Not enough Michigan Republicans support the plan for it to advance now. But some in the GOP say they are open to expanding the health insurance program if changes are made to it.

Those could include making more participants pay co-pays. Advocates for the poor counter that they can't afford the co-pays.

A broad coalition of businesses, hospitals and low-income advocates support Medicaid expansion and say it's a good deal for the state. Conservative groups oppose it.

Medicaid expansion is optional under the Supreme Court's interpretation of the federal health care law.