Discussing 'a $600 million dessert' Updated: Friday, September 6, 2013 KALAMZOO, Mich. (NEWSCHANNEL 3) - In the days after the State Senate narrowly extended Medicaid coverage to nearly a half-million Michigan residents, it became clear that Senators want poverty-stricken people to help pay for their own health care.Tonight, in Tom's Corner, Tom Van Howe says that by turning down more than a half-billion dollars in Obamacare reimbursements over the first quarter of next year, and then asking poor people to help make up the difference, paints a picture of a remarkably insensitive group of politicians.=====================The Michigan Senate Minority Leader, Gretchen Whitmer, explained her Republican colleagues' opposition to medicaid expansion, which is a part of the affordable care act, this way:"It's because (expansion) is associated with Obamacare and because the tea party in Michigan is the tail that's wagging the dog in this chamber."And I think she's right.There is no other logic to the Senate, 26 of whom are Republicans, and 12 are Democrats, in delaying enrollment from January 1st to April 1st.By doing so they knew full well that they were turning their backs on $7 million a day in federal money to be used for Medicaid.That's a total of more than $600 million. Six-hundred-million that the state loses.That's not a number pulled out of the air by some hand-wringing alarmist. It comes from Jim Haveman, the Director of this state's Department of Community Health.In fact, yesterday he said his estimate may, in fact, be too low.Republican response? Well, we probably won't get that many enrolled right away, so that figure may be too high.So what's their best guess? They haven't got one.Senate Majority Leader Randy Richardville, who to his credit, helped form the tiny coalition to get the matter through the Senate last week, doesn't even want to talk about it."It's like we had this really big dinner," he said. "We got the dinner done and people are going to ask for dessert. “We're going to skip the dessert on this one. We're done. The legislature in total has gone through enough with this issue."Dessert? He thinks $600 million is dessert? Sounds more like a main course of steak, potatoes, and choice of vegetable for a half-million people to me.And of course during that same 90 day period state hospitals will continue offering what will amount to roughly a quarter of a billion dollars in expensive emergency room care to poor people.Much of the cost of that gets picked up by the insured who pay higher premiums, and some of it gets picked up by federal reimbursement. But reimbursements will be reduced as of January 1, because that's ostensibly when people start signing up for Obamacare.Look, you don't have to be a fan of Obamacare to take the money. Obamacare—even though it's the law of the land—may not work.But the money is there for the taking. It's just smart government.Phil Power, a former University of Michigan Regent, now a writer for Bridge Magazine, said yesterday he sometimes wonders if Republican lawmakers in Lansing would even vote against something called "Obamataxcut." Good point.And then the icing on the cake. The Senate wants poor people, not just the new ones, the ones just above the poverty line, but all of them, to pay 5 percent of their income in copay fees.So in addition to rent, food, transportation, clothing, and other things they can't afford, they have to fork over 5 percent in copay fees.After four years it'll go up to 7 percent. Nobody knows how it'll get collected.But its an intimidating little add-on that'll probably keep any number of qualified people from breaking the door down to enroll.And those fees, all by themselves, could actually block the Medicaid expansion itself. The Center for Medicare and Medicaid Expansion has to approve Michigan's legislation.And an expert said yesterday she thought the CMS would be taking a close look at Michigan's bill before giving it an okay.Forget dessert. We may lose the whole enchilada.In this corner...I'm Tom Van Howe.