3 claiming to be physicians were in attendance, and all were in favor of it. Sadly, misinformation and half-truths filled the emotionally charged room. Because of this, I want to set the record straight here so my friends and allies can speak to the issue intelligently.

Before Obamacare was signed into law, the national cost was a big issue- and it still is. Keeping it under $1 TRILLION was widely claimed, and we already know this was false. The more expensive it becomes, the greater the need for rationing of services. This need to keep costs down is the driving force behind expanding Medicaid.

Without expanding Medicaid eligibility, the working poor who make 33% more than the Federal Poverty Level would be required to get their health insurance from private insurance companies via the Mi. Federal Health Exchange, and due to the Obamacare regs- they would be subsidized at 100% of the cost by the Feds. So in effect, the working poor would receive free health insurance that is accepted by nearly all health care providers.

This is far better for those people than having Medicaid coverage because less than half of all Primary Care providers currently accept Medicaid in Michigan. To make matters worse, only a small percentage of those service providers accept new Medicaid patients. And specialists that accept Medicaid are remarkably scarce. This is one of the largest reasons for so many going to an emergency room for routine care.

Adding another half million Medicaid patients to this problem will make this considerably worse. Currently, Michigan reimburses doctors and labs about 47% of what they charge, and the state is considered a "slow pay" client. Slow pay/low pay = widespread avoidance. BTW, the projections being used to determine how many residents will qualify for Medicaid are all based on current economic conditions. If the Michigan economy falters, the number of people eligible for Medicaid will increase significantly.

When Obamacare is fully implemented, Americans will be hit with more than 140 new taxes- regardless of whether or not the state they live in agreed to MedEx. (I heard proponents of MedEx claim we avoid those taxes by expanding Medicaid- and it went unchallenged by Senator Kowall and all the other attendees). Some misinformed legislators are claiming that since we're gonna pay all this extra cash for Obamacare taxes, we should expand Medicaid to recoup some of that money. Others have claimed the money will go to other states if we don't expand Medicaid. NOT TRUE!

Industry experts have estimated that expanding Medicaid in Michigan will provide a $2 billion- $3 billion windfall for our hospitals- next year, and the amount will rise significantly every year thereafter.

Remember the Stimulus Package? Michigan received $3.8 billion from it. $2 billion was spent by Gov Granholm to cancel our accrued debt in the same amount- for Medicaid expenses. How soon they forget.

And finally, the Obama Administration has offered to cover all the additional costs of MedEx for 3 yrs, and then just 90% from then on. 3 yrs from now will put us well into the first year of a new administration, and you can rest assured the new administration will be implementing new priorities for their current fiscal reality.

I have been recently told by a Senate Caucus leadership team member that we need to call Senators Kowall, Casperson, and Geoff Hansen and ENCOURAGE them to vote against MedEx. Casperson- and Hansen in particular, have constituencies most likely to be affected by this issue.

So IMO, the most compelling argument for them includes the fact that their constituents will be far better served by getting their free insurance through the exchange- instead of our broken Medicaid system in Michigan. A simple phone call in the next 2 or 3 days will be the most effective way to express yourself.

Whatever you do, please don't threaten them in any way. When you tick someone off, their natural desire is to do the exact opposite of what you want them to do, and many will seek revenge.