May 10, 2013, Weekly Vote Report

Refillable beer, "electric carriages" and Obamacare

House Bill 4254, Exempt “electric carriages” from motor vehicle regulations: Passed 35 to 0 in the Senate
To exempt “electric carriages” from regulations and taxes authorized under the Michigan vehicle code. These are defined as “a horse-drawn carriage that has been retrofitted to be propelled by an electric motor instead of by a horse and that is used to provide taxi service.” The bill would benefit a Detroit operation called "Andre's Carriage Tours" by letting it operate statewide.

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Who Voted "Yes" and Who Voted "No"

Senate Bill 27, Authorize refillable beer container sales: Passed 37 to 0 in the Senate
To allow package liquor stores, beer and wine stores, bars and restaurants licensed to sell alcohol to refill clearly labeled “growlers” (sealable containers of up to one gallon) with beer for consumption off-premises. The Senate also passed by the same 37-0 margin bills allowing wineries to sell wine and offer tastings at farmers markets, subject to specified restrictions and fees.

Who Voted "Yes" and Who Voted "No"

Newly Introduced Bill of Interest:
House Bill 4714, Accept Federal Health Care Law Medicaid Expansion, with Conditions

With some fanfare House Republicans introduced a bill to accept the component of the federal health care law (“Obamacare”) that would expand Medicaid eligibility to families and childless adults up to 138 percent of the federal poverty level, but make this contingent on the federal government allowing the state to implement specified Medicaid reforms. The bill is sponsored by Reps. Matt Lori and Al Pscholka.

The expansion was originally mandatory for states under the law passed by congress, but the Supreme Court ruled it can only be optional for states. Under current provisions, the feds are supposed to pay 100 percent of the expansion’s cost during the first three years (not counting administration costs), with the state responsible for not more than 10 percent of the costs starting in 2020.

In its current form, the reforms required by the bill appear to be “poison pill” ones the Obama administration would not approve. They include:

- A four year cap on Medicaid benefits for non-disabled adults.
- A requirement that non-disabled adult beneficiaries must contribute “up to” 5 percent of their income as deductibles, copays, etc.
- Allow the state to offer Health Savings Accounts for non-disabled adult beneficiaries.
- Allow non-disabled adults to choose a “contracted health plan” through the agency styled as the “exchange.” (All or most Michigan Medicaid recipients are already enrolled in contracted managed-care plans, so without the other reforms this would not appear to represent a significant change in the status quo.)
- Allow the state to impose “healthy behavior incentives” on non-disabled adults.
- Allow “telemedicine” services for beneficiaries.
- Impose a price cap on the amount hospitals can charge “uninsured individuals under 100 percent of the federal poverty level.”
- Require the federal government to permanently assume 100 percent of the state’s administration costs (this does not appear to apply to the state’s eventual 10 percent share of the actual benefit costs.)

Democratic legislators generally condemned the proposed reforms, especially the four-year time limit on benefits. However, along with hospitals and other special interests who are lobbying intensely for the Medicaid expansion, some of them characterized the bill as a “good starting point” for a possible compromise containing much weaker reforms the Obama administration would accept, or else one that merely requires the state to request federal permission to enact the reforms, rather than actually receive this permission.

The bill was referred to the House Committee on “Michigan Competitiveness,” chaired by Rep. Mike Shirkey. 

Update: The bill's sponsors have told Michigan Capitol Confidential their intention is that after the first three years the federal government would continue to pay 100 percent of the benefits of those covered by the expansion, not just 100 percent the state's administration costs, which is what the text appears to call for. A potential amendment could clarify this.