A divided Michigan Senate on Tuesday passed a spending plan that would provide health care to the poor and disabled.
But Republicans and Democrats got into some skirmishes over whether young adults should be denied Medicaid and if courts should be created for the mentally ill in the $12.5 billion Department of Community Health spending plan that takes effect Oct. 1.
Republicans blocked Democrats' efforts to continue allowing 19- and 20-year-olds to qualify for Medicaid, saving $14.5 million.
Sen. Deb Cherry, a Burton Democrat, said taking away Medicaid coverage for those young adults is foolish. Some are living on their own after leaving foster care, she said, and others would turn to more costly care in the emergency room if they don't have health insurance.
"I don't think we wish to have those young adults without health insurance," Cherry said. "They need it, we should be providing it."
Republicans responded that Democratic Gov. Jennifer Granholm has in the past proposed not allowing new 19- and 20-year-olds to be covered by Medicaid. The federal government doesn't require Medicaid coverage for that age group.
Sen. Roger Kahn, a Saginaw Republican overseeing the community health budget, said lawmakers shouldn't lose sight that overall spending would increase $434 million, or 3.6 percent, over current spending in the Senate bill, which passed 20-18.
He added that Medicaid caseloads aren't growing as fast as expected for the first time in years, which could free up money later on for the extra spending pushed by Democrats.
Besides losing the fight over health care coverage for 19- and 20-year-olds, Democrats were unable to create pilot courts for criminals with mental illnesses, a proposal backed by Granholm. The courts could have diverted some offenders to community-based treatment rather than sending them to jail.
Democrats and Republicans also differed over whether more money should be spent to increase awareness of sexually transmitted diseases, bring meals to seniors, improve access to dental care for underserved children and prevent cancer and other diseases.
Spending on health care ranks second-highest in the state budget, behind only money for K-12 schools.
Besides paying the health costs of Michigan's 1.5 million Medicaid recipients, the Senate-passed bill would increase reimbursements to pharmacists, pay mental health workers more, ban tobacco in psychiatric facilities and add pregnant patients to managed-care plans.
The measure will be considered by the House starting next month. A final deal on that budget and other state spending for the next fiscal year will hinge on revised tax revenue estimates released in May.
Democratic Sen. Jim Barcia of Bay City joined 19 Republicans to pass the community health budget. GOP Sens. Bruce Patterson of Canton and Alan Sanborn of Richmond joined 16 Democrats who voted against it.
Also Tuesday, the Senate passed spending plans for universities, community colleges and the Department of Education. It's expected to approve prison, K-12 and other budgets later this week before leaving for a two-week spring break. The House is on vacation this week and next.