House Subcommittee Approves DCH Fiscal Year 2015 Budget

Full report in PDF

The governor’s budget recommends total funding for the Department of Community Health of $17.4 billion, including $2.9 billion in state General Fund dollars, an increase of approximately 3% over the current year adjusted appropriation of $16.9 billion. The bulk of the funding is for the state’s Medicaid and Healthy Michigan Plan programs (74%), followed by mental health and substance use disorder services (18%).

The budget for the Department of Community Health is the state’s largest, growing by over 60% between Fiscal Years 2005 and 2014. Of note, the state General Fund investment has only increased 13% over the FY2005 appropriation. This year, federal funds make up nearly 69% of the DCH budget.

The governor’s FY 15 budget includes many positive recommendations including full-year funding for the Healthy Michigan Plan, continued expansion of Healthy Kids Dental, continuation of half of the primary care rate increase, funding to begin implementation of the Mental Health and Wellness Commission recommendations, and restoration of funding for senior meals and services.

However, there are troubling shortfalls in the Medicaid health plan services, as well as in the public mental health system. Also troubling is the acknowledgement in the budget of the shortfall in the Health Insurance Claims Tax, with no recommendation to resolve it. These funds are used to match federal funds to provide Medicaid services.

Also of concern is the practice of taking ongoing program funding and arbitrarily reclassifying all or part of it as “one-time” funding as has been done with graduate medical education and several other programs over the last several years.

The House Appropriations Subcommittee on health spending concurred with the Executive Budget recommendation on full-year funding for the Healthy Michigan Plan, the Healthy Kids Dental expansion, continuation of the Medicaid primary care increase, funding for the Mental Health and Wellness recommendations, and funding to restore senior meals and services. The House subcommittee recommended different sources of funding for some of the Executive recommendations and included initiatives related to diabetes prevention and pilot projects to support those with Alzheimer’s Disease in their homes.  

Medicaid

Approximately one in every five Michigan residents is enrolled in Medicaid for their healthcare coverage, and more than half of all births in the state are paid for by the program. In each of the last three years, half of the children in the state have been covered by Medicaid as child poverty in Michigan continues to increase. In the current fiscal year, the governor projects that 1.82 million Michigan residents will be covered by Medicaid, with an additional 214,000 benefiting from the implementation of the Healthy Michigan Plan that will take effect on April 1st.

Governor’s Budget:

  • The governor’s budget for Fiscal Year 2015 recognizes state General Fund savings of over $243 million as a result of federal approval of Michigan’s waiver to expand Medicaid through the Healthy Michigan Plan, which took effect on April 1, 2014. The savings are realized because the state currently spends 100% state General Funds for limited services to very low-income uninsured individuals, and with the expansion, federal funds will be available to pay for services for this population. The governor recommends that half of the savings, or $122 million, be placed in a newly created Health Savings Fund that would ensure that the state has sufficient funds to cover future reductions in federal matching funds. Healthy Michigan Plan funding is 100% federal for calendar years 2014, 2015, and 2016. The federal funding declines during calendar years 2017- 2019, reaching 90% in 2020, where it remains.

House Subcommittee:

  • The House subcommittee concurred with the Executive Recommendation.

Governor’s Budget:

  • The Healthy Michigan Plan, championed by Gov. Snyder, will provide comprehensive health coverage to about 400,000 currently uninsured people in the state through 2015, nearly doubling the projected enrollment for Fiscal Year 2014. This comprehensive program covers individuals with incomes up to 133% of the federal poverty level. Full-year funding of $2.2 billion, all federal funds, is recommended. A staffing increase of 36 positions is included to administer the program.

House Subcommittee:

  • The House subcommittee House subcommittee concurred with the full-year funding recommendation as well as the additional staff to administer the program, but created a new line-item for the staffing costs rather than include them in the Medical Services Administration line-item.

Governor’s Budget:

  • The governor recommends $25.2 million for autism services, down from $35.2 million this year. The funding reduction is not a program reduction, but reflects a slow start-up for the program due to the need to develop provider capacity. To increase needed capacity, $3 million in continuing “one-time” funding, increased from $2 million in the current fiscal year, is recommended to train autism services providers through the creation of university autism centers. In Fiscal Year 2014, grants of $500,000 each are allocated to Eastern Michigan, Western Michigan, Central Michigan and Oakland Universities. The Fiscal Year 2015 recommendation allocates $1 million each to Eastern Michigan, Western Michigan and Michigan State Universities.

House Subcommittee:

  • The House subcommittee concurred with the $10 million reduction in autism services, but did not concur with the recommended increase in university training funds. The House subcommittee reduced the funding from $2 million to $1.5 million in “one-time” grants and specified $$500,000 in grants to Eastern and Western Michigan Universities and $500,000 to Michigan State University.

Governor’s Budget:

  • The governor recommends $26 million in state funds, bringing in $49.4 million in federal funds, to continue approximately half of the rate increase for primary care providers. This rate increase, required in Fiscal Years 2013 and 2014, was 100% federally funded for the first two calendar years. In calendar year 2015, the rate increase is no longer required or 100% federally funded, so a state investment is required to continue.

House Subcommittee:

  • The House subcommittee concurred with continuing the rate increase, but recommended a lower level of funding — $21.4 million state funds, $40.7 million in federal funds.

Governor’s Budget:

  • The governor eliminates the special payment for rural and sole community hospitals. The funds were classified as “one-time” funding in Fiscal Year 2012, but converted to ongoing funding for Fiscal Years 2013 and 2014.

House Subcommittee:

  • The House subcommittee rejected the Executive recommendation to eliminate the payment and recommended continuation, but changed the source of funding from state and federal funds to provider taxes and federal funds, maintaining the state funds savings included in the Executive Budget.

Healthy Kids Dental

Michigan currently provides enhanced dental services to more than 500,000 children in 78 counties. Access to dental services is essential to prevent tooth decay, the number one chronic disease in children.

Governor’s Budget:

  • The governor recommends $5.4 million in state General Fund and $10.3 million in federal funds to expand the Healthy Kids Dental program to an additional 100,000 children in Kalamazoo and Macomb counties. With that expansion, the program would cover over 611,000 children in 80 of 83 Michigan counties. Not yet covered are more than 400,000 children in three of the most populated Michigan counties that are the home to many low-income children and children of color, including Wayne, Oakland and Kent counties.
  • Healthy Kids Dental improves access to care by partnering with Delta Dental of Michigan to increase provider reimbursement rates and simplify administration.

House Subcommittee:

  • The House subcommittee concurred with the Executive Recommendation. The House subcom-mittee made no recommendation to expand to the remaining counties.
  • With Michigan’s dismal ranking in the Race for Results for African American children, Expanding Healthy Kids Dental to the remaining counties presents a tremendous public policy opportunity.

 

 

 

Mental Health and Substance Abuse Services

Since Fiscal Year 2005, Medicaid-related mental health spending has increased by over 50%, while non-Medicaid spending has decreased, leaving thousands of residents without needed services. Funding for substance use disorder services increased by 12%, largely because of increases in federal funding, but fewer individuals were served in Fiscal Year 2013 than in the previous 9 years, despite the growing problem with heroin/other opiates addiction.

Governor’s Budget:

  • With the expansion of Medicaid eligibility, individuals enrolled in the Healthy Michigan Plan will also have access to comprehensive mental health and substance use disorder services. As mentioned above, great concern has been raised about the adequacy of the funding to provide the promised services.

House Subcommittee:

The House subcommittee concurred with the Executive Recommendation.

Governor’s Budget:

  • The governor also recommends $15.6 million in state General Fund, $5 million of which is “one-time” funding, to begin implementation of the recommendations of the Mental Health and Wellness Commission, which released its recommendations for improvements in mental health services in January 2014.

House Subcommittee:

  • The House subcommittee concurred with the Executive, and also added potential federal funding (yet to be identified), increasing programming capacity by $22 million.

Governor’s Budget:

  • The governor recommended $3.4 million in state General Fund for the Mental Health Diversion Council to treat those with mental illness or developmental disabilities in settings other than the criminal justice system. Additional funding of $2.7 million is included in the Judiciary and Corrections budgets.

House Subcommittee:

  • The House subcommittee concurred with the Executive Recommendation.

Public Health and Children’s Services

  • Nearly two of every three dollars spent on public health services is federal. Over the last decade, nearly all increases in total public health funding have been from federal grants or other sources, while state funding has remained essentially flat.

Governor’s Budget:

  • The governor recommends continuation funding of $39.4 million for local public health services. Appropriations for local public health essential services, while increased by $2 million in Fiscal Year 2014, remain below the Fiscal Year 2005 appropriation.

House Subcommittee:

  • The House subcommittee provided a $1.5 million General Fund increase, bringing the House subcommittee recommendation up to the level of the Fiscal Year 2005 appropriation.

Governor’s Budget:

  • The governor includes $2.5 million in state funds to conduct a regional needs assessment and expand home visiting services to at-risk families with young children in rural areas in the Upper Peninsula and Northern Lower Peninsula.

House Subcommittee:

  • The House subcommittee concurs with the governor, but funds the expansion with federal (TANF) funds, rather than state funds.

Governor’s Budget:

  • The proposed budget includes $2 million in “one-time” funding for a pilot program to improve child and adolescent health services by working with two existing school-based clinics to identify satellite locations that will be serviced by mobile teams, increasing access to nursing and behavioral health services in schools.

House Subcommittee:

  • The House subcommittee concurs with the pilot program, but funds with federal (TANF) funds, rather than state funds.

Governor’s Budget:

  • The essential health provider program was increased by $600,000 to reflect the projected additional private revenue. This program assists primary care providers who practice in medically underserved areas with the repayment of their educational loans.

House Subcommittee:

  • The House subcommittee concurred with the Executive Recommendation.

Governor’s Budget:

  • After three years of “one-time” funding, island (Bois Blanc, Mackinac, Beaver, and Drummond) health clinic funding was converted to ongoing funding.

House Subcommittee:

  • The House subcommittee concurred with the Executive Recommendation.

Services for the Aging

Governor’s Budget:

  • The governor’s budget includes $5 million in state funds to help eliminate a waiting list of an estimated 4,500 seniors eligible for home-delivered meals ($1.8 million) and in-home services ($3.2 million) provided through Area Agencies on Aging around the state. With this increase in home-delivered meals, the reductions in funding over the last decade have been completely restored.

House Subcommittee:

  • The House subcommittee concurred with the Executive Recommendation.

Governor’s Budget:

  • The governor also expands funding by $9 million in state funds, $17.2 million in federal funds to eliminate the waiting list for the MIChoice program that provides in-home and community services to help seniors or those with disabilities remain in their homes rather than moving to nursing homes, serving an additional 1,250 individuals.

House Subcommittee:

  • The House subcommittee concurred with the Executive Recommendation.

Governor’s budget:

  • The governor recommends the expansion of PACE (Programs for All-Inclusive Care for the Elderly) to more counties, funded through corresponding savings in nursing home costs.

House Subcommittee:

  • The House subcommittee concurred with the Executive Recommendation.

House Subcommittee Initiatives

  • The House subcommittee added $150,000 state General Fund to increase diabetes prevention funding to $800,000.
  • The House subcommittee added $150,000 state General Fund to establish a pilot program to provide more comprehensive services and supports to individuals with Alzheimer’s disease to enable them to remain in their homes as long as possible, delaying potential moves to long term care facilities.

 

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

A Closer Look at the Governor’s FY 2015 Budget for the Department of Community Health

Full report in PDF

The governor’s budget recommends total funding for DCH of $17.4 billion, including $2.9 billion in state General Fund dollars, an increase of approximately 3% over the current year adjusted appropriation of $16.9 billion. The bulk of the funding is for the state’s Medicaid and Healthy Michigan Plan programs (74%), followed by mental health and substance use disorder services (18%).

The budget for the Department of Community Health is the state’s largest, growing by over 60% between Fiscal Years 2005 and 2014. Of note, is that the state General Fund investment has only increased 13% over the FY 2005 appropriation. This year, federal funds make up nearly 69% of the DCH budget.

The FY 15 budget includes many positive recommendations including full-year funding for the Healthy Michigan Plan, continued expansion of Healthy Kids Dental, continuation of half of the primary care rate increase, funding to begin implementation of the Mental Health and Wellness Commission recommendations, restoration of funding for senior meals and services, to name a few.

However, there have been troubling shortfalls identified in the Medicaid health plan services as well as in the public mental health system. Also troubling is the acknowledgement in the budget of the shortfall in the Health Insurance Claims Tax with no recommendation to resolve it. These funds are used to match federal funds to provide Medicaid services.

In addition, we continue to be concerned about the practice of taking ongoing program funding and arbitrarily reclassifying all or part of it as “one-time” funding as has been done with graduate medical education and several other programs over the last several years.

Details on specific Executive Budget recommendations follow:

Medicaid: Approximately one in every five Michigan residents is enrolled in Medicaid for their healthcare coverage, and more than half of all births in the state are paid for by the program. In each of the last three years, half of the children in the state have been covered by Medicaid as child poverty in Michigan continues to increase. In the current fiscal year, the governor projects that 1.82 million Michigan residents will be covered by Medicaid, with an additional 214,000 benefiting from the implementation of the Healthy Michigan Plan that will take effect on April 1.

  • The governor’s budget for 2015 recognizes state General Fund savings of over $243 million as a result of federal approval of Michigan’s waiver to expand Medicaid through the Healthy Michigan Plan effective April 1, 2014. The savings are realized because the state currently spends 100% state General Funds for limited services to very low-income uninsured individuals, and with the expansion, federal funds would be available to pay for services for this population. The governor recommends that half of the savings, or $122 million, be placed in a newly created Health Savings Fund that would ensure that the state has sufficient funds to cover the future reductions in federal matching funds. Healthy Michigan Plan funding is 100% federal funding for calendar years 2014, 2015, and 2016. The federal funding declines during calendar years 2017- 2019, reaching 90% in 2020 where it remains.
  • The Healthy Michigan Plan, championed by Gov. Snyder, will provide comprehensive health coverage to about 400,000 currently uninsured people in the state through 2015, nearly doubling the projected enrollment for FY 14. This comprehensive program covers individuals with incomes up to 133% of the federal poverty level. Full-year funding of $2.2 billion, all federal funds, is recommended. A staffing increase of 36 positions is included to administer the program.
  • The governor recommends $25.2 million for autism services, down from $35.2 million this year. The funding reduction does not represent a program reduction rather it represents a slow start due to the need to develop provider capacity. To increase needed capacity, $3 million in continuing “one-time” funding, increased from $2 million in the current fiscal year, is recommended to train autism services providers through the creation of university autism centers. One million dollars each is allocated to Eastern Michigan University, Western Michigan University and Michigan State University.
  • Funding of $26 million in state funds, bringing in $49.4 million in federal funds, is recommended to continue approximately half of the rate increase for primary care providers. This rate increase, required in FY 13 and FY 14, was 100% federally funded for the first two calendar years. In calendar year 2015, the rate increase is no longer required or 100% federally funded, so a state investment is required to continue.
  • The special payment for rural and sole community hospitals is recommended for elimination. It was classified as “one-time” funding in FY 12, but converted to ongoing funding for FY 13 and FY 14.

Healthy Kids Dental: Michigan currently provides enhanced dental services to more than 500,000 children in 78 counties. Access to dental services is essential to prevent tooth decay, the number one chronic disease in children.

  • The governor recommends $5.4 million in state General Fund and $10.3 million in federal funds to expand the Healthy Kids Dental program to an additional 100,000 children in Kalamazoo and Macomb counties. With that expansion, the program would cover over 611,000 children in 80 of 83 Michigan counties.
  • Not yet covered are more than 400,000 children in three of the most populated Michigan counties that are the home to many low-income children and children of color, including Wayne, Oakland and Kent counties. Healthy Kids Dental improves access to care by partnering with Delta Dental of Michigan to increase provider reimbursement rates and simplify administration.

Mental Health and Substance Abuse Services: Since Fiscal Year 2005, Medicaid-related mental health spending has increased by over 50%, while non-Medicaid spending has decreased, leaving thousands of residents without needed services. Funding for substance use disorder services increased by 12%, largely because of increases in federal funding, but fewer individuals were served in FY 13 than in the previous nine years, despite the growing problem with heroin/other opiates addiction.

  • With the expansion of Medicaid eligibility, individuals enrolled in the Healthy Michigan Plan will also have access to comprehensive mental health and substance use disorder services. As mentioned above, great concern has been raised about the adequacy of the funding to provide the promised services.
  • The governor also recommends $15.6 million in state General Fund, $5 million of which is “one-time” funding, to begin implementation of the recommendations of the Mental Health and Wellness Commission, which released its recommendations for improvements in mental health services in January 2014.
  • The governor recommended $3.4 million in state General Fund for the Mental Health Diversion Council to treat those with mental illness or developmental disabilities in settings other than the criminal justice system. Additional funding of $2.7 million is included in the Judiciary and Corrections budgets.

Public Health and Children’s Services: Nearly two of every three dollars spent on public health services is federal. Over the last decade, nearly all increases in total public health funding have been from federal grants or other sources, while state funding has remained essentially flat.

  • The governor recommends continuation funding of $39.4 million for local public health services. Appropriations for local public health essential services, while increased by $2 million in FY 2014, remain below the Fiscal Year 2005 appropriation.
  •  The governor includes $2.5 million in state funds to conduct a regional needs assessment and expand home visiting services to at-risk families with young children in rural areas in the Upper Peninsula and Northern Lower Peninsula.
  • The proposed budget includes $2 million in “one-time” funding for a pilot program to improve child and adolescent health services by working with two existing school-based clinics to identify satellite locations that will be serviced by mobile teams, increasing access to nursing and behavioral health services in schools.
  • The essential health provider program was increased by $600,000 to reflect the projected additional private revenue. This program assists primary care providers who practice in medically underserved areas with the repayment of their educational loans.
  • After three years of “one-time” funding, island (Bois Blanc, Mackinac, Beaver, and Drummond) health clinic funding was converted to ongoing.

Services for the Aging:

  • The governor’s budget includes $5 million in state funds to help eliminate a waiting list of an estimated 4,500 seniors eligible for home-delivered meals ($1.8 million) and in-home services ($3.2 million) provided through Area Agencies on Aging around the state. With this increase in home-delivered meals, the reductions in funding over the last decade have been completely restored.
  • The governor also expands funding by $9 million in state funds, $17.2 million in federal funds to eliminate the waiting list for the MIChoice program that provides in-home and community services to help seniors or those with disabilities remain in their homes rather than moving to nursing homes, serving an additional 1,250 individuals.
  • The governor recommends the expansion of PACE (Programs for All-Inclusive Care for the Elderly) to more counties, funded through corresponding savings in nursing home costs.

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

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…)

A gift for the future

From the First Tuesday newsletter
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 The holidays are upon us, and I’d like to offer Michigan the gift that keeps on giving – 10 ways to invest in our future.

The generations that came before us knew what it took to build a Mighty Mac, freeways and strong universities. Yet today, when you hear about economic development, you often hear about tax cuts, not investments. We can’t cut our way to prosperity. We simply must pay it forward for future generations and give them the investments they need for a strong economy.

A recent report by Senior Policy Analyst Pat Sorenson offers 10 ways to invest in our economy. It’s the League’s gift for the future:

1.
Invest
In early childhood.
2. Make sure all kids get
a great education – and a diploma!
3. Make college affordable 4. Encourage good health
with access to physical and mental health treatment 5. Offer help
with basic needs to those who cannot work or who cannot find
a job. 6. Invest in community services to attract businesses and young
professionals. 7. Generate revenue by strengthening the personal income tax,
based on the ability to pay. 8. Make sure businesses pay their fair share 9. Bring sales tax
into the modern age by taxing services and Internet sales. 10. End ineffective tax breaks
and put funds
into what works.

Happy holidays, and make sure to sign up for our Dec. 9 policy forum!

– Gilda Z. Jacobs

Ten steps to boost Michigan’s economy

new report by the League outlines 10 steps Michigan must take to improve its economy, refuting the myth that tax cuts are a shortcut to economic prosperity. Included in the report are strategies for investing in the services and infrastructure needed to create jobs and fuel economic growth, as well as tax changes that modernize and strengthen the state’s revenue system.

It is an agenda for long-term economic prosperity that includes investments in education from early childhood through higher education, access to the health and mental health services needed for a healthy workforce, basic income security for those who cannot work or find jobs, and support for the community services businesses and consumers rely on. (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…)

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