Healthy Michigan Plan gets healthy start!

The Healthy Michigan Plan, Michigan’s Medicaid expansion, opened for enrollment on April 1, and within the first 72 hours, 36,329 applications were submitted through the MIBridges website and 20,995 were approved for coverage. By Tuesday, the number of enrolled shot up to 59,280 — an amazing number for a two-week period.  That means that more than 109,000 people are now covered, including those who were transferred over to the plan from the Adult Benefits Waiver program.

The program is off to a great start — great news for Michigan’s low-income uninsured. The online enrollment system is working well with the majority of applications being processed in a matter of minutes or even seconds.

The Department is urging applicants to use the website, if possible, due to the quick response time. However, applications can also be made in person at a local Department of Human Services offices or by phone.

Unlike the Health Insurance Marketplace (Healthcare.gov) there is no defined enrollment period for the Healthy Michigan Plan. It is open all year.

The Healthy Michigan Plan provides comprehensive coverage to low-income uninsured Michiganians with incomes below 133% of the federal poverty level.

Most Healthy Michigan Plan participants will select a managed care plan to receive their care. Participants will have access to a broad range of services including preventive services as well as the services needed to keep chronic conditions, such as diabetes, under control.

My colleague, Judy Putnam, recently had the opportunity to chat with a low-income worker who had just gained coverage under the Healthy Michigan Plan.

A caterer by trade, Connie Rush, 50, of Ann Arbor, said he has not been able to afford health insurance for many years — even working multiple jobs. Rush said he is healthy but at an age where he needs to check on such things as cholesterol and blood sugar levels and blood pressure. The Healthy Michigan Plan will allow him preventive care he didn’t have before.

“Instead of not going to a doctor, I will go to a doctor,” Rush said. “At least I know if I do go to a doctor, I’m covered. It’s less stress, definitely.”

He added: “At last I have a safety net. I am very happy that this opened up.”

– Jan Hudson

Attorney general needs to move on

Attorney General Bill Schuette continues his fight to harm Michiganians by pursuing frivolous lawsuits against the Affordable Care Act.

First he fought to have the law declared unconstitutional and lost — the U.S. Supreme Court ruled the ACA does not violate the Constitution. Now he is fighting to end the premium tax credits for more than 144,000 Michiganians who have so far qualified for them.

Nearly 87% of those who have enrolled in a health plan in Michigan are eligible for premium tax credits to help them pay their insurance premiums. Why would he want to harm more than 144,000 people in his state — his neighbors, his friends, his constituents?

Attorney General Schuette joined a lawsuit that would eliminate premium tax credits for low- to moderate-income Michiganians. He argues because Michigan deferred to the federal government to operate its health insurance Marketplace rather than establishing its own, Michigan residents do not qualify for premium tax credits. According to the attorney general, the tax credits are not authorized in the law for those states that do not establish their own Marketplaces.

Yet both the debate surrounding the ACA and the law itself assumed premium tax credits would be available in all states. Congressional intent is very clear. All of the Congressional Budget Office estimates assume premium tax credits would be available in every state regardless of whether the state or federal government operates the Marketplace.

If premium tax credits are eliminated, many will be forced to forgo their newly acquired healthcare coverage and be forced to return to being uninsured. A central purpose of the Affordable Care Act is to make affordable healthcare coverage available to nearly every American. Without tax credits, coverage is simply unaffordable.

It is time for Mr. Schuette to uphold the Affordable Care Act, the law of the land, and to act on behalf of his constituents and their well-being.

– Jan Hudson

Healthy Michigan Plan enrollment opens April 1

The Department of Community Health has announced open enrollment will begin for the Healthy Michigan Plan on April 1. This long-awaited announcement is great news for Michigan’s low-income uninsured residents.

Starting next week, adults (ages 19-64) in families with incomes below 133% of the federal poverty level (up to $15,521 for an individual or $31,721 for a family of four) who are not currently eligible for Medicaid or Medicare, and not pregnant, will be able to apply for the comprehensive coverage offered by the Healthy Michigan Plan. Citizenship, or lawful admittance to the U.S., is also required.

Healthy Michigan Plan enrollment will be open all year long, unlike the Marketplace www.healthcare.gov, which has designated open enrollment periods and where the initial enrollment period will close on March 31.

Applications for HMP are available online (www.michigan.gov/mibridges or www.healthcare.gov), by phone, or in-person. For the fastest eligibility determination, the Department is advising applicants to use the MIBridges system (www.michigan.gov/mibridges) where eligibility determinations may be returned in a matter of minutes. Department of Human Services local offices are expected to extend their hours to accommodate those who would like to apply in person.

This program is Michigan’s expansion and modification of the Medicaid program as provided in the Affordable Care Act. It is a credit to Michigan policymakers who passed legislation creating the program and permitting Michigan to accept the federal funds available for this program. Numerous states have refused to accept the federal funds to expand Medicaid, leaving their lowest-income residents uninsured and with no options.

Recognizing the low incomes of the enrollees, the HMP includes comprehensive benefits which may not otherwise be available to this population including dental, hearing, and vision benefits in addition to the services required by the ACA. Enrollees will be required to pay co-pays for some services and those with incomes between 100% ($11,670 for an individual, $23,850 for a family of four) and 133% FPL will be required to pay an income-based contribution of 2% for their coverage. Together, the payments cannot exceed 5% of the family income. Participation in healthy behaviors will provide the opportunity to reduce both the income-based payment and the co-pays.

A fact sheet is available on the League’s website for more information.

The implementation of the Healthy Michigan Plan provides the opportunity for those who work, are least paid and uninsured to gain healthcare coverage and peace of mind.

– Jan Hudson

MI exceeds healthcare enrollment target

Enrollment in healthcare plans under the Affordable Care Act is picking up steam, particularly in Michigan.

Nationwide, more than 4 million people have enrolled in healthcare coverage through a state-operated exchange or the federal Marketplace through Feb. 26. And in Michigan, more than 112,000 individuals have enrolled in a plan through Feb. 1, placing Michigan 12% above its federally set target for the period and one of only a handful of states to exceed its enrollment target.

As of Feb.1, more than 255,000 Michiganians had completed an application and been determined eligible to enroll in a Marketplace health plan. With an estimated 500,000 to 600,000 Michiganians eligible to purchase coverage on the Marketplace, this is an impressive start.

Not only is Healthcare.gov working, individuals and families are finding plans that meet their needs, and their budgets — and they are enrolling.  This is great news for those who have gained comprehensive, affordable healthcare coverage.

Among enrollees:

  • 56% are female
  • 55% are between 45 and 64 years of age
  • 26% are ages 19-34
  • 73% opted for a Silver Tier plan(this is the plan on which the premium tax credits are based and not the least expensive plan)
  • 86% are eligible for premium tax credits and/or cost-sharing subsidies (that reduce out-of-pocket costs)

Those who have not yet enrolled in a plan still have time to review their options and enroll. The deadline for this open enrollment period is March 31. Those who have not yet checked out Healthcare.gov still have time to shop, make a selection and enroll. Assistance, through Healthcare.gov  or Enroll Michigan, is available for help with applications, plan selection, and enrollment.

Premium assistance calculators are also available to provide an estimate of the amount of premium tax credits that could be available for an individual or family. Kaiser Family Foundation and Michigan Department of Insurance and Financial Services each has a calculator available.

These calculators are great resources for those who may believe there are no affordable options in the Marketplace for them.

Another upcoming opportunity to obtain healthcare coverage is enrollment in the Healthy Michigan Plan, Michigan’s Medicaid expansion. This program will provide comprehensive benefits to those with incomes below 133% of the federal poverty level (up to $15,521 for an individual or $31,721 for a family of four). While the program will begin on April 1, the date when open enroll will begin is not expected to be announced until mid-March.

In the meantime, individuals enrolled in the Adult Benefits Waiver (also known as the Adult Medical Program) are being transitioned to the Healthy Michigan Plan and have the opportunity to select a managed care plan prior to the April 1 implementation date.

Slowly but surely, the Affordable Care Act is making affordable, quality healthcare coverage available, making the promise a reality and making healthcare coverage a right not a privilege.

– Jan Hudson

Exhausted but inspired

I recently returned from Health Action 2014, Families USA’s annual conference, in my usual condition – exhausted yet inspired! It was a good year for Michigan: Dizzy Warren, of Michigan Consumers for Healthcare, was awarded one of the three Advocate of the Year awards, and Michigan blogger Amy Lynn Smith won the painting created onsite by Regina Holliday!

The conference opened with a cancer survivor sharing her story of having her COBRA coverage end on Dec. 31, 2013 during her cancer treatment. Thanks to the Affordable Care Act, she was able to sign up for coverage starting Jan. 1 and continue her treatments uninterrupted.

She introduced Vice President Joe Biden who shared his relief that we will no longer debate whether healthcare is a right or a privilege. With implementation of the ACA, it’s a right.

“And we’re not going back!” Biden said.

He stressed the importance of healthcare coverage, sharing his own story, and spoke of the peace of mind those who gain coverage will experience.

A few highlights:

  • Ezra Klein shared thoughtful comments about the need to implement the law, learn from experience, and modify it as needed. The ACA is a real law, and because of it, real people are able to go to the doctor!
  • Kentucky Gov. Steve Beshear embraced the Affordable Care Act as a great opportunity for historic transformation in his state. “It is the morally right thing to do,” he said. Through an executive order, he established a state-operated marketplace, and through executive authority he was able to expand Medicaid eligibility. He expressed disappointment that more states are not setting politics aside and doing what is right and best for the people.
  • Dr. Harold Freeman described his patient navigator programs which coordinate care and remove barriers to needed services by piecing together the fragmented healthcare system for individual people. He described it as a ‘relay races in which the patient is the baton and the hand-offs must be well done.’
  • George Halverson shared a number of stunning statistics on brain development and the need for interventions and upstream efforts similar to those used in the medical system to prevent heart attacks or strokes. The No.1 predictor of who will go to jail can be linked to the number of words in a child’s vocabulary upon kindergarten entry! Furthermore, 70% of people in jail can’t read or read poorly. The first three years of brain development are critical and current science can predict with high accuracy who will be able to read and who won’t. It was a most sobering presentation.
  • Regina Holliday, an inspiring presenter, talked about using art in patient advocacy efforts. She used art to sustain her in her grief after her 39 year-old husband died. She painted during the conference; Amy Lynn Smith won the painting.

The conference was chocked full of great presentations and workshops. I presented on Michigan’s Bumpy Journey to passing the Medicaid expansion legislation. I was thrilled to be able to say that Michigan has done the right thing.  It was heartbreaking to hear the stories from the states where policymakers are refusing to accept the federal funds to expand Medicaid eligibility.

There is still much to be done to make the promise real.  Time to get to work!

– Jan Hudson

War on Poverty: Part 2

From the League’s First Tuesday newsletter
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Today marks the 50th anniversary of President Lyndon Baines Johnson’s now-famous State of the Union address that launched the War on Poverty:

“Unfortunately, many Americans live on the outskirts of hope — some because of their poverty, and some because of their color, and all too many because of both. Our task is to help replace their despair with opportunity.

While some pundits will undoubtedly seize the anniversary as an opportunity to wrongly declare the War on Poverty a failure, we should instead recommit to LBJ’s vision, as there is plenty of evidence that it worked. And what an incredible return on investment! (more…)

Healthy Michigan Plan moves forward

Great news to start the year! The federal government Monday approved Michigan’s request to expand Medicaid eligibility through a new program, the Healthy Michigan Plan.

This action brings Michigan one step closer to providing comprehensive coverage to Michigan’s low-income, uninsured residents.

It has been a long, tough road to get to this point. (more…)

1.5 million lose health insurance in Michigan

Michigan continued its dubious No. 1 ranking in the nation for having the highest number of people — workers and their family members — lose their employer-sponsored healthcare coverage, according to a recent report released by the Economic Policy Institute.

According to the report, more than 1.5 million Michiganians lost their coverage over the period 2000-2001 to 2011-2012. Ohio was right behind Michigan with 1.4 million Ohioans losing coverage. (more…)

Affordable Care Act works even if the website doesn’t

Amid all the reports of problems with the launch of healthcare.gov, the new federal health insurance Marketplace website – and there have been big problems – it is important to be reminded of the opportunity and security that the Affordable Care Act is providing.

A recently released report concludes: “In short, the Affordable Care Act is working even better than expected, producing more coverage for much less money.” (more…)

Marketplace coverage is affordable

We all need access to affordable, quality healthcare coverage so that we can make responsible healthcare decisions to take care of ourselves and our families. Access to unprecedented opportunities will become available when the problems that have plagued the opening of the Health Insurance Marketplace are resolved – and they will be resolved.

Affordable coverage is made possible by the advance premium tax credits available to those with incomes between 100% and 400% of the federal poverty level – $23,550 to $94,200 for a family of four, and the cost-sharing subsidies available to those who purchase a silver-level plan with incomes between 100% and 250% of the federal poverty level – $23,550 and $58,875 for a family of four. (more…)

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