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

For Immediate Release
June 7, 2017

Contact:
Alex Rossman
arossman@mlpp.org
517.487.5436

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

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

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

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

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

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

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

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

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

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

To learn more, please visit:

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

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

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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.

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.

Kresge grant helps League redefine health policy work in Michigan and Detroit

For Immediate Release
March 31, 2017

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

$600,000 grant funded two new health policy analyst positions, helps League improve integration of state health and human services

LANSING—A $600,000 grant from The Kresge Foundation awarded to the Michigan League for Public Policy will help transform the League’s health policy work in Detroit and around the state. The funding enabled the League to hire two new health policy analysts, one focusing on Medicaid and the other specializing in the social determinants of health.

“These policy analysts provide valuable expertise regarding additional opportunities to integrate health and human services policies that will lead to great health and well-being for Michiganders,” said David Fukuzawa, managing director for The Kresge Foundation’s health and human services programs. “The League will serve as a valuable resource for Michigan’s Department of Health and Human Services as the department continues to develop integrated services for the state.”

The funding from The Kresge Foundation will support the League’s research and analysis examining the current health and well-being of Detroiters and Michigan residents. The League will identify gaps in state services and support systems and create specific policy recommendations to address those gaps. This work by the League’s two new health policy analysts will advance public policy change by supporting the integration of health and human services and helping lawmakers, state department officials and service providers better understand the connection between health and other factors.

“The Kresge Foundation has been a longstanding supporter of our work at the League, but this significant grant will help take our health policy efforts to the next level,” said Gilda Z. Jacobs, president and CEO of the Michigan League for Public Policy. “We work on a variety of issues to improve the physical and economic well-being of kids and families in Detroit and around the state, and we are seeing more and more how all of these issues connect. A child’s health is directly impacted by their environment, nutrition and family’s income, and their health affects their education and future occupations and earnings. We need comprehensive strategies to tackle all of these issues, and this grant will enable us to do that.”

The League’s health policy analysts will research and write reports, analyze current and proposed policy, and work with partners, department staff and policymakers on social determinants of health and Medicaid-related issues. Emily Schwarzkopf, the League’s health policy analyst working on Medicaid, has hit the ground running as the League and our partners work to protect the Affordable Care Act and the state’s Medicaid expansion program, the Healthy Michigan Plan. Health Policy Analyst Julie Cassidy will be working on the social determinants of health, a relatively new focus of health policy work that takes a holistic approach and incorporates other needs and services.

The Kresge Foundation is a $3.6 billion private, national foundation that works to expand opportunities in America’s cities through grantmaking and social investing in arts and culture, education, environment, health, human services and community development in Detroit.

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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.

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.

Many bright spots in governor’s budget, but cloud of tax cut still looms

For Immediate Release
February 8, 2017

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

Governor’s budget includes funding for many League priorities that support kids, workers and families

LANSING—The Michigan League for Public Policy issued the following statement on Governor Rick Snyder’s 2018 budget presented this morning. This statement can be attributed to Michigan League for Public Policy President & CEO Gilda Z. Jacobs.

“The governor’s budget today is very positive and includes money for many of the programs and services that help struggling workers and families. The League has been a champion for leveraging federal funds to support important state services, and the budget includes $6.8 million to draw down the federal money needed to keep the Heat and Eat program going and $8.4 million in state funds for child care to secure much-needed federal funding. The budget upholds continued funding for the Healthy Michigan Plan, which provides healthcare for more than 600,000 Michiganians with low incomes under the Affordable Care Act, and we appreciate Governor Snyder’s continued commitment to protecting that successful program in Michigan. (more…)

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.

Promoting Healthy Michigan Plan key to a healthy Michigan

In January, I joined the Michigan League for Public Policy as their communications associate. I’m able to work with the communications department assisting with a variety of tasks and working on issues that I’m truly passionate about. I love writing, both personally and professionally, and am excited to have this avenue to interact with people who are equally passionate about the League’s work. (more…)

Another milestone for the Healthy Michigan Plan

The Healthy Michigan Plan reached another milestone this week with enrollment topping 481,000. That number exceeds the original enrollment projection of 477,000 for the entire program. It was expected to take two years to achieve full enrollment.

What an accomplishment in nine months!

The best part is that enrollees are actually receiving healthcare services. According to the Department of Community Health, more than 315,000 primary care and preventive care visits have occurred since the program was implemented. Enrollees are clearly engaged in improving their health and taking advantage of the services now available to them to do so. (more…)

400,000 reasons to give thanks

From the First Tuesday newsletter
Sign up for the newsletter and enews here

As we head into the month of November, there are more than 400,000 reasons to give thanks.

That’s how many previously uninsured or underinsured people in Michigan are now able to access healthcare thanks to the Healthy Michigan Plan.

The plan passed the Michigan Legislature last year with bipartisan support as part of Medicaid expansion under the Affordable Care Act. About half the states have taken this step to improve the health of their citizens.

The League was part of a strong, diverse coalition that supported the expansion. Those efforts are now bearing an amazing amount of fruit. (more…)

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