Health
6:00 pm
Fri October 5, 2012

Michigan takes another step towards health care exchange

State officials have chosen Priority Health HMO as the benchmark for a new health care exchange.

It's another step towards the inevitable - unless the next President and Congress make major modifications to the Affordable Care Act, or nullify it completely.

Uninsured people will be required to buy health insurance through state health care exchanges by January 1, 2014.

The state's decision means all other health insurance companies must offer at least the same level of benefits as Priority Health HMO.

Those benefits include preventive services like mammograms and well-child visits with no co-pay.

Priority Health HMO is the state's second largest, after Blue Care Network HMO.

Joan Budden is with Priority Health. She says the HMO offers a lot of preventive health care - and encourages members to use the care.

"So in the end if you do provide good quality care, it does result in lower health care costs, and I think it's been borne out in the study," says Budden.

Governor Rick Snyder is pursuing a state and federal government partnership that will run Michigan's exchange, after the state legislature failed to act to set up a state-only run exchange.

State Republican leaders hope the federal Affordable Care Act will be nullified.

As it is, the federal government plans to provide tax credits to people who can't afford to buy health insurance from a company that is in the exchange.

Employer-provided health insurance plans will also have to match the minimum level of benefits in the exchanges - unless the employer gets a waiver.

Individuals will not have to pay more than 9% of their income for health insurance. 

People who choose to remain uninsured will pay a tax penalty, which will increase every year until it reaches the maximum penalty.