LANSING, Mich. (AP) — Gov. Rick Snyder may have to convince lawmakers across the political spectrum that expanding Medicaid eligibility under the Affordable Health Care Act will allow Michigan to also plug a gap in its increasingly underfunded mental health care system.
Last June, the Supreme Court empowered states to choose whether to opt into the Medicaid expansion. If Michigan does, some 500,000 additional residents would be covered by the joint state-federal health care program for the needy. But Republicans, who control the Michigan legislature, are reluctant to use that power.
Snyder, also a Republican, has said one of the benefits of opting in is that it would allow the state to significantly expand assistance for those who need mental health care.
The governor said Friday that he has not yet made his decision, but will announce it during his budget address Feb. 7. But he also said he has concerns about whether Michigan's health care system and providers would have the capacity to handle the increased number of people who would qualify for coverage.
Approximately 70 percent of state psychiatric hospitals have closed since the mid-1980s, and the bulk of mental health services are now provided by the state's 46 Community Mental Health boards. The state cut non-Medicaid mental health funding by about $44 million between fiscal years 2007 and 2012, and advocates say those reductions have left the system underfunded.
Michigan Department of Community Health Director James Haveman said he expects Snyder to allocate about $5 million more under the new budget for the creation of youth mental health programs.
Snyder on Friday also urged lawmakers to "really focus on this mental health question," and "not to rush to gun legislation." Snyder recently vetoed legislation that would have allowed concealed weapons in churches, schools and day care centers, though lawmakers have introduced several gun-related bills since the legislative session began Jan. 9.
An expansion of Medicaid would "be a wonderful first step in his commitment" toward improving mental health, said Malisa Pearson, executive director of the Association for Children's Mental Health.
But Snyder can expect backlash from GOP lawmakers if he chooses to go through with the Medicaid expansion. Sen. Bruce Caswell, a Hillsdale Republican, introduced a bill last week that would prohibit Michigan from expanding eligibility.
Republicans want to fully understand the long-term effects before agreeing to expanding Medicaid, said Ari Adler, spokesman for House Majority leader Jase Bolger. "There is no guarantee that the federal government won't change its mind and provide less funding at some point."
The needle that Snyder must thread on mental health runs both ways: He would have to persuade reluctant Republican colleagues who are no fans of a government program that they see as overreaching, and deal with Democrats still smarting from what they see as his about-face on right-to-work legislation that limits union power.