1994 principles relevant today

Federal health care reform is starting a new chapter in Michigan. Beginning tomorrow, enrollment will open for the new high risk pool  for those with pre-existing conditions who have been uninsured six months. Coverage will be effective Oct.  1.

This component of the health care reform law got off to a rocky start when the Michigan Legislature failed to approve the expenditure of the federal funds for the high risk pool.  The federal government had to step in and make alternate arrangements.

Health care reform implementation merits ongoing and careful thought and planning by policymakers, with input and monitoring by consumers, to ensure the best possible outcome for all of us.

The Michigan League for Human Services developed a set of health reform principles in 1994 that are still relevant today and can serve as a good resource.

They provide a good road map for navigating many upcoming implementation issues including:

  • The critical importance of a comprehensive package of benefits for those newly eligible for Medicaid (there is an option to provide a lesser package of benefits) as well as for those who purchase coverage through the Health Insurance Exchange (the “Expedia” of private insurance options).  A comprehensive package would include the full range of mental and physical health services, as well as dental and substance abuse services.
  • Adequate state regulatory and monitoring resources to ensure mandates are implemented timely and effectively, and that there are strong enforceable consumer protections.
  • Availability of access to quality care both geographically and culturally.  There are many opportunities in the law to expand or promote primary care.
  • Reasonable and adequate provider payment rates in public programs to ensure that current and newly eligible persons have access to care and not just a card.
  • An increase in the meaningful and cost-effective use of health information technology.
  • Promotion of quality, not quantity, of care through incentives or payments for outcomes, or other payment reforms for providers; and quality consumer education to help guide treatment decisions.
  • A priority for funding prevention and wellness options included, but not funded, in the law.
  • Development of effective cost containment strategies that maintain or improve quality care and are not simply code words for cuts in programs or services.

Additional food for thought is provided by the State Consortium on Health Care Reform Implementation in a State Health Policy Briefing. This brief describes 10 aspects of federal health reform that states must get right if they are to be successful in implementation.

The group’s top priorities include:

1. Be strategic with insurance exchange

2. Regulate the commercial health insurance market effectively

3. Simplify and integrate eligibility systems

4. Expand provider and health system capacity

5. Attend to benefit design

6. Focus on the dually eligible

7. Use your data

8. Pursue population health goals

9. Engage the public in policy development and implementation

10. Demand quality and efficiency from the health care system.

(The State Consortium on Health Care Reform Implementation is a collaboration among the National Governors Association, the National Academy for State Health Policy, the National Association of Insurance Commissioners, and the National Association of State Medicaid Directors.)

There have been and will continue to be numerous opportunities for comment as federal regulations are developed and finalized.  The federal government has established a website where you can readily view the regulations for which comments are being accepted.  You are encouraged to take advantage of these opportunities and let your voice be heard in this historic process.

It will take ongoing vigilance to ensure the best implemenation for all.

—  Jan Hudson

Michigan prepares to launch high-risk health insurance pool

Michigan prepares to launch high-risk health insurance pool (League’s view included in this first step in health care reform implementation) August 29, 2010 — Macomb Daily -> Click here to read this article

Renew tax credits to help struggling families, economy

Renew tax credits to help struggling families, economy (A viewpoint on federal tax credits from Sharon Parks) August 26, 2010 — Detroit Free Press -> Click here to read this article

Child welfare study shows worsening economic trends in Ogemaw County

Child welfare study shows worsening economic trends in Ogemaw County (A look at the national Kids Count report with local numbers added) August 24, 2010 — Ogemaw County Herald -> Click here to read this article

Sandbox Party: An election year for kids

Thursday, the Sandbox Party will hold its conference to mobilize a broad range of stakeholders to support a coherent system of early care and education in Michigan.  The League is proud to be a supporter of this important event, designed to draw candidates’ attention to the needs of children.

An early care and education system would assure that children are born healthy; that they thrive and develop on track without suffering from untreated health conditions or avoidable developmental delay;  that they enter the K-12 system ready to succeed; and that they can read proficiently by the end of the third grade.

This goal is also the very first  strategy recommended  in the Early Warning report (pdf) recently issued by the Casey Foundation. It presented four recommendations  to increase the share of fourth graders proficient in reading.

In Michigan (pdf) only three of every 10 fourth-graders could read proficiently by the fourth grade, according to the 2009 National Assessment of Educational Progress. Children who can read proficiently by fourth grade are prepared to learn by reading as they advance academically.  Those without at least a modest skill level will be at high risk of being retained in grade and dropping out of school.

In reality all of us are stakeholders in this Sandbox effort as the state struggles to move forward economically and to increase the educational attainment of more residents so they can compete in the global economy.  By 2018 estimates suggest that two of every three jobs in Michigan will require training or education beyond high school.

Right now we’re still trying to make sure more youth complete their high school education, particularly low-income and minority youth.  The first step to reaching that goal will require making sure that more children have what they need in early childhood to prepare them to be lifelong learners.

— Jane Zehnder-Merrell

Peter Luke: Students take hit on state cuts to higher education

Peter Luke: Students take hit on state cuts to higher education (Columnist uses League data about state disinvestment in higher education) August 22, 2010 — Mlive.com -> Click here to read this article

Helping kids feel good about themselves

With the start of school just a few weeks away, many families are planning shopping trips to get the right outfits for that important first day of school.

Thanks to a state program, some 157,000 children in Michigan’s poorest families will be able to join the annual back-to-school shopping ritual.

Department of Human Services Director Ismael Ahmed announced Thursday that children in families receiving cash assistance (FIP grants) will receive $79 per child the first week of September for the children’s clothing allowance.

“It’s designed to help children feel good about themselves in going back to school,’’ Ahmed said at a press conference.

That is a little less than last year ($84 per child) but it will go a long way in buying shoes, underwear, and new or used clothes for the new school year.

The League has advocated for the clothing allowance for many years. We agree that all kids deserve a good start at the beginning of the school year. Many of us can recall the excitement that accompanied the new outfit, new shoes and a spanking new pack of Crayolas.

It’s important that all children get to partake in that excitement, but it’s especially true for disadvantaged kids, who are at high risk of falling behind and dropping out.

As the Legislature and governor try to finalize the budget for the year starting Oct. 1, such items as the clothing allowance are in ongoing jeopardy. The governor called for unspecified cuts of $50 million in next year’s Department of Human Services budget to try and balance the budget. That came after the Legislature resisted her ideas for new revenue, including a reasonable plan to reduce the sales tax but expand it to services.

The state budget is a complicated document that’s developed in a complicated process but sometimes our choices become clear and simple, such as making sure that all kids have a good start and decent clothes as the new school year commences.

— Judy Putnam

Aiding Low-Income Citizens

A talk with Sharon Parks on aiding low-income citizens (A Q-and-A with League President & CEO Sharon Parks) August 18, 2010 — Lansing City Pulse -> Click here to read this article

Editorial: Michigan, colleges have room to improve tuition costs

Editorial: Michigan, colleges have room to improve tuition costs (Editorial using League research from “Pulling the Plug” report) August 17, 2010 — MLive -> Click here to read this article

Even amid affluence, food needs surging

Even amid affluence, food needs surging (Economic Security Bulletin used for story about need in Livingston County) August 16, 2010 — Livingston Daily.com -> Click here to read this article

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