affordable care act

"It’s not perfect, it does need to be fixed," said Udow-Phillips on the Affordable Care Act. "But it’s a place to start from.”
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Word came from the federal government this week: premiums for popular health plans sold on are going up an average of 25% next year.

And, depending on where you live, you may have fewer choices when shopping on the exchange.

According to Jay Greene, the biggest turnaround for hospitals was in Southeast Michigan because the number of uninsured people dropped so significantly.
Phalinn Ooi / Flickr -

It's been more than two years since the Healthy Michigan Plan opened the Medicaid rolls to over 600,000 low-income Michiganders. What has this meant for the financial health of Michigan's hospitals and health plans?

According to Jay Greene of Crain's Detroit Business, the numbers show that hospitals are thriving under the Affordable Care Act and the Healthy Michigan Plan.

When the Affordable Care Act became law, many thought hospitals would be overwhelmed by new patients. The data show otherwise.
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The Healthy Michigan Plan launched in April 2014. It opened the Medicaid rolls to hundreds of thousands of low-income people for the first time. And no one was quite sure what to expect.

There were widely held fears that the flood of previously uninsured people would make it harder for everyone to get doctor's appointments, and that hospitals would be overloaded with seriously sick patients who, until then, didn't have insurance coverage.

Now, two years down the road, there's enough data for experts to study and analyze.

Insurance companies in Michigan are asking for, on average, 17.2% higher rates for individual plans next year.
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The insurance companies offering health plans on Michigan's public exchange have a collective eye fixed on January 1, 2017.

That's when they hope they'll be able to start charging, on average, 17.2% more for individual health insurance plans.

Marianne Udow-Phillips joined us today to talk about what's behind these hefty rate increase requests.

steve carmody / Michigan Radio

Rates could be going up next year for people who buy health insurance on Michigan's public exchange.

More than a dozen companies have submitted requests for rate changes to the Michigan Department of Insurance and Financial Services (you can see the requests here). The companies that sell to the largest share of the individual market are Blue Care Network with a 14.8% requested increase, Blue Cross Blue Shield at 18.7%, and Priority Health at 13.9%.

The average increase is 17.2%.

Most religions have some basic creed all members are supposed to profess. Many political parties do as well.

I’m not sure what that would be for Democrats these days.

But for today’s Republicans, one basic article of faith is bitter opposition to the Affordable Care Act, perhaps better known as Obamacare.

Virtually every Republican running for federal office has vowed to work to repeal Obamacare.

Actually, they usually say “repeal and replace,” though they are usually pretty vague about what, if anything, they’d replace it with.

Gov. Snyder's proposed budget would set aside over $100 million for the Healthy Michigan plan
Zoe Clark / Michigan Radio

Gov. Rick Snyder’s new budget contains over $100 million for Healthy Michigan.

That’s a reminder that it’s time for the state of Michigan to pony up some of the Medicaid expansion program’s operation cost. That Healthy Michigan program means health insurance for some 600,000 lower-income Michiganders.

There must be Republican strategists who are secretly relieved and happy that the U.S. Supreme Court upheld the subsidies that help millions buy health insurance.

Had they ruled the other way, not only would millions of people have lost coverage, but it would have caused immense problems for a private health insurance market that has changed the way it does business to comply with the Affordable Care Act, usually known as Obamacare. Opponents were hoping the high court would invalidate the subsidies based largely on semantics.

The U.S. Supreme Court.
Supreme Court of the United States

The U.S. Supreme Court has ruled in favor of one of the central parts of the Affordable Care Act, keeping the law in place in states throughout the country.

Their decision comes three years after the high court upheld the constitutionality of the law.

The case before the court, King v. Burwell, centered on health care exchanges run by the federal government – as is the case in Michigan.


Five years ago today, President Obama signed the Affordable Care Act into law. It’s the law widely known as “Obamacare.”

The University of Michigan’s Center for Healthcare Research & Transformation decided to see what Obamacare has meant for Michigan and the results of their survey are out today.

If Marianne Udow-Phillips, director of the Center for Healthcare Research and Transformation, had to grade the ACA, it would earn “certainly no lower than a B.”

Andrian Clark / Flickr

DETROIT - Federal health officials say about 300,000 Michigan residents have signed up for health care through the federal exchange, most with financial help.

U.S. Health and Human Services Secretary Sylvia Burwell told reporters Tuesday that the 299,750 sign-ups as of Jan. 16 represent those who have selected a health plan or re-enrolled, not paid. Of those, 33% enrolled for the first time.

Marianne Udow-Phillips is Director of the University of Michigan's Center for Healthcare Research.
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Marianne Udow-Phillips, Director of the UM Center for Healthcare Research, is not making any more predictions. 

At least, not about health insurance coverage rates in Michigan.

Alex Proimos / flickr

Most Michigan patients should be able to access primary care doctors - even though the Affordable Care Act means more people are likely looking for appointments.

Nine out of ten Michigan primary care doctors say they have capacity for new patients. And almost two-thirds say they are accepting new Medicaid patients.  That's according to a 2014 survey conducted by the Center for Healthcare Research & Transformation.

Satori World Medical / Flickr

Open enrollment for the Affordable Care Act is in its second year. Many of the benchmark plans that were available for 2014 are changing for 2015.

How has enrollment been going and what do we need to know as we enroll? Marianne Udow-Phillips is the Director of the Center for Healthcare Research and Transformation at the University of Michigan.

*Listen to Udow-Phillips above.

Lord Mariser / Flickr

The U.S. Supreme Court has agreed to hear yet another challenge to the constitutionality of the Affordable Care Act.

The case, King v. Burwell, argues that because of the wording in a clause of the ACA, people who get insurance through a federal exchange and not a state-run exchange should not be entitled to tax credit subsidies.

As the Obamacare battle continues, Dr. Howard Markel, physician and medical historian from the University of Michigan, thinks it might be helpful to look back -- 69 years back, to this exact day, November 19, in 1945. That’s when President Harry Truman spelled out a ground-breaking idea: a “universal” national health care program.


Health insurers and are now gearing up for year two of the Affordable Care Act.

Open enrollment begins two months from today – November 15. And this year, there's a new twist: renewals and plan changes.

Marianne Udow-Phillips is the director of the Center for Healthcare Research and Transformation at the University of Michigan. She says consumers have to do their homework to compare different health plans this year.

"Some [rates] are up, and some are down ... Even those who have coverage now, it would be very important for consumers to actually look at the choices again and see what is the best match with the premiums and the networks that are offered," says Udow-Phillips.

* Listen to our conversation with Marianne Udow-Phillips above.

Genesee Health System in Flint, MI. One of the MI health service centers to receive Affordable Care Act funding.
Genesee Health System / Facebook

Three-dozen health care centers in Michigan are being given more than $8.5 million in Affordable Care Act funding. 

The announcement was made Friday by U.S. Health and Human Services Secretary Sylvia Burwell. In all, $295 million was awarded to 1,195 centers across the country. 

According to a press release from the U.S. Department of Health and Human Services, the funding will enable targeted health centers to:

Outside the Community Health and Social Services Center in Detroit.
CHASS / Facebook

Part of the Affordable Care Act calls for big investments in community health care centers to increase access to primary health care services. The health care law calls for a total investment of $11 billion over a five-year period “for the operation, expansion, and construction of health centers” throughout the country.

Today, Health and Human Services Secretary Sylvia Burwell announced that $35.7 million in Affordable Care Act funding will go to 147 health centers in 44 states.

The funding will support 21 new construction projects and 126 renovation projects.

Seven of those health centers are in Michigan. These seven centers will split close to $1.7 million to support construction and facility improvements.

Here’s the list of health centers receiving funding:

ACA ruling and its impact on Michigan

Jul 24, 2014
Michigan State Capitol
Jimmy Emerson / Flickr

This week two separate federal appeals court rulings came down on opposite sides of a key provision in the Affordable Care Act. This leaves thousands of low and middle income Michiganders who signed up for healthcare through Michigan’s exchange in a bit of limbo. 

Jennifer White, host of All Things Considered, is joined by Marianne Udow Phillips, Director, Center for Healthcare Research and Transformation and Ken Sikkema, former Senate Majority Leader and Senior Policy Fellow at Public Sector Consultants. 

Phillips states that although these rulings were issued nothing is going to change immediately and that it is important to understand that the legal rulings will take time to play out. 

“It would have a huge impact and it would really push the whole system into chaos,” explains Phillips. “There are 240,000 in Michigan who have already gotten health insurance coverage through the health insurance exchange with a subsidy, and so were they to lose that subsidy, almost all of them would not be able to afford healthcare coverage.” 

Sikkema states that it is a very polarizing topic and coupled with an election year, politicians and candidates have honed in on the issue. “It already is a big political issue; it’s the primary political issue for Republicans who are running for office” says Sikkema, “but it’s really hard to look in your crystal ball and see what the future of the Affordable Care Act is going to be.”

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In less than four months, Michigan has already hit its 2014 enrollment goal for the state’s expanded Medicaid program.

More than 322,000 low-income Michiganders now have government sponsored healthcare through the Healthy Michigan program.

Officials with the Michigan Department of Community Health (MDCH) say the dramatic jump in enrollment will help boost the state’s economy.

“We’ve heard stories about people who are now addressing some really serious health problems that prevented them from working,” said Angela Minicuci, a spokesperson for MDCH.

Lindsey Smith / Michigan Radio

The federal health care exchange for private insurance under the Affordable Care Act closed on March 31. 

The very next day, the attention turned to Healthy Michigan, the state's expanded Medicaid system for some 477,000 low-income Michiganders.

It looks like the state's Healthy Michigan plan is on track for enrollee sign-up.

Don Hazaert is the director of Michigan Consumers for health care, which helps people sign up for the coverage.

*Listen to the full interview above. 

A computer screen showing in action.
Steve Carmody / Michigan Radio

That's one of the lessons drawn from a report put out by the law firm Mehri & Skalet.

The author of the report, Jay Angoff, once led the U.S. Health and Human Services office in charge of implementing the Affordable Care Act.

Angoff looked at the amount it cost to set up health care exchanges in each state along with the number of enrollees in each state through March 31, 2014.

By doing that, he came up with a “cost-per-enrollee” for each state’s health care exchange.

Overall, the average cost-per-enrollee was $922. The average cost was higher for states with their own exchanges, and lower in states with the federally-run exchange.

Farm in rural Michigan
user acrylicartist /

One of the most important aspects of the Affordable Care Act is consumer choice. More choice leads to more competition among insurers, and that can mean lower costs to consumers.

But, as Michiganders shopped for health coverage on the federal marketplace, the amount of choice was not even.

If you lived in Wayne, Oakland or Macomb Counties, you got to choose from 55 insurance plans. If you lived in Delta County in the Upper Peninsula, you were only offered 5 plans, all of them from Blue Cross Blue Shield of Michigan.

Josh Fangmeier is a health policy analyst with the Center for Healthcare Research and Transformation. He joined us today.

Listen to the full interview above.

One of the most important aspects of the Affordable Care Act is consumer choice. More choice means more competition among insurers, and that can lead to lower costs for consumers.

But if you live in a rural area, you may not have a whole lot of choices when it comes choosing a health plans. On today's Stateside, we took a look at health care in Michigan's rural areas.

Then, Michigan’s new crowdfunding law opens the door to everyday people who want to invest in Michigan-based startups and small businesses. We heard about the benefits and risks that come with crowdfunding for equity.

And, we spoke with Garrison Keillor about the 40th anniversary of A Prairie Home Companion and his upcoming book.

First on the show, Detroit Emergency Manager Kevyn Orr is in Lansing today and tomorrow, getting face-time with the lawmakers whose vote is crucial to the so-called grand bargain, the complicated deal to protect city retirees and the collection at the Detroit Institute of Arts.

Orr heads to Lansing with a new piece of the puzzle in hand: a tentative five-year deal reached Monday with AFSCME, Detroit's largest employee union.

Detroit News reporter Chad Livengood joined us today to give us an idea of what progress has been made and what lies ahead for the city.

Jonathan Oosting

The Affordable Care Act shop door now has a "closed" sign on it, for the most part.

The open enrollment deadline passed at midnight.

Attention in Michigan now swings over to Healthy Michigan.

That's the official name for Michigan's expanded Medicaid program. It allows the state to bring more low-income residents into the Medicaid fold using funding available through the Affordable Care Act.

And Michigan's Medicaid expansion is something other states are watching because of a couple of important new twists to the program.

MLive Capitol reporter Jonathan Oosting joins us now.

Today is the day.

If you don’t sign up for health-care coverage by midnight tonight, you might not be able to get coverage until next year. And if you choose not to get covered, you might get dinged on your 2014 taxes –also known as the "individual shared responsibility payment."

If you can afford health coverage, but you decide to do without, here's how much you might have to pay:

  • In 2014, it's 1% of your yearly income or $95 per person, whichever is higher.
  • In 2015, it’s 2% of your yearly income or $325 per person, whichever is higher.
  • In 2016 and later years, it’s 2.5% of your yearly income or $695 per person, whichever is higher. 
  • After 2016, the fee is adjusted for inflation.

To avoid any potential fees, you need to sign up by tonight.

There are exceptions.

When you think "Michigan," you think tourism, right? Or, for some, maybe it's Tim Allen telling you about the state's open roads, fall colors, glistening lakes. Tourism means big business for the mitten. We look at how the changing climate might impact what more than 4.4 million out-of-state visitors will be able to do and enjoy when they come to the Great Lakes State. 

 Then, we spoke with Michigan author Laura Kasischke about her latest novel, Mind of Winter. And Daniel Howes joined us for our weekly check-in, to discuss Mary Barra and the ghost of GM's past. Also, women are underrepresented in the  STEM (science, technology, engineering and mathematics) fields, but there is one University of Michigan student group trying to change that. And, we are one week into spring but still getting snow. Meterologist Jim Maczko spoke with us about when we can expect warmer weather.  First on the show, we are closing in on the deadline to purchase health insurance or face a penalty under the Affordable Care Act. 

Erin Knott is the Michigan Director of Enroll America, a non-profit, non-partisan group trying to get people enrolled in health insurance.

Erin joined us today to discuss the upcoming deadline. 

user striatic / Flickr

We are closing in on the deadline to purchase health insurance or face a penalty under the Affordable Care Act. Erin Knott is the Michigan Director of Enroll America, a non-profit, non-partisan group trying to get people enrolled in health insurance.

Erin joined us today to discuss the upcoming deadline. 

Listen to the full interview above.

Andrian Clark / Flickr

March 31 looms ever closer.

That's the deadline for you to get health insurance under the Affordable Care Act. After then, you'll only be able to get insurance on the health care exchange when there's a big change in your life: a birth, divorce, death, losing your employer-sponsored insurance, or moving to another state.

The latest numbers show 144,586 people in Michigan have gotten health insurance under Obamacare.

And, with more people covered, doctors and hospitals are expecting an uptick in treating one of our state's biggest health challenges: obesity. 

We're joined by Heather Howard, program director of the State Health Reform Assistance Network. 

Listen to the full interview above.

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There is little question that the Affordable Care Act is a game-changer for Americans who had jobs where no insurance was available from their employer, or who had pre-existing conditions, or whose incomes did not qualify them for Medicaid, or who could not afford to buy health coverage.

But as the health care picture brightens for these Americans, there are others who are, frankly, sick of the ACA and the upheaval it has brought to their lives.

Detroit News business columnist Daniel Howes took a look at what the ACA has meant for a typical small Michigan business.

Howes joined us today and we asked him to tell us about American Gear & Engineering. It’s the company he profiled in today's column of the Detroit News.