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

 

A better budget for all Michiganians

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In our world, “winning” isn’t clear-cut. There’s no finish line, no time limit, no line judges, and certainly no landslides. Our victories are determined not by a final score, but by a day-to-day analysis of how Michiganians are impacted by policies and programs. And when the state budget bills were passed by the Michigan Legislature in late June, they included several victories for us and the people we’re fighting for.

diversity 428x200Though we still have concerns about certain elements of the final budget, we are pleased that this budget was largely created with the well-being of Michigan residents in mind.

Food Security

One of our most important policy priorities is that of food security, and the new budget certainly earns solid marks in that area. A major goal of the League this year has been to support “heat and eat” to secure additional food assistance for hundreds of thousands of Michigan families, seniors and people with disabilities. Seeing this program funded is reassuring. The budget contains support for other valuable food programs, including “double-up food bucks” in Flint, which helps residents who receive food assistance make their dollars go further when purchasing fruits and vegetables that help combat the effects of lead exposure.

We had hopes that the Legislature would fund the Corner Store initiative, which provides grants to small food retailers, allowing them to make fresh, nutritious foods available in low- and moderate-income areas. However, we are grateful for the acknowledgment that this is an important program and hope that funding becomes available for it in the future. Another positive point in the healthy foods column is funding for farmers markets to purchase wireless equipment, allowing them to accept Bridge Cards.

Child Care and Education

Child care is another big focus of the League’s, not just due to the learning environment it provides for kids but because of the significant expense and concern it means for most parents. The final budget includes $8.4 million in state general funds and $19.4 million total to increase child care provider reimbursements—paving the way for more access to higher-quality care for families with low incomes. In addition, $5.5 million in federal funding from the Child Care Development Fund is appropriated to increase the entry eligibility level from 125% to 130%of poverty.

The expansion of At-Risk funding for students in struggling families is encouraging, as is the increase in per-pupil funding, particularly at the high school level. While the increase is not yet on par with inflation, it is certainly a move in the right direction. Another gain is the Legislature’s decision to increase funding for the Pathways to Potential program, which places ‘success coaches’ in schools to identify barriers faced by students and their families. This important program—left out of an earlier budget draft—will help students access important services, and the League commends Gov. Rick Snyder for recommending its expansion.

Healthcare

The decision to continue funding the Healthy Michigan Plan is a positive for all Michiganians—especially the 670,000 residents who rely on the plan for healthcare.

Department of Corrections

We are pleased that the Residential Alternative to Prison program was expanded. It provides low-risk probation violators an opportunity to avoid going to prison and instead enter a residential program in which they receive occupational training and cognitive behavioral programming. The budget not only continues this program in Wayne County, but adds $1.5 million to replicate it in 13 counties on the west side of the state.

Federal Cuts Loom

Unfortunately, the gains made in this budget could be undone by the senseless and insensitive policies being considered in Washington. If the Trump budget or the U.S. Senate’s Better Care Reconciliation Act (BCRA) are passed, the people of our state will lose many valuable resources and benefits. These federal cuts and program eliminations would dramatically shift costs to our state budget and force the Michigan Legislature to make cuts of their own.

While we celebrate the victories in the 2018 state budget, we urge you to take action against these proposals that would undo the good progress we’ve made. Please keep up the pressure in the fight against the repeal of the Affordable Care Act and the elimination of the highly successful Healthy Michigan Plan. And if you haven’t already, please contact your members of Congress and tell them you strongly oppose the Trump budget and its historically harmful cuts to the services our residents depend on.

Our success in the state budget process shows the power of persistence and advocacy. We will continue to put that same energy into policy work at the federal level, and we hope you will, too.

— Gilda Z. Jacobs

Helping women helps children

I’ve always been interested in how our society treats women. Women are impacted negatively in almost every sphere of their lives: social, personal, economic, professional. Women are less likely than men to be in the labor force, and more likely to live in poverty. And it’s even worse for women of color who face a number of institutional barriers.

Lately, we’ve been hearing a lot about how women are affected in policy: maternity leave and child care policies in the Trump budget that benefits the rich, the American Health Care Act’s negative affect on women, access to equal pay … and the list goes on. All of these policies that impact women usually have consequences—positive and negative—for our children. If women can’t afford healthcare, housing and basic necessities, it’s often children who suffer. We can only work to help our children through the equal support of their mothers.

Kids mom brushing teethData shows that a family’s struggles are a child’s struggles. In Michigan, 22% of our children are in poverty, 54% of third graders aren’t reading proficient, 9.1% have dropped out of high school and 15% live in households that were food insecure in the past year. The average median income for Michigan families with children is $61,600, and for Black/African-American households that number is less than half: $27,200. Ten percent of children live in extreme poverty, and 24% of Black/African-American children experience extreme poverty. All of these factors of children’s well-being are directly influenced by parents’ economic standing.

Parents often face significant obstacles in their daily lives. And when families can’t afford to provide food or buy school lunches, don’t have reliable forms of transportation, or have to work multiple jobs during teacher office hours, students experience challenges outside their control.

If you want to help children, you have to help the people in charge of them: parents. And often in cases of poverty, their mothers. Fifty-two percent of Michigan children living in one-parent (mother) households are in poverty.

Women and families need to be fully supported if they’re going to be successful and if we’re going to have a successful society. Our government needs to accept responsibility for better supporting our families and our children.

My experience as a woman, and as a child in a household with income instability, pushed me towards policy and political science, because disadvantaged and vulnerable people need to be heard in our world and our culture. I couldn’t ask for a better place to work. The League works tirelessly to improve the economic security of those living in Michigan, and to improve the lives of children.

To take care of children we must take care of their families.

As a new member of the League, this is why I do the work that I do. As a data lover, I hope to help inform work that improves the lives of kids, mothers and all families in Michigan.

— Harriet McTigue

CREC yourself before you wreck yourself

“CREC yourself before you wreck yourself.” For the last 11 years, I have been trying to slip that joke into my work in the Legislature and now the League. And I had an epiphany yesterday that I might finally be able to do it…as long as I put my own name on it.

I also need to give it a proper explanation, as there’s probably a small sliver of people who know what CREC is AND get 90s Ice Cube lyrics. CREC stands for Consensus Revenue Estimating Conference. Held in January and May of every year, CREC is comprised of the directors of the House and Senate Fiscal Agencies and the state treasurer or budget director.

These fiscal experts analyze and report on economic indicators and state revenue projections. The consensus that is reached during the January conference becomes the revenue basis for the governor’s budget proposal, and the consensus reached during the May conference become the revenue basis for the budget bills passed by the Legislature.

The May Consensus Revenue Estimating Conference was earlier this week, and the news on state revenues is not great. But there is a silver lining, at least to me—it makes “wreck yourself” particularly relevant.

Since January, some Michigan legislators have been really hot on cutting the state income tax. This is a bad idea on its face, but especially in this current context. As League CEO Gilda Z. Jacobs said, “Given the fluctuations in state revenues, it was and continues to be foolhardy to consider tax cuts that would further jeopardize state services.”

if-only-i-had-checked-myselfSee! “CREC yourself before you wreck yourself” is not just a (bad) pun—it’s a valid point. The very intent of the Consensus Revenue Estimating Conference is for lawmakers to check themselves and incorporate these estimates into their state spending and budgets. And if they don’t take these forecasts seriously and make poor fiscal decisions, they stand to wreck our state budget, our state services and ultimately our state.

The Legislature needs to let talk of an income tax cut die. And when the House and Senate budget committees begin meeting soon, lawmakers should be sensible and strategic with our state dollars, investing in the programs and services that support our workers and families and get the most bang for our state bucks. For example, increasing state funding for child care and heating assistance can leverage hundreds of millions of dollars in federal funding.

The next few weeks are critical to the state budget and the priorities you and I value. To help you get involved, the League has put together a timeline and advocacy tips on the state budget. We also continue to produce budget briefs on some of the issues that are most important to us and to you: supporting education, including child care, K-12 schools and colleges and universities, protecting healthcare and the Healthy Michigan Plan, and reducing incarceration and providing adequate support for prisoners.

Whether you can work a rap reference in or not, I hope you will join the League in standing up for these budget priorities and urging lawmakers to make smart investments in our state’s future.

Alex Rossman

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

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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.

New League report and online tool calculate how much it really costs to make ends meet in each county

For Immediate Release
May 3, 2017

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

For 20 years, League has been publishing report to help policymakers understand true economic struggles of Michigan families

LANSING—It costs a Michigan family between $2,580 and $4,722 a month to pay for necessities and provide for themselves and their family according to Making Ends Meet in Michigan, a new report released by the Michigan League for Public Policy today. The monthly income necessary to make ends meet for a single parent with two kids is $3,943, and it costs a single worker $1,923 a month to get by.

The report analyzes and compiles state and county data on the costs of housing, food, child care, healthcare, transportation, and clothing and other household necessities along with likely taxes owed, to identify the Basic Needs Income Level. The Basic Needs Income Level is the amount of household income a family or individual must have to have in order to meet basic needs without public or private assistance. It’s what it really costs to live in a county.

An online calculator available at www.mlpp.org/calculator can be used to calculate the cost of living by county and family size. This report uniquely analyzes four different household sizes in each county—single, single parent, two parents/both working and two parents/one working. All families assume two children under age 5.

“For too long, policymakers have only used the poverty level and unemployment to assess how people in Michigan are doing, but there’s so much more to every Michigan family’s story and struggles than that,” said Gilda Z. Jacobs, president and CEO of the Michigan League for Public Policy. “This report seeks to draw attention to how much it really costs for families to make ends meet both statewide and in each county, and how our state’s current wages and services are not cutting it.”

The federal poverty threshold determines who is counted as officially poor but tells us little about whether a person or family is living in economic security. It does not reflect regional and local differences in the cost of living and is based on a model that, while adequate when first devised in 1965, is less reflective of today’s economic realities.

The Basic Needs Income Level calculated in this report is intended to help lawmakers and residents easily understand how much income a family needs in order to pay for all of its basic expenses. The Basic Needs Income Level can be used to measure the economic security of Michigan’s working families, assess the adequacy of worker wages and benefits, promote programs and policies that assist families in need, and as a benchmark by which to assess the quality of jobs being created in the state.

With this localized data on how much it really costs for families to make ends meet, the Michigan League for Public Policy’s report reframes the discussions around need, wage standards, public assistance and what it means to live in economic security. The League is focused on ensuring all Michigan residents have economic security because simply lifting people out of poverty is not enough. In addition to showing that the poverty level alone is not an adequate measure of stability, this data also shows that the state’s unemployment rate is not the only—or an adequate—benchmark for economic recovery.

“This data backs up what we’ve been saying the last few years as Michigan has ‘recovered’: the recovery is still not reaching everyone, many people are working in low-wage jobs and barely getting by, and the high costs of child care and healthcare are breaking people at all income levels,” Jacobs said. “There are a variety of policy changes lawmakers can make to help address this, including increasing the minimum wage, upholding healthcare and strengthening child care supports, passing a statewide earned sick leave law, and creating a fairer tax system that helps struggling workers as much as it does the wealthy.”

The League continues to connect the challenges facing Michigan kids and residents with the policy solutions to help them. To that end, Making Ends Meet outlines the following policy recommendations for lawmakers to better support their constituents:

  • Protect Michigan’s expansion of Medicaid and the federal Affordable Care Act as a whole;
  • Restore and strengthen the Michigan Earned Income Tax Credit;
  • Update Michigan’s child care subsidy;
  • Raise the minimum wage;
  • Invest in skills training and adult education.
  • Enact workplace protections such as earned sick leave and predictable scheduling; and
  • Create a more adequate tax system, including a graduated income tax.

In this report, housing costs are based on the Fair Market Rent (the 40th percentile of rents in each county) provided by the United States Department of Housing and Urban Development (HUD). Food expenses are from the United States Department of Agriculture’s Low-Cost Food Plan. Child care costs are based on the 2015 Cost of Care Report from the Early Childhood Investment Corporation and healthcare expenses are calculated using the federal healthcare marketplace exchange. Finally, costs for clothing, household necessities, personal care and telephone come from the Bureau of Labor Statistics Consumer Expenditure Survey and may vary depending on the family’s circumstances. Taxes are based on income and family size. For additional information, including data appendices and more details on how each of these expenses was calculated, go to www.mlpp.org/resources/making-ends-meet-in-michigan.

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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.

Protect healthcare for 650,000 Michiganians

pdficonApril 2017
Emily Schwarzkopf, Policy Analyst

Continuation of the Affordable Care Act (ACA) and the Healthy Michigan Plan are critical for Michigan residents and the state’s economy. In recognition of the program’s success, the governor recommended, and the League supports, sufficient funding for the Healthy Michigan Plan in the 2018 budget year.

Budget Brief JPG USE THIS ONE

Sixty percent of Healthy Michigan enrollees report that their ability to access primary care was better than prior to being enrolled, and 70% stated that they were more likely to contact a primary care provider before going to the emergency room. Eighty-six percent of enrollees have reported that their ability to pay their medical bills has improved since being enrolled in the program.

The program has also made a significant impact on Michigan’s economy. The Healthy Michigan Plan has resulted in 30,000 jobs annually, $2.3 billion in additional personal spending power, and $150 million in state tax revenue as a result of added economic activity. Further, 90% of hospitals report reductions in uncompensated care, with overall uncompensated care dropping by nearly 50% across the state.

BACKGROUND ON MEDICAID EXPANSION

When it was first passed, the ACA included a requirement that states expand Medicaid to those with family incomes at or below 133% of the federal poverty level. The existing Medicaid program generally had only covered the aged, blind and disabled up to 100% of poverty, with higher income levels for certain populations (children and pregnant women) and lower for others (childless adults).

However, the June 2012 United States Supreme Court decision questioning the constitutionality of the ACA (National Federation of Independent Business v. Sebelius) found the provision to require states to expand Medicaid unconstitutional. As a result, states were given the option to expand their Medicaid programs without penalty. State programs would be covered 100% by federal funding through calendar year 2016. The federal match rate will phase down to 90% over the next five calendar years: to 95% in 2017, 94% in 2018, 93% in 2019 and 90% in 2020 and all subsequent years.

BB Protect healtcare for 650,000 Michiganians chart 1The Healthy Michigan program has been shown to be incredibly successful for those receiving coverage through the plan. The benefits for Healthy Michigan enrollees must be based on federal benchmark coverage and include the 10 essential healthcare services. The plan also covers dental and vision services, hearing aids and nonemergency medical transportation.

MICHIGAN’S FEDERAL WAIVERS

The legislation that created the Healthy Michigan program required Michigan to get two waivers from the federal government. The first waiver allowed the state to include cost-sharing requirements (including copays) and the use of health savings accounts into which newly-eligible enrollees would contribute. The contributions of enrollees could be reduced if certain healthy behaviors are addressed.

The second waiver limited the amount of time an enrollee could be enrolled in the Healthy Michigan Plan to 48 months. Once the 48-month cap is reached, an individual would have the opportunity to remain on Medicaid with higher cost-sharing requirements or purchase private insurance through the healthcare exchange and be considered eligible for premium tax credits. Both of these waivers were approved by the federal government.

Another important component of Michigan’s legislation is that should annual state savings and other nonfederal savings associated with the implementation of the program not be sufficient to cover the reduced federal match, the Healthy Michigan program would end. The state realizes savings from programs that were previously funded either partially or entirely by the state General Fund that are now covered in Healthy Michigan, including non-Medicaid mental health funding, Adult Benefits Waiver program, prisoner healthcare costs and Plan First! Waiver program costs. Savings can also be seen as a result of revenue from the Health Insurance Claims Assessment, the use tax on Medicaid managed care organizations, provider assessments and an established hospital quality assurance assessment program retainer on special hospital payments.

CONTINUED THREATS

Despite the recent defeat of the federal American Health Care Act, there is still the possibility that Congress will fundamentally change the way Medicaid funding is allocated and limit how long Medicaid expansion will continue. As Congress moves forward on other priorities, including tax reform, there is the possibility that Congress, in order pay for tax breaks, could shift the costs of the Medicaid program to the states through block grants or per capita caps. There also is a chance that Congress could make changes in Medicaid financing in the forthcoming federal budget or when the Children’s Health Insurance Plan (CHIP) funding is reauthorized in late summer or early fall. While the League encourages the Michigan Legislature to continue funding for the Healthy Michigan Plan in 2018 and beyond, it is also important to stay vigilant in protecting Medicaid funding and the Affordable Care Act.

THE GOVERNOR’S 2018 BUDGET RECOMMENDATION

The governor’s executive budget proposal includes continued funding for this critical program. Since the state is required to pay a share of the costs, the governor has recommended total funding of $4.1 billion, including a $200.4 million investment of state General Funds to cover the costs of the state’s match contribution. This amount does not take into account additional savings from revenue impacts or other budgetary savings created as result of the implementation of the Healthy Michigan Plan.

Major flaws exposed in U.S. House Republicans’ healthcare plan

For Immediate Release
March 16, 2017

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

League, federal analysis show that plan will eliminate health coverage for 24 million people, cut $880 billion from Medicaid and shift costs to state

LANSING—Congressional Republicans’ plans for Medicaid funding will hobble Michigan’s budget and jeopardize healthcare for at least 2.5 million state residents according to a new fact sheet, Medicaid block grants and per capita caps are bad for Michigan’s health, released by the Michigan League for Public Policy today. This analysis comes on the heels of the Congressional Budget Office’s (CBO) report this week that showed the House Republicans’ health plan to replace the Affordable Care Act (ACA) will ultimately result in a drastic increase in the number of uninsured in the country and substantial cuts to federal Medicaid funding.

“The Affordable Care Act was a groundbreaking policy that significantly reduced the number of uninsured in Michigan and improved people’s health,” said Gilda Z. Jacobs, president and CEO of the Michigan League for Public Policy. “On the other hand, the House Republicans’ alternative plan is an absolute disaster. It will result in 24 million people losing health insurance, cut $880 billion from Medicaid, and stifle state Medicaid funding through per capita caps. The only people who will benefit from it are wealthy individuals who will get tax breaks while our residents, our small business owners and our hospitals all suffer.”

The CBO estimates that the House Republican health plan would cause 24 million people nationwide to lose insurance coverage by 2026, including 14 million people next year. The plan will slash federal Medicaid spending by $880 billion and gives $600 billion in tax cuts primarily to the wealthiest Americans while raising premiums for millions of consumers. Additional analysis on the plan is available from the Center on Budget and Policy Priorities.

“The Affordable Care Act and the related Healthy Michigan Plan have been vital in reducing our state’s uninsured rate and have provided health coverage for millions of residents,” Jacobs said. “The governor supports the Healthy Michigan Plan and it was created with bipartisan support, but putting per capita caps on or block granting our state’s Medicaid funding will put this highly successful program at risk.”

The House Republicans’ current healthcare plan will put per capita caps on federal Medicaid funding for the states, giving Michigan and other states a fixed amount of money per Medicaid enrollee. Other Republican healthcare proposals have proposed distributing Medicaid funding through block grants where the federal government would send each state a specific amount of funding to support the entirety of the Medicaid program.

Using per capita caps or block grants to distribute federal Medicaid funding will limit the amount of federal funding that states receive, shifting costs and risk to states, hurting local economies, and putting quality coverage for seniors, people with disabilities and families with kids at risk. This shift could result in a significant financial strain on state budgets, forcing Michigan lawmakers to limit spending on Medicaid by reducing the number of people it covers or cutting other vital state programs including education, public safety or infrastructure.

The League has been a major supporter of the ACA since its inception, particularly the expansion of Medicaid through the Healthy Michigan Plan that currently insures 650,000 state residents with low incomes. The League put together a fact sheet on the ACA’s tangible benefits for Michigan residents, businesses, hospitals and our state economy.

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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.

Promoting the Healthy Michigan Plan: Budget cuts to outreach jeopardize success

Budget Brief JPG USE THIS ONEpdficonThe Michigan League for Public Policy advocates for adequate healthcare coverage for all Michiganians, with an emphasis on ensuring that all eligible people are aware of the health insurance options and services available to them and their families. The League supports full funding for the state’s Healthy Michigan Plan, and strongly opposed cuts in the 2017 budget that will reduce the state’s ability to reach out to the uninsured by marketing and advertising enrollment opportunities.

Lowering healthcare costs for all consumers, including employers who provide coverage, depends on reducing the ranks of the uninsured. When uninsured individuals need healthcare, especially in emergencies, many are unable to pay the costs out of their pocket. The cost of that uncompensated medical care has to be absorbed, and the solution has been to spread the responsibility for paying it across the healthcare system, increasing costs for everyone who receives care or pays insurance premiums, including employers.

The Healthy Michigan Plan

Michigan took a bold step to address this problem when it created the Healthy Michigan Plan in 2012—expanding access to comprehensive healthcare through the state’s Medicaid program to adults with low incomes.

bb-promoting-the-healthy-michigan-plan-pdfThe successful Healthy Michigan Plan was one of the first of its kind in the country, taking advantage of new flexibility in federal law to create a healthcare system that balances consumer protections, robust health coverage and positive self-care. The program uses incentives to encourage consumers to adopt healthy behaviors that can also contain costs over the long term, like quitting tobacco use and losing weight. Healthy Michigan enrollees pay a share of the cost, too, in the form of contributions to an account that pays a portion of the cost of services they use.

Eligible individuals are childless adults who often work in low-wage jobs without access to employer-sponsored coverage and don’t earn enough to purchase healthcare insurance.

The first round of enrollees included uninsured persons who were aware of the new option and how to enroll—sometimes with assistance. Reaching the remaining eligible population would not only help more Michigan residents with low incomes protect themselves against unexpected and potentially devastating medical bills, it would also lower healthcare costs for all by closing the healthcare insurance coverage gap. But doing so will require targeted outreach efforts and the funds to pay for them, including those cut in the 2017 budget.

Healthy Michigan Plan Funding and Outreach

The final 2017 Michigan budget includes the state funding needed to cover the decline in federal funding for the Healthy Michigan Plan which is scheduled for January 1, 2017. Currently, the federal government pays 100% of the costs of the Healthy Michigan Plan, the highest federal match ever paid out to states for covering eligible populations via the Medicaid program. Every enrollee in the program not only helps reduce Michigan’s uninsured population, but also brings needed federal funds back to the state to pay for it. While the percentage of the federal match decreases from the original 100% Michigan has enjoyed in the first few years of the program, it remains generous, declining slightly over the coming years until bottoming out at a 90% federal match to the state’s 10% share.

Governor Rick Snyder’s proposed budget for next year also called for level funding for the Healthy Michigan Plan call center ($19.5 million) and program marketing ($2 million). Unfortunately, over the opposition of the League and numerous other advocates, the Legislature reduced the Healthy Michigan Plan call center by $8.1 million ($1.6 million in state funds), and cut marketing and advertising funding by $1 million ($500,000 in state funds).

The League has opposed both budget and statutory restrictions on outreach for the Healthy Michigan Plan. Failure to reach out to cover the uninsured increases the hardships faced by many families with low incomes who do not have access to healthcare coverage. But it also ensures that healthcare costs will continue to rise for all residents individually and for the state as a whole due in part to the lack of preventative healthcare, overutilization of emergency rooms and uncompensated care.

The League also urges policymakers to take advantage of all available federal funds. The sooner the state enrolls all eligible individuals, the sooner it receives the match at the highest level of federal contribution. Early savings to the state have already totaled more than $200 million through a combination of drawing down matching funds and shifting formerly state-funded healthcare programs to the Healthy Michigan Plan.

Many eligible individuals will never know about their opportunity to enroll in the Healthy Michigan Plan if it isn’t promoted publicly. By refusing to devote modest funds to reach the maximum number of eligible Michigan residents today, Michigan lawmakers are unnecessarily increasing the future long-term costs for all consumers and the state by turning away badly needed federal matching funds that can serve to fire up the economy while addressing the healthcare needs of low-wage workers.

Devoting resources to increase enrollment in the Healthy Michigan Plan helps close the coverage gap—a fundamental part of controlling healthcare costs for all. Taking explicit steps to ban funding today and in the future results in very modest, short-term savings, but it hurts Michigan residents and increases the state’s liabilities in the future. Instead of intentionally limiting promotion and, in turn, public awareness and use of this program, it’s time to celebrate the success of the Healthy Michigan Plan by investing in outreach and making sure all eligible Michigan residents are enrolled.

We need to narrow Michigan’s income gap

It’s no secret—income inequality exists in Michigan. However, when nearly 1 in 4 kids still live in poverty in the state and when too many Michigan residents must cobble together multiple part-time jobs just to barely make ends meet, income inequality is a problem. And more must be done to lift our most vulnerable residents to help narrow the gap. (more…)