is, when it comes to benefits for workers.

Medicaid expansion in trouble in Mich. Legislature

Mar 23, 2013

Governor Rick Snyder and health advocates have their work cut out for them persuading the GOP-led Legislature to expand Medicaid coverage to hundreds of thousands more residents.


The Affordable Care Act requires that for those Americans who can afford it, they must carry some form of health insurance starting on January 1st, 2014 or pay a fee.

Online 'health care exchanges' will be set up to help people buy health insurance who can't access it through an employer. If the states don't set up an exchange, the federal government will.

Gov. Snyder wanted legislators to set up a state-run exchange last year, but Republican legislators refused to vote on it, hoping the federal health care law would be overturned.

That didn't happen and the timeline for a state run exchange has passed.

Now some state Republicans are reluctantly voting in favor of a setting up a federal-state run exchange.

Steve Carmody/Michigan Radio

Governor Rick Snyder decides this week whether he will call for expanding Medicaid in his new budget.

The federal government would pick up the entire cost at first, which would allow the state to add nearly 400 thousand people to the Medicaid rolls who are currently uninsured.

One of the goals of the federal health care law is to reduce the number of un-insured people and costly emergency room visits.

But, after the first few years, states will have to pick up part of the cost: 10% by 2020.

Steve Carmody/Michigan Radio

DETROIT (AP) - A federal judge has ruled a property management company owned by the founder of Domino's Pizza doesn't have to immediately implement mandatory contraception coverage in the health care law.

U.S. District Judge Lawrence Zatkoff ruled Sunday in favor of Tom Monaghan and his Domino's Farms Corp. near Ann Arbor. Monaghan, a devout Roman Catholic, says contraception isn't health care but a "gravely immoral" practice.

Suppose that Mike Ilitch, the owner of the Detroit Tigers, said he refused to accept the result of the World Series. He wasn’t going to accept the San Francisco Giants as champions, despite the fact that they swept his team in four straight games.

That would be nuts. But not much more irrational than what Republicans in the state House of Representatives did yesterday. They stomped their feet, whined, pouted and refused to set up a state-run exchange to help citizens and businesses shop for health care, now that they have to buy it.

This won’t make much difference to the average person, and affects only those who don’t have health care now, as well as small businesses, which now have to offer it to their workers.

The only difference is the federal government, not the state, will be running the system that helps people find health care. While this is being called an exchange, it is actually more like a marketplace, where people can shop for health care policies.

user Laura4Smith / Flickr

Over 10 years, Michigan could save a billion dollars and get more than 600,000 previously uninsured people health coverage.

That's the upside of expanding Medicaid in Michigan, according to a new study from the Center for Healthcare Research and Transformation (CHRT) in Ann Arbor. 

The federal government can't force states to expand their programs, but they are offering big incentives: for 10 years, the feds will pick up 100% of the costs of covering newly-eligible Medicaid patients, as part of the Affordable Care Act. 

Steve Carmody/Michigan Radio

LANSING, Mich. (AP) - Michigan Gov. Rick Snyder and his fellow Republicans could find themselves knee-deep in health care issues Wednesday when lawmakers briefly return after a five-week break.

Snyder needs to get reluctant House Republicans on board with his efforts to create an online site where individuals and small businesses can comparison shop for private health insurance.

A debate over establishing an online Michigan exchange where people and businesses can comparison shop for health coverage have been pushed into next year.

Governor Rick Snyder has said he’d like to see a state-run exchange established soon to ensure Michigan does not get pushed onto a federal system set up under the new national health care law.

But he’s been getting pushback from some Republicans in the Legislature.

“My members do not like Obamacare and they see this as steps to the implementation of Obamacare," said State Rep. Chuck Moss (R-Birmingham). "And, given that it’s iffy in the courts and possibly going to be repudiated in the next election, why do we want to get on that train now?”

The U.S. Supreme Court is expected to rule on the legality of the Patient Protection and Affordable Care Act. Business groups have split on creating a state exchange. Governor Snyder says it’s a good idea even if the federal law is reversed.

Lindsey Smith / Michigan Radio

Gov. Rick Snyder wants people in Michigan to do more to promote their own health. He also outlined policies he’d like to see legislators pass to help lower health care costs and improve access.

Snyder says he wants Michigan to create a health care exchange: a place where individuals can compare health care insurance.

The new federal health care law mandates states create their own exchange, join a regional one or wait until the federal exchange is in place.

“Having the idea of having an exchange done right is a good idea and my view is Michigan should establish one. We shouldn’t wait and say the federal government is going tell us it’s their exchange.”

Snyder wants to reform the state’s health code, improve health care for veterans and children with autism. He also wants to reduce regulations on health care professionals.

(photo by Steve Carmody/Michigan Radio)

The federal health care law is scheduled to take effect in 2014.  Health care leaders in Washtenaw County say they are not ready.