Governor Rick Snyder decides this week whether he will call for expanding Medicaid in his new budget.
The federal government would pick up the entire cost at first, which would allow the state to add nearly 400 thousand people to the Medicaid rolls who are currently uninsured.
One of the goals of the federal health care law is to reduce the number of un-insured people and costly emergency room visits.
But, after the first few years, states will have to pick up part of the cost: 10% by 2020.
Doctors and hospitals are urging the governor to expand the program and take the federal money. They say insuring more people is a bargain in the long run, no matter who pays for it.
Some Republicans in the Legislature say they remain skeptical.
