Category: State and National News

Memo from Michigan Department of Insurance and Financial Services (DIFS) details how Republican budget bill would strip Michiganders of their access to affordable health care

 

Today, with the release of a new memo from DIFS, Governor Gretchen Whitmer highlighted the impact of cuts in the Republican budget bill to the Affordable Care Act (ACA). Their bill, including failure to extend enhanced premium tax credits, would raise Michigan’s uninsured rate and kick more than 120,000 Michiganders off their ACA Marketplace plans. Overall, the Republican budget will result in nearly 11 million Americans losing access to care and the cost of health care increasing for nearly every single person.

“Everyone deserves access to quality, affordable health care regardless of their income or work status,” said Governor Whitmer. “Right now, Republicans in Congress are rushing through dangerous cuts to critical health insurance programs that would threaten access to health care for 11 million people. Their bill would raise our uninsured rate by kick more than 120,000 Michiganders off their ACA plans. I’m grateful to DIFS for highlighting the devastating effect this Republican bill will have on the health of our most vulnerable friends, family, and neighbors while jacking up costs on everyone.”

“In Michigan, we’ve been working hard to get our uninsured rate down and help more Michiganders get care when they get sick,” said Lt. Governor Garlin Gilchrist II. “Republican cuts to health insurance programs will reverse our progress. Today’s memo demonstrates just how dangerous these cuts are for Michigan families and our economy. Governor Whitmer and I are proud of our work to expand affordable, accessible health care for Michiganders, and we will keep fighting to make a difference and build a Michigan where everyone can thrive.”

“DIFS is committed to protecting Michiganders and ensuring they have access to affordable high-quality health insurance,” said DIFS Director Anita Fox. “This proposal would limit health insurance access for Michiganders and raise out-of-pocket costs, jeopardizing Michiganders’ health and financial well-being. If consumers have questions about their health insurance, they can call DIFS at 877-999-6442, Monday through Friday from 8 a.m. to 5 p.m., or visit Michigan.gov/DIFS.”

“These reckless cuts to health insurance will leave families choosing between paying bills and getting care, worsening health outcomes, and driving up costs for everyone,” said Monique Stanton, President and CEO of Michigan League for Public Policy. “Politicians are using misinformation to justify cruel cuts to give tax breaks to the wealthy. Congress must reject these cuts and protect affordable health coverage for Michigan families, seniors, and people with disabilities.”

“Protecting and maintaining access to affordable health care ensures that we, as physicians, can continue to provide timely treatment and preventive services to all our patients, regardless of how they receive their health care,” said Amit Ghose, MD, President of the Michigan State Medical Society. “When fewer people can access quality, affordable health care, everyone will pay more and wait more to access their own.”

“The cuts to health insurance coverage that have been proposed in Congress will not only terminate health insurance coverage for hundreds of thousands of people in Michigan, they will slash the resources healthcare providers have to maintain essential healthcare services and result in reduced care for all patients,” says Phillip Bergquist, CEO of the Michigan Primary Care Association. “These cuts will amplify the healthcare access and workforce challenges we’re already navigating, making our communities less healthy, and we will all pay the price of cutting coverage.”

“All Michiganders deserve access to affordable and quality healthcare where and when they need it,” said Michigan Health & Hospital Association CEO Brian Peters. “These proposed changes will cut healthcare coverage for countless individuals, making Michigan unhealthier and leading to worse outcomes and higher rates of uncompensated care. Increasing healthcare costs and reducing access is a bad deal that Michigan hospitals uniformly oppose.”

Effect on U.S. and Michigan Uninsured Rate

Today, DIFS released a memo highlighting the effect Republican cuts to health insurance programs will have on Michigan’s uninsured rate. Since Governor Whitmer took office, she has worked to make health insurance more accessible and affordable by signing legislation codifying the ACA protections into state law and creating the Healthy Michigan Plan. As a result, Michigan currently has one of the lowest uninsured rates in the country of around 5.4%. The Republican bill could potentially result in 120,000 fewer people with health insurance coverage. Their plan would make qualifying for Marketplace coverage more difficult, removing many of the protections that make enrollment in coverage affordable and accessible. These changes would leave millions without coverage nationwide, increasing the uninsured rate as well as the burden of uncompensated care on the health care system.

Medicaid Expansion and Marketplace Impact

The Republican bill states that individuals who are denied or disenrolled from Medicaid due to work requirements are also ineligible for Premium Tax Credits (PTCs), a policy that helps people cover the costs of their health insurance. This addition will make Marketplace insurance unaffordable for individuals who have lost eligibility for Medicaid and strip them of other coverage options, forcing millions of Americans to become uninsured.

The bill would create a major coverage cliff that would leave Michigan adults at 100-140% of the federal poverty level (FPL) with no affordable health insurance options if they fail to meet Medicaid work requirements—even just once. For example, under this bill, a family of four earning between $32,150 to $45,010 would no longer be eligible for Medicaid nor would they have access to PTCs, leaving them uninsured and, potentially, one hospitalization away from bankruptcy.

Marketplace Access and Cost Increases

The bill does not extend the enhanced premium tax credits that make coverage more affordable for individuals purchasing in the Marketplace. Additionally, the bill rolls back protections that allowed eligible families more flexibility in enrolling for Marketplace insurance, reducing the window from year-round to a single month.

While this bill will hurt poor and vulnerable individuals the most, every single American’s access to affordable health care will be put at risk, regardless of income. By reducing access to affordable health care, this bill will dramatically increase the number of uninsured Americans, with ripple effects that will raise costs throughout the health care system.

More restrictive income and eligibility requirements will especially affect:

• Families with newborns who are waiting for Social Security numbers and birth certificates.
• Individuals experiencing income changes due to life events like marriage or job loss.
• Individuals whose income fluctuates throughout the year.
• The risk pool, as healthier people may choose not to enroll, which would lead to a weaker insurance risk pool.

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Contact your Senators to tell them you oppose these cuts: https://mpca.quorum.us/campaign/ProtectMedicaidFromCuts!/

Congress has proposed cutting $715 billion from Medicaid, considering imposing work requirements on people receiving their insurance through Medicaid.

However, this policy’s track record indicates that it may not deliver the savings the GOP desires. Instead, it will terminate healthcare for many and subject providers to unpaid medical bills.

Limited real-world experience suggests that Medicaid work requirements don’t promote employment or save large sums of money, but do cause many enrollees to lose coverage, such as what happened in Arkansas in 2018 and 2019.

Some 18,000 people lost coverage in Arkansas during that time, including many who qualified but were unable to navigate the bureaucracy of work requirements. Many people who should have been eligible got bumped purely over reporting issues, especially beneficiaries with chronic illnesses and other issues that made compliance difficult.

Similarly, the work requirements in Georgia’s “Pathways to Coverage” program aren’t faring any better. They anticipated 100,000 participants, but this month it was revealed that it has just 4,903. That meager enrollment is the product of spending $86 million to have Deloitte Consulting build a verification system that Georgia hasn’t actually used to enforce work requirements.

The 2023 House-passed Limit Save Grow (LSG) bill, which serves as the model for potential work legislation as part of the FY 2025 budget reconciliation, would ban flexible state approaches.  Instead, LSG would function as a massive, mandatory, nonwaivable federal funding clawback.

LSG has no phased-in implementation. States’ obligations would begin immediately on enactment, without time to put into place the automated information systems they will need to compile person-based monthly compliance data (for either work or exemptions) throughout a calendar year.

The only health exemption would be for people documented to be “physically or mentally unfit” for employment.  Even SSI/SSDI beneficiaries would not be exempt under this standard, since many people with disabilities do work.

Take action now to protect Medicaid from cuts: https://hcadvocacy.quorum.us/campaign/ProtectMedicaid/

Sources:

https://www.healthaffairs.org/content/forefront/limit-save-grow-medicaid-work-mandate-legislation-worst-way-operationalize-bad-policy

https://www.modernhealthcare.com/politics-policy/medicaid-work-requirements-arkansas-georgia

New statewide polling shows 83% of Michiganders want to see Medicaid spending increased or kept about the same as Congress considers cutting hundreds of billions of dollars from the Medicaid program, which would terminate healthcare for thousands of Michigan residents. The local results mirror national polls from the Kaiser Family Foundation, Modern Medicaid Alliance, and others consistently showing a lack of support for Medicaid cuts. 

EPIC·MRA, with support from the Community Mental Health Association of Michigan, Michigan Association of Health Plans, Michigan Health & Hospital Association, Michigan Primary Care Association, and Protect MI Care, conducted the new statewide poll to determine where Michiganders stand on proposed cuts to Medicaid.  

Across political views and party affiliations, the percentage of Michiganders who want to see Medicaid spending decreased does not exceed 20% for any specific group, with only 19% of self-identifying Republicans seeking reduced Medicaid support.  

Results reveal that 62% of Michigan residents believe the changes Congress is considering making to the Medicaid program are more about reducing federal spending than improving how the program works for people. Furthermore, 82% of Michigan residents oppose cutting Medicaid spending to pay for tax cuts, and 71% oppose cutting Medicaid in ways that would create a deficit in Michigan’s state budget. 

Reflecting on the significance of Medicaid in Michigan, the poll found that 86% of Michigan residents feel Medicaid is important for people in their local community and 76% express that Medicaid is important for their family members and friends. Michiganders’ feelings about the impact of Medicaid in their communities showed up statewide, with over 80% of people agreeing that Medicaid is important in their community across all regions of the state (From 86% in Wayne, Oakland, and Macomb Counties to 91% in West Michigan, 80% in Central Michigan, and 87% in Northern Michigan). 

“This data sends a clear message: Michiganders from across the state and all walks of life see Medicaid as the important lifeline it is,” said MPCA CEO Phillip Bergquist. “Medicaid cuts under consideration in Congress threaten the health and financial stability of families across our state, and Michiganders don’t support them.” 

2.6 million people get their health insurance through Medicaid in Michigan, representing approximately one in four Michiganders. Medicaid provides coverage for 38% of births in Michigan, 2 in 5 children, 3 in 5 nursing home residents, and 3 in 8 working-age adults with disabilities. And, Michigan’s Medicaid program is efficient, with per-enrollee costs among the ten lowest states in the country. 

To arrange interviews with MPCA or member health centers that would be impacted by potential Medicaid cuts, please contact Luke LaBenne at [email protected] or 517.827.0883.  

The Michigan Department of Health and Human Services (MDHHS) today released a new report detailing the severe impact of proposed Medicaid cuts on health outcomes across the state — a development the Michigan Primary Care Association (MPCA) warns is putting vulnerable communities at even greater risk.

MPCA is the voice of 48 member health centers that provide healthcare through over 400 locations across the state and serve one in every 15 Michigan residents. Michigan’s health centers- sometimes called Federally Qualified Health Centers, Tribal Health Centers, or Urban Indian Organizations- are community-based health organizations that deliver comprehensive primary care and other medical services, dental care, behavioral health care, substance use care, vision care, and more for patients of all ages in rural, urban, and tribal communities across the state of Michigan. Health centers operate as mission-driven, non-profit healthcare providers serving areas and populations that experience recognized challenges accessing healthcare or having sufficient healthcare providers in their area.

On a statewide basis, patients who get their health insurance through Medicaid make up 51% of all Michigan health center patients. Health centers’ patient populations in Bay, Berrien, Calhoun, Cass, Genesee, Grand Traverse, Ingham, Jackson, Kent, Macomb, Monroe, Muskegon, Kalamazoo, Oakland, Saginaw, and Wayne counties could be particularly impacted by proposed changes to the Medicaid program. Health centers serve more adult Medicaid patients in those areas, and many potential Medicaid changes focus on adults.

Proposed changes to the Medicaid program could also negatively impact the stability of health center services. Health centers, which already operate on thin margins, now face even more difficult decisions about staffing, services, and facility operations. Without urgent action to restore and strengthen Medicaid coverage, MPCA warns that more clinics could be forced to scale back critical programs or even close their doors.

This would lead to worse health outcomes throughout the state, including:

• A measurable increase in emergency room visits for preventable conditions
• Decreased access to prenatal and maternal care in underserved areas
• Higher rates of untreated chronic illnesses, particularly diabetes and hypertension
• Financial instability for primary care providers serving low-income populations

“Our health centers are safety nets for their communities,” said MPCA CEO, Phillip Bergquist, “We need to protect Medicaid from cuts not only to keep Michiganders healthy but also to safeguard public health.”

Most of the resources that health centers have to serve their communities come from being reimbursed for the patient services they deliver, and statewide Medicaid makes up 63% of patient services revenue in health centers annually. Losing a meaningful portion of Medicaid revenue could jeopardize the sustainability of some health center services and locations for everyone, not only people who get their health insurance through Medicaid.

If enacted, adult work requirements could result in 52,000 Michigan health center patients who get their health insurance through Medicaid losing coverage and health centers seeing a reduction in revenue of around $38.3 million annually. For comparison, that revenue loss would be equivalent to losing 30% of the federal health center program funding Michigan health centers receive annually, endangering the availability of essential care for tens of thousands of people.

MPCA calls on lawmakers to protect Medicaid from cuts, which would have dire consequences for communities throughout Michigan.

For a copy of the MDHHS report or to arrange interviews with health center leaders impacted by the cuts, please contact Luke LaBenne at [email protected] or 517.827.0883.