"It's scary to think about not having it," she said about the Affordable Care Act. "I know how important it was for me and now I'm seeing a lot of people coming in who haven't seen a doctor in 20 years."
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But the future of what's known as Obamacare, which includes the expanded
The proposal would freeze
In addition to the 656,744 low-income adults who have enrolled in
The expansion proved to be controversial for the state, one of 32 in the nation that accepted federal
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Under the program, the federal government paid 100% of the expansion costs in the first three years. That fell to 95% last year, which translated into a
"Our impact across the state has been humongous," Priest told state senators last month.
By many measures the program has been a success:
* Initially projected to have an enrollment of 470,000, the number of eligible adults -- those within 133% of the federal poverty level of
* Of the total number of enrollees, 590,337 had received a primary care visit with a doctor, 465,449 had preventative health care visits, 53,314 babies -- 46% of the births in the state -- were born to women on
* Uncompensated care at hospitals dropped dramatically in the first full year of the expansion, according to a study by the
But it's now up to the Legislature as it begins to craft the 2018 fiscal budget to try and grapple with what the future holds.
Legislative leaders, who hope to complete work on the budget by early June, don't think there will be much of a change for the fiscal plan they're working on now, but there are some congressional
No matter when the expansion is frozen, costs are likely to go up for the state, Priest said. Federal reimbursement rates will be much lower -- perhaps 60-65% -- for
"And will that trigger provisions in the state law for us to wind down the program altogether?" Priest asked, noting that
Some legislators argue that the program has been a worthy expenditure.
"The program is accomplishing one of the major things we wanted it to do and that's to keep people out of the emergency room as their primary care provider," said Sen.
Snyder has been the chief advocate for the Healthy Michigan program and delivered that message to
"We need to be preparing for 2020. We should not live like everything is going hunky dory until then," said state Rep.
"When the time comes that we can't afford to cover those people anymore, and if that coverage that those people are getting is better than the average middle-class American can get, then I think we're going to look at it and we'll have to re-evaulate this," he added.
Lost in the numbers is the impact of the program for people like Nettle.
In 2013, she was working as a full-time home health aide and her employer paid for her insurance. But when she went back to school to get a nursing degree, she had to scale back to part-time work and lost her insurance.
She went without insurance for two years as she completed her nursing studies at
"The day I found out, I knew I needed to do something," she said, adding that a sister lost a child shortly after the birth because of a congenital defect. "I wanted to make sure I had a healthy baby. Getting that insurance was peace of mind for me."
She was only on the expanded
"Thankfully, I had a normal pregnancy and now I have a 16-month-old son (
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