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health care

steve carmody / Michigan Radio

State Republicans and Democrats are sparring over a proposal to keep some key Affordable Care Act provisions in place in Michigan, even if Congress succeeds in repealing Obamacare.

doctor
Public Domain

More Medicare recipients in Michigan will qualify for subsidies to buy supplemental health insurance that covers their coinsurance and deductibles.

The Michigan Health Endowment Fund announced Monday it's raising the eligibility threshold, starting in July.

Residents with annual incomes at or below 225% of the poverty level – or $26,730 for an individual and $36,045 for a couple – will qualify. The existing cutoff is 150% of poverty - $17,820 per individual and $24,030 per couple.

The monthly subsidy ranges from $40 to $125 depending one's age and disability status.

Unless you spent yesterday in a salt mine, you know that the U.S. House of Representatives passed a bill radically altering the Affordable Care Act.

If you don’t know exactly what’s in this bill, or how it would affect you, you are not alone. Neither did virtually any of the members of congress, all of them Republicans, who voted for this bill, which they are calling the American Health Care Act.

ALEX PROIMOS / FLICKR - HTTP://J.MP/1SPGCL0

In a close vote of 217 to 213, the U.S. House of Representatives passed a new health care insurance plan this afternoon.

For weeks, Republicans have struggled to gain enough votes to repeal and replace the Affordable Care Act.

Doctor's office
steve carmody / Michigan Radio

Relieved Republicans have pushed their prized health care bill through the House. The mostly party-line 217-213 vote advances a bill that addresses their longtime pledge to erase the 2010 Obama health care law.

“Today, I voted to keep the promise I made to the voters of my district to rescue Americans from the collapsing health care law that has raised premiums and deductibles and replace it with a better health care system,” says Rep. John Moolenaar, R-Midland.

Paul Ryan
Gage Skidmore / Creative Commons http://j.mp/1SPGCl0

Republican US House leaders on Friday withdrew their bill to repeal and replace Obamacare. House Speaker Paul Ryan pulled the bill from the floor after it was clear the measure would not have enough votes to pass. This Week in Review, Weekend Edition host Rebecca Kruth and senior news analyst Jack Lessenberry talk about whether Gov. Rick Snyder and Healthy Michigan advocates can breath a sigh of relief.

Capitol Hill
johrling / Flickr - http://j.mp/1SPGCl0

Gov. Rick Snyder has written letters to every member of Michigan's congressional delegation to warn how House Republicans' health care legislation would "adversely impact" the state's most vulnerable residents.

The Preserving Employee Wellness Programs Act would require employees to undergo genetic testing and hand over those results to their employer.
Wikipedia.com

How would you feel if your boss demanded you undergo genetic testing and hand over the results? And if you refuse, you could wind up paying a penalty of up to 30% of your health insurance's total cost?

A bill to do just that cleared a House Congressional committee last week. 

As you almost certainly know, there’s a Republican-backed bill before Congress that would repeal and replace the Affordable Care Act, known to most people as Obamacare.

Republicans control both houses of Congress, and if they stay united on this, the bill should become law, perhaps within weeks.

If that happens, the non-partisan Congressional Budget Office estimates that within nine years, the number of people without health insurance in this nation would grow by 24 million.

The non-partisan Congressional Budget Office estimates the GOP replacement for the Affordable Care Act will mean the number of uninsured Americans would grow by 24 million by 2026.
Steve Carmody / Michigan Radio

You'll be able to buy the health care insurance plan you want. Premiums will be lower. Everyone will be covered. Access to quality, affordable care will improve.

Those promises from President Donald Trump and Republican leaders like Speaker Paul Ryan seem less likely after a report from the non-partisan Congressional Budget Office (CBO).

Researchers at the University of Michigan believe excluding inmates from Medicaid is driving up costs and hurting the health of inmates.
Steve Carmody / Michigan Radio

Expanding Medicaid was a key part of the Affordable Care Act. In our state, it's known as Healthy Michigan, and it has meant health care coverage for more than 600,000 people.

But if you wind up in the criminal justice system, even if its just pre-trial detention, Medicaid benefits turn off immediately.

Researchers at the University of Michigan say excluding inmates from Medicaid is driving up costs and hurting the health of inmates.

Capitol Hill
Jodi Westrick / Michigan Radio

Last week, House Republicans submitted their bill to repeal and replace the Affordable Care Act, also known as Obamacare.

The bill, which has been under intense committee debate, has drawn criticism from Democrats, some Republicans, health care organizations, doctors, and others. But it is largely supported by House Republicans and the White House.

Some of the bill’s provisions would be enacted as soon as it is put into law, including the elimination of individual and employer mandates. Others would be delayed until 2020, such as limiting the Medicaid expansion and a repeal of subsidies for out-of-pocket expenses.

Steve Carmody / Michigan Radio

I have an idea. This should especially appeal to everyone who either didn’t like President Obama, or thought there were flaws in his signature achievement, the Affordable Care Act. Let’s get even by taking health care away from 650,000 Michiganders with lower incomes.

Now, granted, this will have repercussions.

STEVE CARMODY / Michigan Radio

The Next Idea

With all the talk of reforming health care, what if we are missing the bigger picture?

What if all this emotional debate about whether to dismantle the Affordable Care Act, otherwise known as Obamacare, was a waste of time?

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The question of how to improve Michigan's $2.4 billion mental health care system has been on the front burner for the better part of a year.

The latest twist came when Michigan's 11 Medicaid health plans called on state policy makers to give them a greater say in controlling the system. But it was concern over this very action, of moving control of mental health services out of the public's hands and turning it over to for-profit insurance companies, that sparked the year-long dialogue in the first place.

The move blindsided those who were working on a proposal they thought everyone had agreed upon, including the health plans. Among them is Kevin Fischer, executive director of the National Alliance on Mental Illness of Michigan

Clare Luz (left) and Joan Ilardo (right)
Courtesy of MSU Today / Michigan State University

As the retirement-age population grows in Michigan, in-home care is increasingly in high demand. The state, however, is struggling to maintain a workforce that meets the need. 

Two researchers at the MSU College of Human Medicine are working to change that. They received grants from the Michigan Health Endowment Fund. The Fund was set up in 2013 under state law. (Read more about the it here.) 

Michiganders rally at Macomb Community College in Warren to save the Affordable Care Act.
Bryce Huffman / Michigan Radio

Thousands of Michigan residents showed up to a healthcare rally to show Republican leaders they don’t want the Affordable Care Act to be repealed.

Senator Bernie Sanders, along Democrats with Gary Peters and Debbie Stabenow enthused the crowd at Macomb Community College in Warren about fighting to keep their health coverage.

While the Republicans in Washington D.C. have already begun plans to repeal the Affordable Care Act, Democratic leaders say without a replacement plan, about 30 million Americans would lose their health coverage.

user clarita / morguefile

What happens to the state’s economy when 600,000 more Michiganders get health insurance, thanks to the state’s Medicaid expansion – AKA the Health Michigan plan that’s part of the Affordable Care Act?

According to Dr. John Ayanian, professor and director of the Institute of Healthy Policy and Innovation the University of Michigan, you get about 30,000 new jobs a year.

steve carmody / Michigan Radio

LANSING, Mich. (AP) - A push to curtail health care benefits for municipal retirees in Michigan is setting off a fight between those who say billions in debt can no longer be ignored and critics who contend it would cheat people out of coverage.

  The new Republican-sponsored plan could be enacted yet this year. It aims to address $11 billion in unfunded liabilities.

  Starting in May, newly hired municipal workers would no longer qualify for health insurance in retirement. Local governments could instead contribute to a tax-deferred account such as a health savings plan.

Public Domain / http://j.mp/1SPGCl0

A new University of Michigan study is the fourth in the country to look at fear of childbirth and how that fear might affect outcomes for mother and baby. However, it is the first qualitative study and the first to include any people of color or lesbian women.

The study was conducted by Lisa Kane Low, president of the American College of Nurse Midwives, and Lee Roosevelt, a nurse midwife and Clinical Assistant Professor at the Michigan School of Nursing. 

Bruce LaBrecque says there are so many painful issues that a woman's OBGYN might be reluctant to ask about that can be treated with physical therapy.
Steve Carmody / Michigan Radio

Whether it's baby boomers seeking help for aging joints or people seeking alternatives to surgery, the physical therapy industry is growing. And now women are turning to physical therapy for specialized help.

Bruce LaBrecque, an RN and a women's health physical therapist in Bay City with Renue Physical Therapy, joined Stateside to talk about how more and more women, young and old, are turning to physical therapy to address intimate health issues. 

Valenstein hopes the project will help those in need of social services connect with agencies that are better suited to help them.
flickr user Rosser321 / http://j.mp/1SPGCl0

The Next Idea

Take funding from the Affordable Care Act, add a $70 million state innovation model grant to the state Department of Health and Human Services, and you’re about to see an ambitious new project that can change health care delivery in Michigan.

It’s called Michigan’s Blueprint for Health Innovation.

A classroom in Flint.
Steve Carmody / Michigan Radio

A Michigan non-profit group will provide more healthcare resources for Flint public schools.

The Genesee Health Plan is expanding its Community Health Workers program to all Flint Community Schools. The program wants to identify the health care needs of students and families in the community. 

Jim Milanowski is the president and C.E.O. of the health plan.

Courtesy of Predrag Klasnja / https://www.si.umich.edu/people/predrag-klasnja

The Next Idea

In the 1970’s, the Japanese concept of “Kanban” turned the U.S. auto industry on its ear – “just in time” inventory and manufacturing.

Now, that just-in-time concept is being applied to keep people on track after rehabilitation.

Just-in-time adaptive interventions (JITAI) can bring health support to you right through a smartphone.

On July 27, Vayu's fully autonomous drone transported clinical lab samples from a remote village in Madagascar to a laboratory for testing.
Courtesy of Vayu

Fighting disease in developing countries is an uphill battle. 

One of the biggest challenges: the lack of roads. 

How do you get clinical samples – blood, stool, urine – from a remote village to a laboratory where the samples can be tested for disease?

A Michigan start-up called Vayu has taken a promising step toward addressing that crucial problem by using a drone on a life-saving medical mission in Madagascar.

Dr. Daniel Maixner says depictions of electro-convulsive therapy (ECT), like this one in the TV show "Homeland," have harmed the public's perceptions of the treatment. Dr. Maixner calls ECT a "miracle."
Image from the program "Homeland" / Showtime

In the latest edition of Stateside's series Minding Michigan, which explores mental health issues in our state, we take a closer look at electro-convulsive therapy (ECT). 

ECT is largely known as "electroshock therapy," but many in the field consider that to be an outdated term. ECT is a mental health treatment that can be effective for some patients with certain disorders. However, largely because of the way its been portrayed in film or television, ECT is wrapped in stigma and misconception. The University of Michigan Department of Psychiatry has just opened a new mental health unit that expands its ability to offer electro-convulsive therapy to patients.

In addition to providing hundreds of thousands with health insurance, Healthy Michigan has also helped Michigan hospitals save hundreds of millions of dollars because of a reduction in uncompensated care.
Chealion / Flickr - http://j.mp/1SPGCl0

For the first time, researchers show how much patients with private insurance actually pay for hospital stays. Out-of-pocket costs are high and rising fast for many plans, even those considered “good” insurance.

Emily Adrion is a research fellow at the University of Michigan medical school. She and her team looked at the rising out-of-pocket costs for people with private insurance.

Costs are rising in two main areas: deductibles and co-insurance.

To begin with deductibles, Adrion said they rose by around 86% between 2009 and 2013.

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When you or someone in your family feels sick, chances are the first call you make is to your primary care physician.

Ever since 2010, Michigan has been a big part of a demonstration project to make primary care better, to keep people healthier and out of hospitals.

Mark Ilgen says ImPAT is a "psychotherapeutic ... non-pharmacological approach" to helping people adapt to and cope with their pain.
flickr user frankileon / http://j.mp/1SPGCl0

It's become clear that America is in the grips of an opioid addiction epidemic.

But here's a dilemma: what if you're in pain? Is there a way to help patients get relief from pain without resorting to powerful pain medicines that can get you addicted?

A new study indicates the answer could be yes, through something called ImPAT, or Improving Pain during Addiction Treatment. 

Insurance companies in Michigan are asking for, on average, 17.2% higher rates for individual plans next year.
flickr user 401(K) 2012 / http://j.mp/1SPGCl0

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.

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