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affordable care act

Kaiser Family Foundation

updated 1:23 p.m.  from Gongwer News Service:

With the vote, House Speaker Jase Bolger (R-Marshall) issued a statement saying there will be no state-run exchange. Bolger spokesperson Ari Adler said it is "highly unlikely" the bill will be reconsidered.

The Affordable Care Act requires that states set up online "health insurance exchanges" by 2014 so consumers can shop for their insurance plans.

The exchanges are supposed to work like an Expedia or Travelocity for health insurance.

If states don't set one up, they'll be required to use a federal exchange.

Republicans in the Michigan legislature have resisted setting up a state-run exchange, hoping the Supreme Court or a Republican President would knock down the Affordable Care Act.

Neither of those things happened, but the resistance continues, as Chris Gautz of Crain's Detroit Business reports today:

The state House Health Policy Committee this morning voted down a bill that would have created a state-based health insurance exchange, with Republicans continuing their opposition.

Rep. Gail Haines, R-Lake Angelus and chairwoman of the committee, voted yes on SB 693 — to audible groans from those packed into the hearing room. But the measure failed on a 9-5 vote, with two abstentions.

A motion then was made to reconsider the vote, which Haines moved to pass for the day and then adjourned the meeting.

Gautz reports "It is unclear whether the House committee will take up the bill again."

The week in review

Nov 16, 2012
David Defoe / flickr

This week Rina Miller and Jack Lessenberry discuss how Michigan will comply with the Affordable Care Act, and how the U.S. Sixth Circuit Court of Appeals ruled that Michigan's constitutional ban on affirmative action does not hold up under the U.S. Constitution's equal protection clause. Lessenberry also remembered the late former first lady, Helen Millikin.

User: Brother O'Mara / flickr

Michigan's longest serving first lady, Helen Milliken, dies at 89

Helen Milliken was Michigan’s first lady for 14 years, from 1969 to 1983.

The Detroit Free Press writes of a Republican who fought for causes that sometimes were at odds with the party:

Helen Milliken is perhaps best remembered as Michigan’s leading proponent of the Equal Rights Amendment to the U.S. Constitution. The ERA, which would have banned discrimination based on sex and authorized Congress to adopt laws enforcing it, came close to passage (it was approved by Congress and 35 of the needed 38 states, including Michigan).

But she was also a leading advocate for the arts and environment, becoming a political force in her own right.

Missing today's due date, Michigan gets a health care exchange extension

Michigan Republicans don't care for it.

And they've been hoping that provisions of the Affordable Care Act would get struck down. That hasn't happened, and one deadline for action is today.

But as MLive's David Eggert reports, they've been given an extension to decide on whether to set up a state run health care exchange:

The Obama administration late Thursday gave Michigan another month to decide if it wants to build its own online marketplace where individuals and businesses can shop for health insurance.

The deadline had been set for today. But in a bow to a request from the Republican Governors Association, U.S. Health and Human Services Secretary Kathleen Sebelius extended the deadline until Dec. 14.

Detroit Mayor reaches deal to keep city afloat

The dire financial projections for Detroit continue, with some predicting the city could run out of cash in December.

But Michigan Radio's Sarah Hulett reports, Mayor Bing has reached a deal with the state worth $137 million:

Mayor Bing says the agreement will help the city make changes it needs, and avoid running out of cash as early as next month.

"We're asking for $10 million in the month of November. We meet the milestones we've agreed upon, we're asking for $20 million in December, and then we've got another $50 million that will be held in escrow at a later date," Bing said.

The deadline for the Affordable Care Act's open enrollment period is January 31.
user striatic / Flickr

Health insurance exchanges, a crucial part of the federal Affordable Care Act, will have a great impact on Michigan residents.

To better explain the exchanges, we spoke with Helen Levy. A research associate professor at the University of Michigan Institute for Social Research.

Levy is well-versed in the fine points of the Affordable Care Act.

“A Health insurance exchange is a marketplace designed to bring together people who want to buy insurance and companies that want to sell it to them,” said Levy.

The sites on which the plans will be featured will follow the templates of other marketplace sites.

“It’s going to look something like Travelocity but for health insurance. You can scroll through the policies and see what the different premiums are. The exchanges are intended to include community rating. It’s a key part of making affordable insurance available to everyone,” said Levy.

In this morning's headlines. . .

Nov 14, 2012
User: Brother O'Mara / flickr

In health news. . .

Officials with Blue Cross Blue Shield of Michigan say the state Legislature must pass bills to overhaul the health insurer by the end of the year. Under the measures, Blue Cross would become a customer-owned non-profit, and would have to pay state and local taxes. The Lansing State Journal reports,

Even though it would lose its tax-exempt status, Blue Cross says the change in classification — and the lower government regulation that goes with it — is essential for it to be able to compete with other insurers under the Affordable Care Act.Under federal law, Blue Cross must have its products and rates ready by March for an online health exchange where people can compare and buy their own insurance plans, but the organization won’t make it because of the way it’s currently regulated by the state.

Meanwhile, as Rick Pluta reports, "Michigan is unlikely to meet a Friday deadline to tell the Obama administration if it will create a statewide online exchange for people to shop for health insurance. The alternative is for Michigan to become part of a federally managed exchange."

Tribe asks federal court to dismiss lawsuit to block Lansing casino

"A federal judge is being asked to dismiss a lawsuit aimed at stopping plans for a casino in downtown Lansing. The Sault Sainte Marie Tribe of Chippewa Indians delivered its response this week to the lawsuit filed by Michigan’s Attorney General in September.  The lawsuit claims the casino project violates federal law as well as a gaming compact between the state and the tribe. The tribe says that’s not true. The tribe wants to resolve this legal challenge before asking the federal government to take the land around Lansing’s convention center into trust.   The land must fall into trust…before the tribe can begin construction of its casino," Steve Carmody reports.

user Laura4Smith / Flickr

Over 10 years, Michigan could save a billion dollars and get more than 600,000 previously uninsured people health coverage.

That's the upside of expanding Medicaid in Michigan, according to a new study from the Center for Healthcare Research and Transformation (CHRT) in Ann Arbor. 

The federal government can't force states to expand their programs, but they are offering big incentives: for 10 years, the feds will pick up 100% of the costs of covering newly-eligible Medicaid patients, as part of the Affordable Care Act. 

The leader of another Michigan business is suing the federal government over provisions of the Affordable Care Act.

John Kennedy, CEO of Kentwood-based Autocam Automotive, filed a complaint in a federal court in Grand Rapids Monday. In it, he says his company shouldn’t have to provide employees with health insurance that includes contraception coverage he considers “intrinsically wrong and gravely sinful”.

Steve Carmody / Michigan Radio

A Catholic legal group says parts of President Obama’s health care law violate their clients’ religious freedom.

Representatives for the Thomas More Law Center made their arguments on behalf of business owners in a Detroit federal court Friday.

The groups charge that they shouldn’t have to provide employees with health insurance that includes contraception coverage—the so-called “HHS mandate”-- in violation of their first amendment rights.

Photo courtesy of the Snyder Administration

This week on It's Just Politics it’s all about the Blues. Blue Cross Blue Shield, that is. BCBS is, by far, the state’s largest health insurance company. It’s also a state government creation; created by state law. It has its own law, separate from all other insurance companies because it is Michigan’s “insurer of last resort,” meaning that Blue Cross has to take everyone who applies. Its mission: to make sure everyone who wants or needs health insurance in Michigan can get it.

Steve Carmody/Michigan Radio

Michigan legislators are being told that it may already be too late to create an online health insurance exchange. The federal health care law requires states to submit their plans by mid-November, but exchanges require a level of complexity that might make it difficult to have a plan ready in time. 

Steve Carmody/Michigan Radio

LANSING, Mich. (AP) - Michigan Gov. Rick Snyder and his fellow Republicans could find themselves knee-deep in health care issues Wednesday when lawmakers briefly return after a five-week break.

Snyder needs to get reluctant House Republicans on board with his efforts to create an online site where individuals and small businesses can comparison shop for private health insurance.

The President and the Chief Justice: An ironic history

Jul 11, 2012

Of all of the hyper-partisan episodes in the long political career of President Barack Obama, there is one that strikes me as being historically ironic.

In 2005, the then-junior Senator from Illinois voted against the confirmation of U.S. Circuit Court of Appeals Judge John G. Roberts, Jr. as Chief Justice of United States Supreme Court. It turned out to be Justice Roberts whose actions on that court saved President Obama’s signature healthcare legislation.

istockphoto.com

Michigan has to decide whether to expand its Medicaid rolls by up to a half-million people starting in 2014.  The U.S. Supreme Court's landmark decision on the Affordable Care Act struck down a portion of the law that would have required states to expand the program or risk losing all federal aid.

Michigan hospitals support Medicaid expansion.  They spend billions of dollars each year providing charity care for adults without health insurance.

Photo courtesy of the Snyder Administration

The Patient Protection and Affordable Care Act (ACA) is officially the law of the land.  The U.S. Supreme Court has spoken. The health and welfare of millions of people right here in Michigan is at stake. And, it has broad policy implications. But, of course, this is It's Just Politics... which means Rick Pluta, Lansing Bureau Chief for the Michigan Public Radio Network, and Zoe Clark, Michigan Radio's resident political junkie, are not talking policy but, instead, the politics of the Court's decision.

Rick Pluta: A couple of weeks ago we had the Left galvanizing around what’s become known as “Vagina-gate.” A couple of female lawmakers sanctioned, silenced for a day, by state House Republican leaders for things said during a heated abortion debate. It gave the Left a memorable moment to create what appears to be a stark choice to get their people out in November. Now, the Right has this health care decision. Attorney General Bill Schuette – one of the state’s top Republicans and Mitt Romney’s Michigan campaign chair - says this decision is also a political tool.

Bill Schuette: "This decision, I believe, is going to raise the stakes in November. I think it will energize, it will cause a firestorm of protest to be exhibited in the ballot box in November and I think, in the end, it is going to be one of the things that is going to cause Mitt Romney to be the next President."

Zoe Clark: And, so, the Right is incensed. They’re going to use this issue to get out the vote in November, to protest this decision. And Schuette also says, in effect, don’t let this issue whither on the vine.

RP: Right. There are things the state has to start doing to comply with the health care law. The most immediate one is to create these so-called healthcare exchanges where people and businesses can shop online for coverage. And the attorney general is counseling the legislature: Don’t do it. And, of course, Governor Snyder has called for these exchanges. Snyder is not a fan of the law but he is a fan of the exchanges and says it would be a mistake to wait to implement them.

ZC: So, Rick, this seems to be just one more issue where we're seeing division between the very conservative Attorney General, Bill Schuette, and a more-moderate Governor, Rick Snyder.

I wonder how Attorney General Bill Schuette would react if I told him, “Well, I know smoking marijuana is illegal, and I know you are against it. However, an amendment to make it legal might be  on the ballot this November. So, until we know how all that turns out, I think I will act as if the current law wasn’t there.“

mattileo / flickr

Every Thursday we look at Michigan politics with Susan Demas, political analyst for Michigan Information and Research Service, and Ken Sikkema, former senate majority leader and senior policy fellow at Public Sector Consultants.

In what some are calling a surprising decision today, the U.S. Supreme Court upheld the Affordable Care Act. Michigan lawmakers were reacting to the decision throughout the day. Governor Snyder said he doesn’t like the law but he is going to try to follow it.

Stethascope
user mconnors / MorgueFile.com

Hundreds of thousands of Michigan residents already have benefited from the health care law passed in 2009, according to the federal government. Some examples:

  •  More than 23,000 Michigan seniors and people with disabilities have saved $17.6 million this calendar year on prescription drugs because of the law, an average of $757 per person. The money goes to help residents with medical costs after they hit the Medicare Part D prescription drug coverage gap, the so-called "doughnut hole."
  • More than a half-million Michigan seniors have received a free preventive health care service so far this year.
  • Around 1.8 million residents now receive preventative services with no co-pay.
  • Around 57,000 more young adults in Michigan under the age of 26 are on their parents' health insurance plans.
  • Around 7,000 small businesses get federal tax credits for offering health insurance to their employees.
  • Six Michigan health centers have been awarded $3.7 million from the federal government to help expand access to care for 59,431 additional patients.
  • Around 114,000 Michigan residents will get $13.9 million in rebates from insurance companies this summer because of a rule that requires insurance companies give rebates if they don't spend at least 80 percent of consumers' premiums on medical care and quality improvement. The rebates will average $214 for 65,000 Michigan families.

Gerald R. Ford School of Public Policy / Flickr

It’s no doubt a historic day for Michigan Congressman – and the U.S. State of Representative’s longest serving member – John Dingell with today's U.S. Supreme Court decision upholding the constitutionality of the federal Affordable Care Act.

As NPR’s Julie Rover noted in a story on Dingell in 2009:

“Dingell's quest for universal health care began in 1932, when his father, John Dingell Sr., was first elected to the House from Michigan. The elder Dingell quickly became one of the architects of the New Deal… In 1943, the elder Dingell, along with Senators Jim Murray of Montana and Robert Wagner of New York, introduced the first national health insurance bill. The so-called Wagner-Murray-Dingell bill was fought over for years, though it never became law. And when the elder Dingell died in 1955, John Dingell Jr. took over not only his father's seat, but also his quest for national health insurance.”

The Obama administration has given new leeway to states to choose their level of involvement in running health care exchanges. States are required to create the exchanges under the Affordable Care Act.

The exchanges will allow individuals and small businesses to shop for health care plans.

Ari Adler is the press secretary for Michigan House Speaker Jase Bolger.

He says Bolger doesn't plan to move forward on the exchanges until the Supreme Court rules on the Affordable Care Act.

"If we are put in a position where we have to have some sort of health exchange, " says Adler, " [Bolger] is willing to work with the governor and others to put something in place at the state level -- so we do not have the federal government coming in and controlling our health care in Michigan."

Governor Snyder says he wants the Legislature to send him a bill that would create an exchange. He's said waiting too long could leave Michigan vulnerable to missing the federal deadline for creating the exchanges.

He's directed some staff to do preliminary work on setting up an exchange. That work includes creating a database of possible health care plans, and reviewing software programs that other states are developing.

Earlier this year, Michigan Radio's Jennifer White sat down with Helen Levy, a Research Associate Professor at the University of Michigan’s Institute for Social Research who worked with President Obama’s Council of Economic Advisors in 2011.

White talked with Levy about how health insurance exchanges work and  what health care options they may provide to individuals.

Take a listen to their conversation below or read a transcript here.

 

Nobody would dispute that health care is one of the biggest issues facing this nation. And virtually everyone, regardless of their politics, is waiting for the U.S. Supreme Court.

Next month, the nation’s highest court will announce its decision on the constitutionality of the Patient Protection and Affordable Care Act Congress passed two years ago.

Their decision will have a major impact on this nation. But in Ferndale, a small, charming, quirky, and largely working class Detroit suburb, a tiny group hasn’t been waiting.

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10 community health centers in Michigan will get $19.6 million in federal funds.

Those health centers are key primary care providers for uninsured and underinsured people in many communities.

The money is part of about $11 billion provided to community health clinics through the national health care reform law.

A debate over establishing an online Michigan exchange where people and businesses can comparison shop for health coverage have been pushed into next year.

Governor Rick Snyder has said he’d like to see a state-run exchange established soon to ensure Michigan does not get pushed onto a federal system set up under the new national health care law.

But he’s been getting pushback from some Republicans in the Legislature.

“My members do not like Obamacare and they see this as steps to the implementation of Obamacare," said State Rep. Chuck Moss (R-Birmingham). "And, given that it’s iffy in the courts and possibly going to be repudiated in the next election, why do we want to get on that train now?”

The U.S. Supreme Court is expected to rule on the legality of the Patient Protection and Affordable Care Act. Business groups have split on creating a state exchange. Governor Snyder says it’s a good idea even if the federal law is reversed.

Lindsey Smith / Michigan Radio

Gov. Rick Snyder wants people in Michigan to do more to promote their own health. He also outlined policies he’d like to see legislators pass to help lower health care costs and improve access.

Snyder says he wants Michigan to create a health care exchange: a place where individuals can compare health care insurance.

The new federal health care law mandates states create their own exchange, join a regional one or wait until the federal exchange is in place.

“Having the idea of having an exchange done right is a good idea and my view is Michigan should establish one. We shouldn’t wait and say the federal government is going tell us it’s their exchange.”

Snyder wants to reform the state’s health code, improve health care for veterans and children with autism. He also wants to reduce regulations on health care professionals.

A hospital emergency room entrance.
Steve Carmody / Michigan Radio

The federal health care law is scheduled to take effect in 2014.  Health care leaders in Washtenaw County say they are not ready. 

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