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

For Immediate Release
March 16, 2017

Contact:
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.

“We are pleased to see an increase in school funding for at-risk students to help address the extra support that students struggling with poverty and hunger and toxic stress need, and a $60-per-child increase in the state’s school clothing allowance that helps provide clothes for children living in families with low incomes. Today’s budget included funding for the Part-Time Independent Student Grant to help adult students pursue a college degree, something the League has been advocating for years. And we appreciate the governor’s continued call for investment in infrastructure and support for the people of Flint to help them recover and get clean water.

“But all of these encouraging investments could disappear tomorrow if the Legislature goes against the governor’s budget and cuts the state income tax, eroding $250 million to $9 billion from the state’s funds. Kansas and several other states have already made this mistake and suffered severe consequences, and now Republican legislators there are scrambling to undo the policy. If legislators really want to help the people of Michigan, especially those who are barely getting by, they should pass these positive investments, not something that will undermine them.”

The League’s support of the Heat and Eat program was even quoted in the governor’s executive budget (Page 46) released today. The League also continues to warn against the damage a cut to the state income tax could cause, and Kansas, one of the states that has passed a similar measure, is already looking to repeal it.

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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.

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
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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…)

Healthy Michigan plan enrollment tops 275,000

Enrollment in the Healthy Michigan Plan as of June 2 totals 276,622. This is truly remarkable considering the program was implemented just over two months ago on April 1. Genesee County, at 98.5%, has enrolled the highest percentage of those potentially eligible. What a great achievement.

The Healthy Michigan Plan is Michigan’s unique Medicaid expansion plan. It provides comprehensive healthcare coverage to Michigan’s low-income uninsured residents. To be eligible for the program, an individual must be between the ages of 19 and 64, not currently eligible for Medicaid or Medicare, a citizen or lawfully admitted to the U.S., and have income less than 133% of the federal poverty level (up to $15,521 for an individual or $31,721 for a family of four).

Application for the program can be made by phone (1-855-789-5610), online at www.michigan.gov/mibridges, or in person at a local Department of Human Services office. Applications made through the on-line system can have eligibility determined in a matter of minutes and sometimes even seconds. (more…)

House and Senate Approve Corrections FY 2015 Budget

Full Report in PDF

Both the House and Senate have approved their versions of the Fiscal Year 2015 budget for the Department of Corrections, and differences between the bills will now be resolved at a joint House/Senate conference committee.

The total DOC budget approved by the House is $2.04 billion, including $1.98 billion in state General Fund. This is a 0.1% ($2.5 million) increase in total funding, and a 0.9% ($17.2 million) increase in state General Fund dollars, compared with year-to-date funding levels as of Feb. 5, 2014.

The total DOC budget approved by the Senate is $2.03 billion, including $2.0 billion from the state General Fund. This is a 0.3% ($6.5 million) decrease in total funding, and a 0.7% ($14.5 million) increase in state General Fund dollars, compared with year-to-date funding.

The DOC budget is the fifth largest in Michigan, accounting for around 4% of total appropriations from all fund sources in the current fiscal year. When state General Fund monies are considered alone, the DOC budget is the state’s second largest, accounting for 21.3% of the General Fund.

Both the House and Senate budgets are lower than the governor’s recommendation, by $15 million and $24 million respectively. Major discrepancies include funding for a new Hepatitis C treatment program, which the governor’s budget includes but the House and Senate budgets do not; as well as funding for two prisoner re-entry legal services pilot programs, which the House includes, but the Executive and Senate budgets do not.

Included in the DOC budgets are the following changes:

Healthy Michigan Plan

GOVERNOR:

  • Recognizes full-year savings of $19.1 million in state General Fund in Fiscal Year 2015 as a result of the implementation of the Healthy Michigan Plan. Under this plan, low-income individuals ages 19-64 – who are not eligible for or enrolled in Medicaid or Medicare, are not pregnant, and have incomes up to 133% of the federal poverty level – qualify for comprehensive healthcare. The current year budget assumed that most prisoner inpatient hospitalizations, certain services for mentally ill and medically fragile inmates, and some re-entry services would be covered. However, it was subsequently determined that certain treatments for sex offenders and substance abuse are not eligible for Medicaid reimbursement. The executive budget acknowledges that these services are not covered by federal funds, and reinstates $5.1 million in state funds to cover the costs.

HOUSE:

  • Concurs with the governor.

SENATE:

  • Concurs with the governor.

New Hepatitis C Treatment Protocol

GOVERNOR:

  • Includes $4.9 million in new funding to implement a treatment protocol for Hepatitis C, as recommended by the Centers for Disease Control and Prevention. Current treatment duration can take up to one year; includes side effects such as depression, anxiety and anemia; and is not guaranteed to cure the disease. The drugs recently approved by the Federal Drug Administration shorten the treatment period to 12 weeks, have fewer side effects, and a success rate of approximately 95%.

HOUSE:

  • Does not concur with the governor.

SENATE:

  • Includes a $100 placeholder to ensure discussion of the issue in conference committee, expressing concerns about the higher cost of the new treatment protocol.

Mental Health Diversion Council

GOVERNOR:

  • Includes $1 million in state funding for a pilot project that will connect inmates in one local jail with comprehensive mental health treatment as they transition back into the community. This funding is part of the implementation of the recommendations of the Mental Health Diversion Council created by the governor in 2013. This council is tasked with developing methods to divert individuals with mental illness or substance abuse problems out of the criminal justice system and into appropriate treatment.

HOUSE:

  • Concurs with the governor.

SENATE:

  • Concurs with the governor.

Prisioner Education Enhancement

GOVERNOR:

  • Includes $4.3 million General Fund (of which $1.1 million is one-time funding) to expand prisoner vocational education and prepare parolees for entry into the workforce. The added funding will be used to hire 15 additional employment counselors and five instructors. This initiative will focus on helping inmates acquire skillsets that are in demand by employers and connect inmates with employers prior to their release.

HOUSE:

  • Concurs with the governor.

SENATE:

  • Does not include this funding.

Michigan State Industries

GOVERNOR:

  • Includes $12.3 million in restricted funds to cover the administrative costs of Michigan State Industries. MSI is a DOC program that employs inmates while imprisoned. MSI’s stated goal is to give inmates an opportunity to acquire job skills and experience in preparation for their release.

HOUSE:

  • Concurs with the governor.

SENATE:

  • Reduces funding for this program by $6.2 million (50%) in restricted funds, and calls for a study of the program by December 2014.

Goodwill Flip the Script

Flip the Script is a program of Goodwill Industries of Greater Detroit, which provides education, job training and mentoring for young males, 19-29 years old, to encourage their self-sufficiency and prevent their entry into the justice system.

GOVERNOR:

  • Does not include funding for the program, which is a new line item in the Senate budget.

HOUSE:

  • Does not include new funding.

SENATE:

  • Includes $4.5 million in state funds for Flip the Script.

Swift and Sure

The Swift and Sure Sanctions Probation Program is a joint project with Michigan Rehabilitation Services in the Department of Human Services, and is designed to assist mentally and physically disabled probationers find employment.

GOVERNOR:

  • Does not include new funding.

HOUSE:

  • Does not include new funding.

SENATE:

  • Includes $3 million in additional funding to expand The Swift and Sure Sanctions Probation Program.

Prisoner Re-entry Legal Services

Re-entry legal services is a pilot program that would assist ex-offenders with employment, housing, child support and other related matters by providing outreach, education and legal representation.

GOVERNOR:

  • Does not include funding for the program, which is a new line item in the House budget.

HOUSE:

  • Adds $449,000 in state General Fund for two pilot programs to be established in Kent and Oakland counties (the latter also serving Wayne County).

SENATE:

  • Does not include new funding.

Re-entry, Parole, Probation and Community Programs

GOVERNOR:

  • The governor recommends $311.7 million in total funding for re-entry, parole, probation and community programs, a decrease of 4.9% ($15.9 million) compared with year-to-date funding. This decrease reflects expected savings from the implementation of the Healthy Michigan Plan, expected reductions in federal grants, and a transfer of funds to the Correctional Facilities Unit for the newly re-opened Detroit Detention Center.

HOUSE:

  • Includes $312.2 million for re-entry, parole, probation and community programs, a decrease of 4.7% ($15.5 million) compared with year-to-date funding.

SENATE:

  • Approves $315.5 million for re-entry, parole, probation and community programs, a decrease of 4.3% ($14.1 million) compared with year-to-date funding.

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. (more…)