LANSING – If Michigan adopts a Medicaid expansion bill the number of adults in the state without health insurance will drop significantly over the next several years, a projection issued by the Center for Healthcare Research and Transformation reported.

But if the expansion is not approved, then a relatively high number of individuals will remain uninsured, the projection from the University of Michigan-based center said.

In large part that is because the majority of the some 1.1 million adults without insurance would be more likely to get coverage under Medicaid expansion than they would under the health care exchanges.

Marianne Udow-Phillips, director of CHRT, said that from October, when the state’s federally-run exchange is open for applicants, to March 2014, the organization forecasts about 127,000 people will apply for benefits.

While that is a large number, it is far fewer than the number who could be affected and get coverage if Medicaid expansion is approved, Udow-Phillips said, adding that there is something of a myth that most people without insurance will get subsidized help through the federal exchange.

The projection also shows that most people getting coverage either through Medicaid expansion or the exchange were employed.

And it also showed that, outside of the Wayne County, rural areas of the state would be most affected if the proposed Medicaid expansion is approved.

The Senate Government Operations Committee on Wednesday reported a version of HB 4714 to the full chamber that would expand the eligibility for Medicaid to those persons with incomes of up to 133 percent of the federal poverty level. The committee also reported other bills creating a state-run system for those affected populations and one that would create an open market system.

Currently, some 17.8 percent of adults between the ages of 18 and 64 have no health insurance, the projection said. If the Medicaid expansion is approved, 92.9 percent of the uninsured will quality either for Medicaid or the health insurance exchange, the projection said.

Udow-Phillips said if Medicaid expansion occurs by 2019, the number of adults without insurance would go from about 1.1 million people to 500,000. “That’s a big drop,” she said.

If the Medicaid expansion is not approved, then by 2019 more than 800,000 adults will be uninsured in the state, she said.

If the Medicaid expansion is approved, and figuring for population changes, as well as changes in the makeup of health insurance (for example, employers adding or dropping coverage, some lower income workers opting for Medicaid or the exchange instead of employer-coverage) the projection forecasts that by 2019 some 600,000 people will be added to the Medicaid rolls, the largest part of that increase being working, single, male adults, and about 500,000 would be on the exchanges.

The projection also said that about half the projected Medicaid eligible population does not currently have any type of health insurance. The projection also said that about 51 percent of those affected are employed. That goes to what Udow-Phillips said was another myth, that most the people who may be eligible for Medicaid, if eligibility is expanded, were not working.

But of those who would be eligible for subsidized insurance through the exchange, a total of 71 percent are employed, the projection said.

In terms of regional effects, the projection found that now 22.4 percent of adults in Wayne County are not insured, while at the low end 11.1 percent of the adults in Washtenaw County are not.

But aside from Wayne County, an enormous swath of the mid-to-northern Lower Peninsula has more than 20 percent of adults uninsured. The eastern half of the Upper Peninsula also has more than 20 percent of adults uninsured.

If the Medicaid expansion is approved, however, in all areas of the state, at least 90 percent of the adults would be covered. Jackson County would have the highest percentage at 96.9 percent and Berrien County would have the lowest at 90.7 percent.

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