House Subcommittee Approves DCH Fiscal Year 2015 Budget

Full report in PDF

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

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

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

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

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

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

Medicaid

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

Governor’s Budget:

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

House Subcommittee:

  • The House subcommittee concurred with the Executive Recommendation.

Governor’s Budget:

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

House Subcommittee:

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

Governor’s Budget:

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

House Subcommittee:

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

Governor’s Budget:

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

House Subcommittee:

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

Governor’s Budget:

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

House Subcommittee:

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

Healthy Kids Dental

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

Governor’s Budget:

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

House Subcommittee:

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

 

 

 

Mental Health and Substance Abuse Services

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

Governor’s Budget:

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

House Subcommittee:

The House subcommittee concurred with the Executive Recommendation.

Governor’s Budget:

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

House Subcommittee:

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

Governor’s Budget:

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

House Subcommittee:

  • The House subcommittee concurred with the Executive Recommendation.

Public Health and Children’s Services

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

Governor’s Budget:

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

House Subcommittee:

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

Governor’s Budget:

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

House Subcommittee:

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

Governor’s Budget:

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

House Subcommittee:

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

Governor’s Budget:

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

House Subcommittee:

  • The House subcommittee concurred with the Executive Recommendation.

Governor’s Budget:

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

House Subcommittee:

  • The House subcommittee concurred with the Executive Recommendation.

Services for the Aging

Governor’s Budget:

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

House Subcommittee:

  • The House subcommittee concurred with the Executive Recommendation.

Governor’s Budget:

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

House Subcommittee:

  • The House subcommittee concurred with the Executive Recommendation.

Governor’s budget:

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

House Subcommittee:

  • The House subcommittee concurred with the Executive Recommendation.

House Subcommittee Initiatives

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

 

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

Full report in PDF

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

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

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

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

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

Details on specific Executive Budget recommendations follow:

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

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

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

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

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

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

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

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

Services for the Aging:

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

Exhausted but inspired

I recently returned from Health Action 2014, Families USA’s annual conference, in my usual condition – exhausted yet inspired! It was a good year for Michigan: Dizzy Warren, of Michigan Consumers for Healthcare, was awarded one of the three Advocate of the Year awards, and Michigan blogger Amy Lynn Smith won the painting created onsite by Regina Holliday!

The conference opened with a cancer survivor sharing her story of having her COBRA coverage end on Dec. 31, 2013 during her cancer treatment. Thanks to the Affordable Care Act, she was able to sign up for coverage starting Jan. 1 and continue her treatments uninterrupted.

She introduced Vice President Joe Biden who shared his relief that we will no longer debate whether healthcare is a right or a privilege. With implementation of the ACA, it’s a right.

“And we’re not going back!” Biden said.

He stressed the importance of healthcare coverage, sharing his own story, and spoke of the peace of mind those who gain coverage will experience.

A few highlights:

  • Ezra Klein shared thoughtful comments about the need to implement the law, learn from experience, and modify it as needed. The ACA is a real law, and because of it, real people are able to go to the doctor!
  • Kentucky Gov. Steve Beshear embraced the Affordable Care Act as a great opportunity for historic transformation in his state. “It is the morally right thing to do,” he said. Through an executive order, he established a state-operated marketplace, and through executive authority he was able to expand Medicaid eligibility. He expressed disappointment that more states are not setting politics aside and doing what is right and best for the people.
  • Dr. Harold Freeman described his patient navigator programs which coordinate care and remove barriers to needed services by piecing together the fragmented healthcare system for individual people. He described it as a ‘relay races in which the patient is the baton and the hand-offs must be well done.’
  • George Halverson shared a number of stunning statistics on brain development and the need for interventions and upstream efforts similar to those used in the medical system to prevent heart attacks or strokes. The No.1 predictor of who will go to jail can be linked to the number of words in a child’s vocabulary upon kindergarten entry! Furthermore, 70% of people in jail can’t read or read poorly. The first three years of brain development are critical and current science can predict with high accuracy who will be able to read and who won’t. It was a most sobering presentation.
  • Regina Holliday, an inspiring presenter, talked about using art in patient advocacy efforts. She used art to sustain her in her grief after her 39 year-old husband died. She painted during the conference; Amy Lynn Smith won the painting.

The conference was chocked full of great presentations and workshops. I presented on Michigan’s Bumpy Journey to passing the Medicaid expansion legislation. I was thrilled to be able to say that Michigan has done the right thing.  It was heartbreaking to hear the stories from the states where policymakers are refusing to accept the federal funds to expand Medicaid eligibility.

There is still much to be done to make the promise real.  Time to get to work!

– Jan Hudson

Walking the walk with infant mortality

Factors that may drive Michigan’s tragically high infant mortality rate include stress, unemployment, poverty and neighborhood safety in addition to what might be thought of as the more traditional reasons, such as lack of healthcare or poor safe sleep practices, according to a new report from the Michigan Department of Community Health. The report takes a broad look at why Michigan’s rate is so high and in particular why an African American infant in Michigan is 2.6 more times likely to die before reaching the child’s first birthday than a white infant. (more…)

Mapping the facts

Did you know that Michigan has the longest freshwater shoreline in the world?  That would certainly explain why we have more lighthouses than any other state.  Michigan also has the largest state park and state forest system of any state and is the biggest producer of tart cherries in the United States.

Click here to go to Mapping the Facts

But it also has the 15th-highest poverty rate in the nation and the fourth-highest unemployment rate.  And while one in every four children in the state lives in poverty, it’s much higher in Lake County where almost half of all children live below the poverty line, the highest in the state.  And while you may know that Isabella County has the highest poverty rate in Michigan at 30%, did you know that Clare County has a higher poverty rate than Wayne County?  Or that Baraga County has the highest unemployment rate and Washtenaw County the lowest? (more…)

Two steps forward….

From the First Tuesday newsletter
Sign up for newsletter and email alerts

Tuesday marked two beginnings: The start of a new state budget year and the launch of the enrollment period for the Health Insurance Marketplace — all while the specter of a federal shutdown begins.

The Oct. 1 start of the state fiscal year represents our big opportunity to address inequities, close gaps and set the investments for the future of Michigan. The new budget has a mixed record in that regard. To be applauded is the impressive bipartisan effort, led by Gov. Rick Snyder, to expand Medicaid in our state. As a result, we will be able to pay for the medical care of hundreds of thousands of uninsured adults in Michigan using available federal dollars. (more…)

Medicaid expansion approved but implementation delayed

It’s thrilling that the Legislature has finally approved the expansion of Medicaid eligibility providing the opportunity for up to 470,000 low-income, uninsured parents and individuals to gain healthcare coverage. That is great news!

It’s not thrilling, however, that the Senate did not give the bill “immediate effect,” meaning that rather than the Jan. 1, 2014 effective date included in the bill, implementation could be delayed until April 1, denying coverage to uninsured residents for an extra three months. (more…)

Medicaid is not broken

Medicaid is not broken. That is the conclusion reached by the Center for Healthcare Research and Transformation in its newly released analysis  of the Cover Michigan Survey 2013. The report found that those using Medicaid as their source of  health coverage in 2012 were more satisfied than those using Medicare or private insurance.

The survey found that 65% of responders with Medicaid rated their coverage as excellent or very good, with 19% rating Medicaid as good. With an overall positive rating of 84%, it is hard to conclude that Medicaid is broken. (more…)

Take a vote, save a life

Please call your state senator and encourage him/her to ‘take a vote and save a life’ by voting for the expansion of Medicaid eligibility as called for in the Affordable Care Act – it’s truly a matter of life and death.

In its report, Dying for Coverage, Families USA found that 763 Michiganians between the ages of 25 and 64 died prematurely due to lack of healthcare coverage in 2010. The expansion of Medicaid eligibility to citizens with incomes below 133% of the federal poverty level ($15,282 for a family of one, $25,975 for a family of 3) will allow that number to be dramatically reduced and provide care for the sick and protection for the healthy. (more…)

Celebrate July 4th by participating in democracy

From the First Tuesday newsletter
Sign up for news and alerts

As you prepare to celebrate the Fourth of July and the founding of our democracy, please exercise your right to participate by signing a petition or contacting your state senator to support the Healthy Michigan plan.

This is the expansion of Medicaid under the Affordable Care Act that will extend health insurance to low-income uninsured adults, the majority of whom are working. A hearing will be held at 9:30 a.m. Wednesday followed by a Senate session at 10 a.m., though the full Senate is not yet expected to take up the issue. (more…)

Next Page »