LANSING - The Republican-dominated Michigan Senate adjourned Thursday without voting to provide medical insurance to hundreds of thousands of low-income adults under the federal health care law, prompting an uncharacteristically angry Gov. Rick Snyder to demand an up-or-down vote.
"Take a vote, not a vacation," the Republican governor said during a late afternoon Capitol news conference in which he implored every state resident to ask GOP senators to vote on Medicaid expansion soon. "Isn't that what we deserve to move forward?"
Snyder cut his trade trip to Israel short to be back in Lansing on Thursday and lobby the Senate for hours. The chamber adjourned, however, and does not plan to return for two months - a serious blow that likely means 320,000 adults will not be added to Medicaid in 2014.
Nurses listen this week outside the Anderson House Office Building in downtown Lansing, as Michigan nurses rally for expanding Medicaid in Michigan. (AP photo)
The GOP-led House approved Medicaid expansion legislation a week ago, including provisions to make newly insured recipients pay for some of their care. And it is believed the measure would clear the Senate with a mix of Democratic and Republican votes if a vote is called.
Senate Majority Leader Randy Richardville, however, had trouble finding at least half of the 38-member chamber's 26 Republicans to vote yes or at least support proceeding with a vote, thresholds he wanted.
He said the debate "is not over," but Snyder countered that time is running out and "not making a decision is a decision."
Richardville said the bill will be referred to a committee, and a work group will spend the summer reviewing it and alternative proposals.
"On this issue, I want to make sure that this is truly bipartisan," he said. "We're talking about huge money, we're talking about huge implications. We have 12 Democrats. I think 13 Republicans is a reasonable amount to request on something like this."
Senate Minority Leader Gretchen Whitmer, an East Lansing Democrat, said the unwritten majority-of-the-majority rule is "baloney" and an "excuse not to do something."
Snyder said it was unclear if he could call lawmakers back to Lansing under a provision in the state constitution allowing him to convene the Legislature for "extraordinary occasions."
He declined to say if he would consider vetoing every bill sent to his desk until legislators pass the expansion - a tactic recently used by Arizona Republican Gov. Jan Brewer.
"I don't view it as insignificant that I'm standing here in a press conference asking 10 million people to bug the living daylights out of their senator until they come vote on something," Snyder said.
Hospitals, insurers, nurses, small businesses and advocates for the poor are pushing the Senate to act, while conservative and tea party groups are pressuring senators to stand firm.
Snyder is among nine GOP governors who support providing more government-funded insurance, saying it will make people healthier and save money because fewer uninsured will go to the emergency room for uncompensated care. He has opposition, though, from Republican senators such as Patrick Colbeck from Wayne County's Canton Township.
Colbeck said he is not swayed by efforts to make the bill more palatable to the GOP and that "Obamacare" should be repealed.
"Government solutions are not the right solutions," he said. "When you look at where we are actually getting better quality and better access and lower prices, it's out in the free market. We're going in the exact opposite direction."
Medicaid covers roughly one in five Michigan residents, mainly low-income children, pregnant women and disabled people but also some poorer working adults. The legislation, if the federal government signs off on it, would provide Medicaid to nearly a half-million more adults by 2022, cutting the state's uninsured nearly in half.
The federal health care overhaul lets states expand Medicaid to adults making up to 133 percent of the poverty level, or about $15,500 for an individual. The U.S. government is offering to cover the entire cost initially and 90 percent later.
The bill includes requirements that new enrollees making between 100 and 133 percent of the poverty line pay up to 5 percent of their income on medical expenses. They would have to contribute up to 7 percent after getting Medicaid for four years, or shop for insurance from a new marketplace where they could qualify for tax credits to help pay for it.
Medicaid recipients could lower their premiums and co-pays if they meet healthy behaviors like not smoking.
Snyder said expansion makes sense fiscally and is the right thing to do for people.
"We're talking human beings here," he said, becoming visibly emotional while recounting what he asked individual senators he met with throughout the day. "How are you going to feel if we do nothing and you walk in there and you see chair after chair of working poor people, hard-working people sitting in those chairs knowing that's their health care system, when we could have given them a better answer? I know of no way to explain why you cannot act."
Associated Press writer Jeff Karoub in Detroit contributed to this report.
House Bill 4714: 1.usa.gov/12nvl2W