Health
10:12 am
Wed September 11, 2013

6 things to know about healthcare changes in Michigan

Back in June, we wrote about some changes Michiganders will see in healthcare starting this fall. That's when people who currently do not have health insurance will be able to shop for a plan online.   

But a lot can change in three months — and that’s especially true when it comes to implementing the Affordable Care Act.

Here’s an updated rundown of what’s going on with healthcare in the Great Lake State.

So wait...what’s going on with Medicaid?

After a summer of ideological back-and-forth, the state’s House approved Medicaid expansion, sending the bill to Gov. Rick Snyder’s desk for his signature. Under that expansion, some 400,000 uninsured Michiganders will now be eligible for Medicaid.

But in the Senate, the bill “fell two votes short of giving it immediate effect.”

So what does that mean for Michigan’s uninsured?

As a result of the delayed implementation, those who are now eligible for expanded Medicaid will have to wait until the spring — probably March — to enroll.

But according to Michigan Radio’s political analyst Jack Lessenberry, we still don’t know if a tax penalty will apply to those who now won’t have insurance by the January 1, 2014 deadline. The ACA stipulates that the penalty will not apply to those who live in states where Medicaid expansion was not passed. What about people who live in states where it was passed, but where implementation will be delayed?

But how do I find out if I’m eligible for expanded Medicaid?

Good question.

Starting on October 1, healthcare exchanges — which are like online marketplaces for insurance — will go live.

Once these marketplaces are up on the web, you’ll be able to put in information about your income, your family size, and other details. The exchange will then inform you of your Medicaid eligibility, or point you to other subsidies and plans that may work for you.

But if you want to sneak a peek at what your eligibility might look like, head over to healthcare.gov.

Put in some of your information, and the site will give you an idea of what might be waiting for you in October.

Everyone keeps talking about the new Medicaid expansion covering folks whose income is below 138 percent of the federal poverty level. Can you tell me what that means without all the math?

Marianne Udow-Philips, director of the Center for Healthcare Research and Transformation, talked to Cyndy Canty about the upcoming changes to healthcare on Stateside.

Udow-Philips says If you’re an individual, and you make less than $15,900 a year, you’ll likely be eligible for Medicaid.

If you’re in a family of four, and your income is less than $32,500 a year, you’ll be eligible for Medicaid.

But my income is above those numbers, and I’m still looking for a better healthcare plan. What can the exchanges do for me?

This is where the tax credits come in.

If you’re an individual, and you’re making between $15,900 and $46,000 a year, you’re potentially eligible for subsidies that can lower your healthcare costs.

If you’re in a family and your income is between $32,500 and $94,200 a year, you may also be eligible for subsidies.

Remember, the tax credits are on a sliding scale, so in general, the lower your income, the more help you may be eligible for.

OK, so I’m going to check out my options on the exchange. What kind of prices can I expect to see?

Hold tight.

“We haven’t yet seen the prices announced in Michigan,” said Udow-Philips. “We’re expecting those to be announced in a couple of weeks, maybe a week or so before the exchange opens.”

But once they do come out, Udow-Philips emphasizes the fact that pricing is really going to depend — on a whole lot of factors.

When you log into the exchange, you’ll see four Olympic-inspired plans: bronze, silver, gold, and platinum.


As you go up the ranks, you’ll typically see broader coverage and lower co-pays — but for more money each month.

So depending on what plan you pick and how many tax credits you’re eligible for, you’ll see variations in the actual cost.

To give you an idea of what this has looked like in other states, Udow-Philips points to what’s going on with the Ohio exchange.

“In Cleveland, for a single adult who is 25 years old and has an income of $25,000 per year, the premiums on the Silver plan are $196 a month,” said Udow-Philips. But that individual would get a tax credit of $52 a month. So their actual cost for very good insurance would be $144 a month.”

I have a couple of preexisting conditions. How will that affect my ability to look for new insurance this year?

Whether you buy insurance on the exchange or not, starting in 2014, health insurance companies will no longer be able to exclude someone from coverage because they have a preexisting condition.

“That really was one of the most important things about this law,” said  Udow-Philips. “It’s really designed to make the market better.”

- Melanie Kruvelis, Michigan Radio Newsroom