health insurance

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37,000 low-income Michiganders and small-business customers may be eligible for health coverage through a new health insurance cooperative, the Lansing State Journal reports.

With $72 million in federal funding, Consumers Mutual Insurance of Michigan is an alternative health care option for families and businesses looking for coverage after provisions of the Affordable Care Act go into effect January 2014.

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No-fault overhaul moves forward

"A state House panel has voted on a bill to overhaul Michigan’s auto no-fault system. Right now, people who are severely injured in an auto accident can get unlimited lifetime medical benefits. The legislation would cap those benefits at $1 million," Jake Neher reports.

House adopts wolf hunting bill

"The state House has approved a measure that would allow an Upper Peninsula wolf hunt to go ahead regardless of a referendum on the question," Rick Pluta reports.

Health insurance for live-in partners stays

"A decision to provide health insurance to same-sex domestic partners of Michigan state government employees is intact. In an order released Thursday, the state Supreme Court unanimously declined to hear an appeal filed by Republican Attorney General Bill Schuette. The state health insurance plan covers non-family members who've lived continuously with state workers for at least a year," the Associated Press reports.

Steve Carmody/Michigan Radio

State lawmakers are grappling with an issue that pits Michigan’s firefighters against insurance companies.

A bill before the Senate Judiciary committee would expand workers compensation coverage to Michigan’s five thousand paid firefighters to include ten types of cancer, including respiratory tract, bladder, skin, and brain.

The change would ‘presume’ fighting fires caused the cancers and not require firefighters to prove exposure on the job is responsible.

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."

LANSING, Mich. (AP) - A Republican state lawmaker says Blue Cross Blue Shield of Michigan should pay $500 for every Michigan resident as part of legislation that would convert the company from a charitable trust of the state to a customer-owned nonprofit .

Rep. Tom McMillin proposed Friday that the state's dominant insurer be required to transfer $5 billion to Michigan's 10 million residents as payment for the conversion.

Blue Cross says the conversion would help it better compete under the 2010 Affordable Care Act.

Blue Cross Blue Shield building on Lafayette in Detroit.
Mikerussell / wikimedia commons

LANSING, Mich. (AP) — The Michigan Senate has approved a Blue Cross Blue Shield of Michigan overhaul that supporters say levels the playing field among health insurers and critics argue doesn't adequately protect elderly and vulnerable residents.

The Senate passed the legislation Wednesday. The House is expected to consider it when the chamber returns after the November election.

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Faith-based groups look to health insurance alternative

"Members of faith-based groups in Michigan could soon be allowed to share the costs of their medical bills as an alternative to buying health insurance. The state House is expected to vote this week on the measure. Several states already allow faith-based groups that share the costs of medical bills. Republican state Representative Lisa Lyons sponsored the measure. She says some families and businesses have found it’s a way to manage their healthcare costs. And that’s because there’s no guarantee anyone’s medical bills will be covered. The commitment to share the costs of medical bills is a faith-based promise, but not a legal contract. Members of health care ministries are exempt from the requirement in the new federal health care law that most people carry insurance starting in 2014. That’s led some critics to complain that faith-based medical bill-sharing could undermine the benefits of the federal health care law," Rick Pluta reports.

World's largest property auction in Wayne County

"Wayne County has finished the first round of what’s been called the 'world’s largest property auction.' The county is trying to get rid of more than 22-thousand tax-foreclosed properties by auction. More than 20,000 of them are in Detroit. But despite the glut of vacant properties, housing prices are headed up in certain areas of the city. Leaders in Detroit’s downtown and midtown areas say housing demand now outpaces supply there," Sarah Cwiek reports.

Hunters track deer virus

"State wildlife officials are looking to hunters to help track a virus that's been killing thousands of Michigan deer. Many hunters spent this weekend in the woods, a few of them deer-hunting legally, but most stalking deer ahead of next month's opening of bow season. Some 4,000 deer have died of the virus in Michigan since July. And there are outbreaks in eleven other states as well, including Ohio and Indiana. Dan O’Brien is a veterinarian with the Michigan Department of Natural Resources. He says the Michigan outbreak has affected deer in 24 counties. O’Brien says the outbreak will continue until a hard freeze kills off the insects that spread the virus to the deer.  The virus is not harmful to humans," Steve Carmody reports.

Blue Cross Blue Shield would undergo major changes under proposed legislation.
Wikipedia

There was another day of hearings yesterday on Governor Rick Snyder’s proposed overhaul of Blue Cross-Blue Shield of Michigan.

Other insurance companies say any reforms should make it easier for them to compete with the Blues.

Other insurers have long complained about their inability to win a bigger piece of Michigan’s insurance marketplace. Blue Cross covers four million Michiganders.

Rick Murdock is with the Michigan Association of Health Plans. It’s an organization of 15 for-profit insurers that compete with Blue Cross.

"There’s no disputing the fact that Blue Cross-Blue Shield has 70 percent of Michigan’s commercial insurance market – a monopoly by any definition," said Murdock.

A Blue Cross representative said the proposal will create more competition, and Blue Cross will, for the first time, pay taxes. But he also said the Blues’ marketplace advantage comes from being a not-for-profit company not focused on maximizing profits, and that would not change under this overhaul.

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.

Michigan Gov. Rick Snyder.
Governor Snyder's office / State of Michigan

Update 5:30 p.m.

Governor Rick Snyder has proposed an overhaul of the rules covering Blue Cross-Blue Shield of Michigan. Blue Cross would have to pay taxes adding up to $100 million a year or more.

But the company could also make changes to its rates a lot more quickly and easily. That would help it compete for business.
    
Andy Hetzel is a vice president at Blue Cross. He says the new federal health care law is changing the insurance marketplace and Michigan needs to keep up.

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There's been no action by the state House yet on creating online exchanges for people to comparison shop for health coverage.

That’s after another day of hearings by two state House committees on the question.

Governor Rick Snyder is pushing the Legislature to act quickly so Michigan qualifies for federal planning grants, and does not risk being forced into a federal system.

Representative Al Pscholka chairs the House budget subcommittee that would fund the exchange.

He says the numbers are big, and he wants to step carefully.

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.

Steve Carmody/Michigan Radio

EAST LANSING, Mich. (AP) - Michigan State University has dropped mandatory health insurance for students after opposition from lawmakers.

Officials said Friday that insurance available through the school will be voluntary, but they'll still ask if students have coverage this fall. Only 320 students were automatically signed up last year.

But one of them was the son of a state lawmaker, Rep. Jeff Farrington, R-Utica, who got a bill. It turned out that Farrington's son had insurance.

Lindsey Smith / Michigan Radio

Despite some public pressure, Grand Rapids City Commissioners declined to support a proposal that would restrict abortion coverage for city workers. A group turned in more than a thousand signatures in favor of the proposal last month.

Health insurance for Grand Rapids city workers does not cover any elective surgeries. So abortions are only covered when deemed “medically necessary”. The proposal would’ve defined that to mean only in cases of rape, incest and to protect the health of the mother.

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The Michigan Legislature passed a series of autism coverage bills that have been sent to Governor Snyder for his approval.

Lt. Governor Brian Calley was been a central advocate of the bills. He also has a 5-year-old daughter with autism.

The bills would change Michigan insurance code, which would require that certain evidence-based therapies be covered, up to certain limits.

Dru Bloomfield / Flickr

Yesterday, the Michigan Legislature passed a series of autism coverage bills that will go to Governor Snyder.

It was one of the first significant pieces of legislation to move through the legislature with broad bi-partisan support.

The bill requires insurance companies to pay for autism spectrum disorder (ASD) diagnosis and treatment for children up to age 18.

Under the bill, insurance companies regulated by the state will have to cover expenses for ASD therapy and diagnosis...

  • of up to $50,000 a year for kids younger than 7,
  • $40,000 a year for kids ages 7-13,
  • and $30,000 for kids up to age 18.

Questions about funding

The law will go into effect on October 1, but some questions have been raised about part of the funding for the mandated coverage.

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The state House has approved a measure that will require insurance companies to cover autism treatments for children. The state Senate is expected to concur with the House action later today and send the bill to Governor Rick Snyder's desk.

Senate bills 414, 415, and 981 would require the following, according to the House Fiscal Agency:

  • Require group and individual health plans to cover services for autism spectrum disorders (ASD) in a manner similar to physical illnesses.
  • Allow health plans to limit coverage for ASD treatment to a yearly maximum based on age, and limit coverage to children 17 years of age and younger.
  • Allow insurers to request, among other things, a review of ASD treatment.
  • Provide a limited exemption for qualified health plans offered under the federal Patient Protection and Affordable Care Act.
  • Create the Autism Coverage Incentive Act and the Autism Coverage Fund.
  • Establish the Autism Coverage Incentive Program, under which insurance carriers could seek reimbursement from the Fund for expenses incurred in providing coverage for ASD.

The House Fiscal Agency writes:

The Governor's FY 2012-13 Executive Budget Recommendation for the Department of Community Health includes an increase of $34.1 million Gross ($10.1 million GF/GP) to fund autism spectrum disorder treatment for the Medicaid and MIChild eligible children under the age of six.

The report indicates that approximately 2,000 kids under the age of six would meet the criteria that would be established with the new policy. 2,000 kids with an "average expenditure of $17,000 per child."

The Autism Coverage Incentive Program is expected to cost the state between $500,000 to $1 million to administer.

Michigan doctors say they are spending too much time writing prescriptions for their patients.

‘Prior authorization’ was intended to reduce the cost to insurance companies by having patients use generic drugs. But doctors say the process is bogged down in Michigan by 150 insurance companies each requiring doctors to fill out different forms.   

Stephen Newman is the president of the Michigan State Medical Society. He says doctors often spend half their time with a patient trying to wade through the ‘prior authorization’  process.

"That’s a waste of time, both for the patient as well as the physician,"  says Newman,  "And it leads to inefficiencies…that leads to emergency room visits that are unnecessary. 

The State Senate Insurance committee today approved legislation to streamline ‘prior authorization’ by requiring all insurance companies use the same form.      

Insurance industry representatives at the committee meeting were divided on the legislation.

The Michigan Senate passed legislation today establishing a system of veterans' courts.
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LANSING, Mich. (AP) - The Michigan Senate soon could vote on bills aimed at requiring insurance companies to cover some types of treatment for autism.

The Senate's Health Policy Committee on Thursday approved a bipartisan package of bills related to autism coverage, sending the bills to the Senate floor. They go to the House if the Senate passes them.

One bill sets up a fund to help reimburse insurers for paid claims related to diagnosis and treatment of autism. That provision is included in hopes of lessening opposition from business and insurance groups.

Previous efforts to mandate autism coverage have stalled in Michigan.

More than half the states require insurers to provide autism coverage. Gov. Rick Snyder says it's time or Michigan to join them.

An Ottawa County Circuit Court judge is ordering Blue Cross Blue Shield to pay the City of Holland $1.6 million. Holland is one of dozens of communities that sued Blue Cross over variable fees charged on insurance claims filed by employees.  The city claims the insurer didn’t tell them about the fees for 17 years.

Blue Cross Blue Shield spokesperson Helen Stojic says the fees were not hidden.“As the lawsuit proceeds to the appellate courts we’re confident that the legal process will result in a finding that our access fee were known to our customers,” Stojic said.

ehealthinsurance.com

Under the Federal Affordable Care Act, states are required to create a health care exchange. An online place where people can comparison shop for health insurance. It looks much like a Travelocity or Orbitz website, but for health insurance.

Many Republicans in the Michigan legislature want to hold off on creating this exchange until the Supreme Court rules whether the act is constitutional.

A national advocacy group for autism-treatment says Michigan tops its list of states it believes could require insurance companies to cover treatments for autistic children this year.

Rick Remington, with the New York-based group Autism Speaks, said the support of Republican leaders in the Michigan legislature along with Governor Rick Snyder bodes well for autism-treatment legislation.

“It’s been before the legislature for a number of years, it’s gotten strong support from Governor Snyder, as well as the advocacy of the lieutenant governor,” Remington said. “We’ve got strong support, bi-partisan support from the Michigan legislature. So, we’re very confident we will see a bill become law this year.”

Twenty-nine states already have insurance mandates for autism-treatment.

Remington said advocates for autism coverage are becoming more prevalent in legislatures throughout the nation as the number of autism diagnoses increases.

Many insurance companies oppose the idea, saying it would increase costs.

A new state tax could be in jeopardy. Starting January 1, every time an insured patient sees a doctor and the claim is submitted to an insurance company for payment, one percent will be added to the bill. The money will help fund Michigan’s Medicaid program.

The Self-Insurance Institute of America is challenging the tax in federal court.

"This will essentially put in new administrative requirements for how health insurers administer health claims," said SIIA COO Michael Ferguson, who says that’s not allowed under federal law.

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More than one hundred workers, union representatives and business lobbyists showed up at the state Capitol today to testify on proposed changes to Michigan’s workers compensation law.

The proposed changes before a state Senate panel would reduce an injured worker’s benefits based on the amount an insurance company believes the worker could be earning at another job.

Chris Luty, with the Michigan State Police Troopers Association, told lawmakers finding a job, especially while injured, is not as easy as some insurance companies would claim.

“What’s available out there – what’s really available out there – and what’s theoretically available out there are often two very different things,” said Luty.

Luty told lawmakers about a state trooper named Drew Spencer, who was hit by a car while on the job. Spencer’s injuries were severe and left him dependent on workers compensation benefits.

“Drew Spencer, like most people within the Department of State Police, has a lot of experience before he came in. He has an education. And when you apply the virtual wage language as I understand it, Drew Spencer would get nothing under this bill, as I understand it,” said Luty.

The proposed changes also includes extending the length of time an injured worker must see a doctor assigned to them by insurance companies rather than their own doctor.

Carl Alden, with the Michigan Association of Chiropractors, says letting injured workers visit their own doctors makes sure workers get the best medical care so they can get back to work more quickly.

“The success of Michigan’s current system shows that making a change is not in the best interest of employers, workers, Michigan, and ultimately the insurers,” said Alden.

Business groups say the proposed changes would help reduce fraudulent claims from workers and provide stability for businesses.

The Senate panel is expected to continue hearings on the workers comp issue when the Legislature returns from a two-week break next week.

Fewer than 100 unmarried state employees are expected to sign-up for health care benefits for their domestic partners by the end of this month.

That would mean less than $600,000 would be spent on live-in partner benefits paid for by the state.

The preliminary estimates are well below what some Republican lawmakers said taxpayers would end up paying for the benefits.

Republican state Representative Dave Agema (R-Ottawa Co.) sponsored a measure to end domestic partner benefits for public employees in the future.

"Numbers aside, it really doesn’t make any difference because what we have now, if it doesn’t stop, it will only grow in the future," said Agema. "We haven’t included the colleges and the local governments and so-forth, so it would only be increased to millions and millions of dollars in the future."

Agema’s proposal could not reverse the decision by the state Civil Service Commission to allow for public employee domestic partner benefits.

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Gov. Rick Snyder presented a health address on Wednesday that outlines his plan to improve the health of Michigan residents. Here to take a look at the politics behind the plan are 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. How are Democrats and Republicans reacting to the governor's plan?

 

LANSING, Mich. (AP) - Republicans who control the Michigan Legislature have started another attempt to block the offering of taxpayer-paid health insurance to domestic partners living with
public employees.

The House passed legislation by a 64-44, mostly party line vote Thursday aimed at prohibiting public employers from offering the benefits. The legislation advances to the Senate.

Minority Democrats say the bills are unconstitutional and would be challenged in court.

Republicans supporting the bills say they reflect the will of Michigan voters who decided in 2004 to define marriage as a union between one man and one woman.

The Michigan Civil Service Commission has voted to allow domestic partner benefits for some state employees starting in October. Republicans tried to overturn the decision but couldn't get the two-thirds majority vote needed in the House.

Lindsey Smith / Michigan Radio

An alliance of medical and educational associations is working to get more children signed up for free or low-cost health insurance programs.

Blue Cross Blue Shield would undergo major changes under proposed legislation.
Wikipedia

LANSING, Mich. (AP) - Michigan Attorney General Bill Schuette says his office is reviewing Blue Cross Blue Shield of Michigan's plans for a joint venture involving a Medicaid coverage company.

The Detroit-based Blue Cross and Philadelphia-based Independence Blue Cross are purchasing AmeriHealth Mercy, which has Medicaid managed-care contracts in states including Pennsylvania, Indiana, and South Carolina.

Schuette said Friday he wants the Michigan-based Blue Cross to provide his office with documentation related to the transaction.

Blue Cross officials said they welcome the inquiry and will work with him to clarify questions about the transaction.

The joint venture could provide an opportunity for Blues insurers nationwide to expand into Medicaid coverage just as states are seeking ways to save money in the program and the ranks of Medicaid enrollees is poised to grow.

A new tax on all health insurance claims waits for approval from lawmakers in the state House. As Michigan Public Radio’s Laura Weber reports, the tax is essential to balance the budget for the coming fiscal year.

Lawmakers must approve the health insurance claims tax in order to replace the existing tax on Medicaid HMOs. The federal government is expected to rule later this year that the existing Medicaid tax is illegal. To continue to receive funds from the federal government to help pay for Medicaid the state must approve the new tax on insurance claims.

Some lawmakers on both sides of the aisle have said they do not like the new tax proposal – Republicans saying they will not vote for a new tax, and some Democrats arguing that it would disproportionately affect some seniors who had their pensions taxed earlier this year.

The House is expected to approve the tax changes when lawmakers return in a couple weeks.

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