My favorite kind of bagels are “Keep Fighting” bagels

I’m no newbie to late nights (that often turned into early mornings) watching legislation be written, debated and voted on. During my four years working in the Michigan Legislature, I saw countless hastily written amendments being put up for votes, short fuses getting the best of everyone, and even chants of “Shame! Shame!” being shouted at the majority party reminiscent of an episode of Game of Thrones after they refused to let members speak.

So when I heard that the U.S. Senate was expecting a long night trying to pass their latest version of the Affordable Care Act, I settled in.

I’ll admit when the evening started, I figured it was a done deal. As the Senate began debate, the months we had spent fighting against efforts to repeal the Affordable Care Act and the healthcare millions of Michiganians depend on were definitely hanging in the balance.

At around 1 a.m., the Twitterverse was going crazy. Things had stalled—votes weren’t being taken, reporters were analyzing body language and many people started predicting that things were not going well for the Majority Leader. Then in dramatic fashion, Sen. John McCain joined Senators Susan Collins and Lisa Murkowski (who had been publicly outspoken about the repeal attempts) in opposition to what was considered the Senate’s last ditch effort to repeal and replace the Affordable Care Act. At 2:30 a.m., I emailed my co-workers in celebration and headed to bed.

The next morning, I thought we needed to celebrate. I stopped at my favorite downtown Lansing bagel shop for bagels. It was there I ran into a friend and told him about my “celebration bagels,” but he reminded me that they should actually just be “relief bagels.” And he was right because the fight to protect all the gains made through enactment of the Affordable Care Act was and is not over.image2

In recent weeks, President Donald Trump has threatened to withhold cost-sharing reduction (CSR) payments and to stifle efforts to enroll people in the ACA exchanges during open enrollment. The Congressional Budget Office recently released a report on the impact of terminating cost-sharing reductions. Cost-sharing reductions are paid to insurers to cover costs of a requirement in the Affordable Care Act that requires them to offer plans with reduced deductibles, co-payments, and other forms of cost-sharing to individuals purchasing plans on the healthcare exchanges. The report found that by not continuing these payments the federal deficit would increase by $194 billion by 2026, would drive insurers to exit the marketplaces, and would cause premiums to increase by 20% in 2018 and 25% in 2020.

We are happy to report that President Trump has decided to fund these payments for the month of August. We encourage Congress to make a permanent, mandatory appropriation to ensure full funding of CSR payments in order to stabilize the marketplace and erase much uncertainty in the insurance market.

There is also word out of Washington that Senators Bill Cassidy and Lindsey Graham are working with the White House to push their plan to repeal and replace the Affordable Care Act. The Cassidy-Graham plan continues many of the same flaws in the previous Senate and House Republican repeal and replace bills—and would have the same damaging consequences.

As an advocate, I get it—it’s been a long eight months and we are all exhausted. We are fighting battles on every corner. But it is important for us to remember why we do this work. Incredible work has already been done and it’s okay that we celebrate the little victories, but the next bagel you buy better be a “keep fighting” bagel, because as Congress returns to work next week, so will we.

Emily Schwarzkopf

 

U.S. House GOP health bill would end the Healthy Michigan Plan and leave 660,000 uninsured

For Immediate Release
June 7, 2017

Contact:
Alex Rossman
arossman@mlpp.org
517.487.5436

New reports reaffirm similar approach under consideration in Senate would shift massive costs to Michigan

LANSING—The Healthy Michigan Plan would effectively end and the 660,000 people who depend on it would lose coverage under the health bill passed by the U.S. House to repeal the Affordable Care Act (ACA), according to a new report from the nonpartisan, Washington, DC-based Center on Budget and Policy Priorities. An additional report released by the Center today shows that delaying or phasing in the House bill’s massive cost shifts to states, as the Senate is reportedly considering, would have no effect on the ultimate outcome.

Michigan is one of eight states that have laws that effectively require their Medicaid expansions to end if federal financial support for the expansion falls. In these states, Medicaid expansion—and the Healthy Michigan Plan—would thus end in 2020 under the House Republicans’ American Health Care Act (AHCA).

The House bill would shift $582.5 million in costs to Michigan, which is more than the state spends on child welfare ($445M GF), early childhood programs ($258M SAF) and at-risk programs ($379M SAF) respectively. The $582.5 million strain on the state budget also is approximately more General Fund money than the state spends combined on the departments of Talent and Economic Development, Education, Military and Veterans Affairs, Agriculture and Rural Development, Environmental Quality, Licensing and Regulatory Affairs, Natural Resources, Civil Rights, Transportation and the Attorney General’s office.

Michigan would almost certainly be unable to absorb these additional costs, especially as more state General Fund money starts going to roads in the years ahead. As a result, Michigan would likely be forced to end its expansion and eliminate the Healthy Michigan Plan, leaving 660,000 adults with low incomes who have gained Medicaid coverage under the expansion at severe risk of becoming uninsured.

“Yesterday, I sat alongside the Michigan Department of Health and Human Services Director and Budget Director, representatives from Michigan’s businesses, and doctors and hospital officials to talk about the success of the Healthy Michigan Plan and the importance of protecting it,” said Gilda Z. Jacobs, president and CEO of the Michigan League for Public Policy. “Yet here we are today with a new independent report showing how the U.S. House’s American Health Care Act will decimate the program and leave more than half a million state residents without coverage. Our state budget can’t afford these costs, and Healthy Michigan enrollees can’t afford to lose their coverage.”

As the U.S. Senate considers changes to the House GOP health bill, some have claimed that phasing the repeal out more slowly or delaying it by two years would avoid these harms. But neither of these proposals change the ultimate outcome: a huge cost-shift to states ending the Medicaid expansion and causing millions to lose coverage.

Other proponents of the House bill have suggested that people who would lose expansion coverage could instead purchase private coverage on their own using the House bill’s tax credits. That is false, the new reports show. Adults with low incomes would face unaffordable premiums if the expansion were repealed, even after taking the House bill’s tax credits into account. For example, premiums after tax credits for Michiganians in poverty would equal a whopping 48 percent of income for 60-year-olds at the federal poverty line. And that’s without taking into account provisions in the House bill that would let insurers go back to charging people with pre-existing conditions exorbitant premiums, stop covering critical services like mental health services and substance use treatment and imposing annual and lifetime limits.

“The American Health Care Act is a bad bill that will be disastrous for the Healthy Michigan Plan and the historic gains in health coverage and access to care that we have achieved under Medicaid expansion, and tinkering with it won’t solve its fundamental flaws,” Jacobs said. “Senators Debbie Stabenow and Gary Peters have been champions for Medicaid expansion and the rest of the Senate should follow suit and scrap the House bill and focus on bipartisan efforts to strengthen, not dramatically weaken, our healthcare system.”

The League is part of the Protect MI Care coalition, an organization of consumer, healthcare and insurer groups in the state who are working together to protect the ACA, the Healthy Michigan Plan and the care they provide. More information on the coalition is available at www.protectmicare.com.

To learn more, please visit:

House Republican Health Bill Would Effectively End ACA Medicaid Expansion
http://www.cbpp.org/research/health/house-republican-health-bill-would-effectively-end-aca-medicaid-expansion

People Losing Medicaid Under House Republican Bill Would Face High Barriers to Coverage
http://www.cbpp.org/research/health/people-losing-medicaid-under-house-republican-bill-would-face-high-barriers-to

###

The Michigan League for Public Policy, www.mlpp.org, is a nonprofit policy institute focused on economic opportunity for all. It is the only state-level organization that addresses poverty in a comprehensive way.

Lawmakers pass healthcare bill that will hurt millions of Michigan residents

For Immediate Release
May 4, 2017

Contact:
Alex Rossman
arossman@mlpp.org
517-487-5436

LANSING—The Michigan League for Public Policy issued the following statement on the U.S. House Republicans’ passage of legislation today to repeal the Affordable Care Act. The statement may be attributed to League President & CEO Gilda Z. Jacobs.

“Today, congressional Republicans passed a healthcare plan that shows they don’t really care about health, and to add insult to injury, they did so with jubilation, not reservation. Instead of helping people, lawmakers voted today to eliminate insurance coverage for 24 million Americans, including the 650,000 Michigan residents who are covered through the Healthy Michigan Plan. They voted to end fair and affordable coverage for millions of people with pre-existing conditions, cut $800 billion in Medicaid funding, and eliminate nationwide bans on annual and lifetime limits.

“It’s particularly disheartening that it took making this bill worse to actually get it passed, but this fight is far from over—it’s just moving to a new venue. The League and our partners in Michigan and around the country will keep doing everything we can to protect healthcare coverage for residents who are struggling physically, mentally or financially. We hope that the Senate will be deliberative and put the real needs of Americans above the political rancor that has unfortunately dominated this debate.”

The League has been a strong advocate for the Affordable Care Act and the related Healthy Michigan Plan, and have opposed the U.S. House’s attempts to repeal it and change how Medicaid is funded. The League is also part of the Protect MI Care coalition, an organization of consumer, healthcare and insurer groups. More information is available at www.protectmicare.com.

Recent League Efforts on Healthcare:

March 16, 2017, Press Statement on AHCA: Major flaws exposed in U.S. House Republicans’ healthcare plan

Budget Brief: Protect Healthcare for 650,000 Michiganians

Fact Sheet: Medicaid Block Grants and Per Capita Caps Are Bad for Michigan’s Health

Fact Sheet: 10 Reasons the Affordable Care Act is Good for Michigan

###

The Michigan League for Public Policy, www.mlpp.org, is a nonprofit policy institute focused on economic opportunity for all. It is the only state-level organization that addresses poverty in a comprehensive way.

Help protect the Affordable Care Act

I’m here to admit it. I’m a health policy nerd. I danced around my office when Michigan received a very important Medicaid waiver and I’m pretty sure all of my friends are tired of me talking about the intricacies of the Affordable Care Act (ACA). Luckily this passion (and a fantastic opportunity) recently landed me a job with the League as a health policy analyst!

I come to the League after nearly four years working on budget and health issues at the Michigan House of Representatives. To this day, my proudest professional accomplishment is my work on the development of Michigan’s Medicaid expansion program, or Healthy Michigan Plan, under the ACA. Working with a diverse coalition of business groups, healthcare advocates, and Republican and Democratic legislators, we were able to develop a comprehensive and unique system of providing healthcare to working people. To date, 646,745 people have enrolled and enrollees have made 2.8 million primary care visits, which has resulted in uncompensated care costs dropping by nearly half in Michigan hospitals. Medicaid expansion is just one important component of the Affordable Care Act—but it’s not the only thing. (more…)