Michigan: Rick Snyder channels Steve Martin from "The Jerk"

"I don't need Obamacare! All I need is this Medicaid expansion!...and this lamp!"


For the most part, Republican Michigan Governor Rick Snyder has taken a fairly hands-off approach when it comes to both the Affordable Care Act and Donald Trump. He pushed for both Medicaid expansion and a state-based ACA exchange, but while he managed to get the former through the GOP-controlled state legislature (albeit 3 months late and with a few conservative trimmings), he failed on the latter front, and pretty much shrugged it off after that. Since then, Michigan's implementation of ACA Medicaid expansion has quietly been pretty damned successful, with 646,000 Michiganders (strike that...it's now up to 666,000!) enrolled in the program...over 6.5% of the entire state's population. Beyond that, however, Snyder has been fairly quiet about the ACA overall to my knowledge.

He's mostly held a neutral approach to Trump as well--he's never really criticized the Orange Menace, but he refused to endorse him during the campaign either, and has mostly kept his mouth shut on the subject...all of which makes this morning's story in the Detroit Free Press rather curious:

Snyder praises Trump, says Obamacare not working

Gov. Rick Snyder today praised what he called "unprecedented" collaboration with President Donald Trump's administration and Congress as they look at ways of reforming the Affordable Care Act, adding that what has become known as Obamacare across the U.S. has failed to adequately serve Americans.

Speaking after he and several other members of the National Governors Association met with Trump, Vice President Mike Pence and other members of Trump's administration, Snyder spoke about the 2010 health care reform law in what may be his toughest rhetoric to date, saying "it hasn't worked" and that insurance access markets are "collapsing."

This is a perplexing thing for Rick Snyder to say. In addition to the massive Medicaid expansion population, there's another 321,000 Michiganders enrolled in ACA exchange policies, of which around 216,000 would almost certainly lose their coverage if and when the ACA is repealed. Add these up and that's nearly a million people coveraged* by ACA policies, or around 10% of the state. Furthermore, unlike states like Arizona and Tennessee where there are major problems with how the law is working out, Michigan's 2017 rate hikes for unsubsidized individual market plans were a relatively tame 17% (versus the 50%+ hikes seen in a couple of states...again, "relatively" is the key term this year), and while a couple of carriers did pull off the MI exchange this year, we still have well over a dozen participating.

*(Thanks to Andrew Sprung for pointing out the typo here...I was gonna correct it but decided I kind of like it. "Coveraged")

In other words, Republican or not, everything about Rick Snyder's history and style suggests that he would be among those pushing for the ACA to be modified/improved rather than scrapped...which is noted in the article:

Snyder has generally been seen as a Republican governor who wants any move to repeal Obamacare to involve some level of accommodation, especially as it touches on Healthy Michigan, the Medicaid expansion program he pushed for under the Affordable Care Act that covers more than 600,000 low-income Michiganders.

Last month, Snyder was among a group of governors talking with U.S. senators about reforming the Affordable Care Act. He also urged Michigan residents in his State of the State speech last month to speak out on behalf of Healthy Michigan, which requires beneficiaries to contribute based on their income, with payments reduced for healthy behavior.

Snyder again touted Healthy Michigan at the White House today but he noted more pointedly his belief that Obamacare — the signature legislative accomplishment of former President Barack Obama and what was then a Congress controlled by Democrats — was largely about access and that "we're seeing a collapse of the access marketplace."

...Snyder said today he hopes Healthy Michigan can be improved upon to provide more "flexibility" in coverage, though he didn't offer specifics. Between Healthy Michigan and individual and small group insurance, more than a million people are insured in Michigan under Obamacare.

(Note: As noted above, "more than a million" is likely pushing it...as noted above, it's currently 666K via Medicaid expansion; to break a million you'd have to use the maximum 321K exchange plan figure (remember, around 10% never pay their premiums), and even then Michigan SHOP enrollment would still have to be at least 13,000 people. Given how anemic the SHOP program has been in most states, that seems unlikely, though it's possible.)

Snyder said policymakers should be excited about the opportunity to improve the law and what he sees as Trump's willingness to consider ideas from the governors in doing so.

OK, so first he supported the ACA. Now he says that it "hasn't worked" and is "collapsing"...but also says that it should be "reformed", that the Medicaid expansion part of it should be "touted" and "spoken out on behalf of", and that the ACA should be "improved upon".

Huh. That's clear as mud. Then again...

"Ultimately, it's about compassion," Snyder said. "We’re talking about people’s lives."

...we are talking about a governor who poisoned 100,000 of his own residents and is now making them pay for the privilege of receiving the undrinkable water he poisoned them with while also sticking the rest of us with the bill for his legal defense for doing so.