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

Chelsea Lewis

Chelsea Lewis

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…)

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