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It took two votes and eight hours of mostly closed-door politicking and vote wrangling, but the state Senate approved a plan late Tuesday to expand Medicaid health care coverage to 470,000 low-income Michiganders.

The historic 20-18 vote makes Michigan the 25th state in the nation to go ahead with the Medicaid expansion as part of the federal Affordable Care Act, according to the Kaiser Family Foundation. Five more states are debating the issue and 21 have decided not to go ahead with the expansion.

The plan almost fell apart when Sen. Patrick Colbeck, R-Canton, decided not to vote the first time the bill came up, leaving it with a 19-18 tally, one vote shy of passage.

A bill needs 20 votes to pass. If Colbeck, an ardent opponent of the expansion, had voted no as expected, a 19-19 tie would havehappened. And Lt. Gov. Brian Calley would have had to cast the tie-breaking vote. He was prepared to support the expansion.

But the Senate immediately voted to allow a reconsideration of the vote, and went into recess to see whether they could muster the one vote needed to break the impasse. Several hours later, an amendment was offered and Sen. Tom Casperson, R-Escanaba, switched his no vote to a yes, giving it a winning 20-18 margin. The amendment basically says that hospitals can’t charge Medicaid patients more than 115% of what they charge Medicare patients.


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