medicaid expansion

Steve Carmody / Michigan Radio

An anti-circumcision group says Michigan’s Medicaid program should stop funding for circumcision.

Michigan has one of the highest circumcision rates in the country.

Norm Cohen is the state director of the National Organization of Circumcision Information Resource Centers. Members of the group picketed at the state capitol today.  Many in the group wore white pants, stained in the crotch with red paint. 

Michigan State Capitol
Jimmy Emerson / Flickr

This week two separate federal appeals court rulings came down on opposite sides of a key provision in the Affordable Care Act. This leaves thousands of low and middle income Michiganders who signed up for healthcare through Michigan’s exchange in a bit of limbo. 

Jennifer White, host of All Things Considered, is joined by Marianne Udow Phillips, Director, Center for Healthcare Research and Transformation and Ken Sikkema, former Senate Majority Leader and Senior Policy Fellow at Public Sector Consultants. 

Phillips states that although these rulings were issued nothing is going to change immediately and that it is important to understand that the legal rulings will take time to play out. 

“It would have a huge impact and it would really push the whole system into chaos,” explains Phillips. “There are 240,000 in Michigan who have already gotten health insurance coverage through the health insurance exchange with a subsidy, and so were they to lose that subsidy, almost all of them would not be able to afford healthcare coverage.” 

Sikkema states that it is a very polarizing topic and coupled with an election year, politicians and candidates have honed in on the issue. “It already is a big political issue; it’s the primary political issue for Republicans who are running for office” says Sikkema, “but it’s really hard to look in your crystal ball and see what the future of the Affordable Care Act is going to be.”

Alex Proimos / flickr

April 1 was an important day for many in Michigan. It was the day nearly half a million people in our state became newly eligible for the expanded Medicaid program.

Since then, more than 300,000 people have enrolled. Many have not seen a physician for a long time. Or, they have relied on emergency rooms for their medical care.

As revealed in a study published in the medical journal JAMA Surgery, there's good news and challenging news in all of this.

Certainly it's good that patients will be able to turn to a physician for medical care.

But the challenge is the overall poor health of many of these patients, especially surgical patients, and that has many implications – to the patients, to the hospitals and to the surgeons treating them.

Chief Medical Officer of the University of Michigan Health System, Dr. Darrell Campbell, Junior, talked about the study on Stateside.

Campbell analyzed data on 14,000 patients who had operations in 52 hospitals in Michigan from July 2012 to June 2013. The study looked at the Medicaid population and compared them to people with private insurance but were around the same age. The study analyzed the condition those patients were in prior to their surgical procedure.

“What we found was that they weren’t in very good shape,” Campbell said. “And that has consequences for the results after they have surgery, not only in terms of how well they do from physical point of view but also the cost and resources that are used afterwards.”

Steve Carmody / Michigan Radio

A bill that would give nurses with advanced degrees more autonomy is coming up for debate in the Michigan House.

Senate Bill 2 would give advanced practice registered nurses, also known as APRNs, the authority to write prescriptions and order tests without a doctor's approval.

The Affordable Care Act has led to more people seeking medical care. Also there is a physician shortage in rural parts of the state. This legislation aims to accommodate more of those additional people.

Steve Carmody / Michigan Radio

Michigan’s expanded Medicaid program is off to a fast start.  

Tens of thousands of people have signed up for the medical coverage in the first week since the enrollment opened.

The Healthy Michigan program has received nearly 55,000 applications since April first; 32,000 Michiganders have already had their applications approved. Tens of thousands more have been moved into the expanded Medicaid program from a different state health assistance program.

Andrian Clark / Flickr

    

Healthy Michigan” is available to more than 470,000 low-income Michiganders between the ages of 19 and 64.

Joining us today is Krista Nordberg, director of enrollment at the Washtenaw Health Plan.

Nordberg says the Healthy Michigan Plan is “extremely comprehensive health care coverage” for low-income individuals. The kind of coverage available includes medical benefits, prescription coverage, dental, vision and mental health services.

But under the new plan, people will be responsible for some of the cost of their health care.

“The co-pays range from about $1 to $3 for the dental and the vision and the prescriptions. And for people with higher incomes – incomes between 100-133% of poverty – they will be asked to contribute to a health savings account, and that is still something being worked out with the state as to how that would be administered through their health plan, and how they will pay into that,” said Nordberg.

For more information about Healthy Michigan click here, or call 1-855-789-5610. 

Today is the day. After months and months of debate, Healthy Michigan is here. That's the official name for the state's newly expanded Medicaid program. Today, on Stateside: Who is eligible for the new coverage and why are other states looking to Michigan for lessons learned?

Then, it made news: the merger between financially struggling Albion High School and its neighbor, Marshall. Now, more than halfway through the school year, we checked in on how the students are faring.

And, a new report is breaking new ground in the study of inequality among our children, and the findings for Michigan children are troubling.

First on the show, another hugely surprising retirement from Congress. Republican Congressman Dave Camp, who represents Michigan's 4th district, announced that he will not run again for re-election. Camp has served in Congress for 24 years and has been chair of the powerful House Ways and Means Committee.

Zoe Clark and Rick Pluta, co-hosts of Michigan Radio's It's Just Politics, joined us today to talk about what’s next for Camp and what this means for Michigan in Congress.

Jonathan Oosting
Twitter

The Affordable Care Act shop door now has a "closed" sign on it, for the most part.

The open enrollment deadline passed at midnight.

Attention in Michigan now swings over to Healthy Michigan.

That's the official name for Michigan's expanded Medicaid program. It allows the state to bring more low-income residents into the Medicaid fold using funding available through the Affordable Care Act.

And Michigan's Medicaid expansion is something other states are watching because of a couple of important new twists to the program.

MLive Capitol reporter Jonathan Oosting joins us now.

Steve Carmody / Michigan Radio

In one month, more than 300,000 people are expected to begin signing up for expanded Medicaid coverage in Michigan. The Medicaid expansion is part of the federal Affordable Care Act.

"Healthy Michigan" would cover nearly everyone, under the age of 65, with an income up to 133% of the federal poverty limit. That translates to individuals making about $15,000 and families of four making less than $32,000.

People in rural areas trying to enroll for health insurance as part of the new Affordable Care Act can face special challenges. Registration must happen online, and many people in Michigan’s rural counties do not have a home computer or access to the Internet. 

Steve Carmody/Michigan Radio

LANSING, Mich. (AP) - Gov. Rick Snyder is proud of the substantial changes he and lawmakers made to Michigan's health care landscape in 2013.

Almost a half-million low-income adults will qualify for government health insurance through an expansion of Medicaid. An overhaul of Blue Cross Blue Shield is creating a nearly $1.6 billion health endowment fund.

More low-income children are eligible for dental coverage.

Steve Carmody/Michigan Radio

LANSING, Mich. (AP) - Gov. Rick Snyder and legislators have enacted more than 200 new laws in 2013, with roughly 70 more awaiting the governor's signature after a final burst of voting.

The year's top laws include a landmark expansion of government-funded medical coverage to hundreds of thousands more low-income adults and restrictions on insurance coverage of abortions.

The Michigan House of Representatives.
Lester Graham / Michigan Radio

Each Thursday we talk Michigan politics with Susan Demas, publisher of Inside Michigan Politics, and Ken Sikkema, former Senate Majority Leader and Senior Policy Fellow at Public Sector Consultants.

The Michigan legislature is on recess until the first week of December. This feels like a much more subdued legislative session compared to last year. Today we ask, what has the legislature checked off it's list, what bills are likely to come up in December?

Listen to the full interview above.

Steve Carmody/Michigan Radio

LANSING, Mich. (AP) - State legislators are divided over a plan requiring Michigan insurers to tell policyholders the impact of the federal health care law on their premiums.

Legislation awaiting a vote in the Republican-led House would require that insurers give annual estimates of the overhaul's effect on premiums.

Republican Rep. Mike Shirkey of Clark Lake says people deserve to know the law's ramifications. He also wants to insulate insurers from being blamed for premium increases.

But Democrats say the bill is nothing more than a political ploy.

Whitehouse.gov

CRYSTAL FALLS, Mich. (AP) - The UP is back on the map.

MLive.com says a map that the White House put up on the website showing which states were expanding Medicaid coverage under the Affordable Care Act was showing an outline of Michigan that omitted the Upper Peninsula.

Michigan is among the states that are expanding Medicaid under the health care law.

Steve Carmody/Michigan Radio

Michigan officials hope to know by Christmas whether the Obama administration has accepted the state’s plan for extending Medicaid coverage to thousands of working poor people.

The state formally submitted its proposal to the federal government today.

The state wants waivers from the usual Medicaid rules so it can charge co-pays, set up health care savings accounts, and use financial incentives to encourage patients to adopt healthy behaviors.

Insurance sure is a hot political topic these days with hearings in Washington on the glitches with the HealthCare.gov website, and the recent fight in the Legislature over the Medicaid expansion. So what better moment to re-kindle the controversy over Michigan’s auto insurance rates and the no-fault law?

Which is exactly what Governor Rick Snyder did this week when he re-started talks among the groups with an interest in an overhaul of the law. That includes doctors and hospitals, insurance companies, and trial lawyers – all major political players in Lansing.

And, certainly, people who’ve been injured in car and truck accidents have a big stake.

Auto insurance is intensely political. (So much so that some states even have elected insurance commissioners.) Pretty much everyone runs the risk of being hurt in a crash, and everyone who owns a vehicle - under Michigan’s no-fault insurance law - is supposed to carry liability coverage.

People are always upset by insurance rates, but none more so than people who live in cities with high premiums. Cities like Detroit and Flint.  Insurance rates actually affect elections. Some city dwellers use out-of-town addresses on their driver’s licenses and voter registration to get lower rates, which also means they don’t vote in local elections.

Steve Carmody/Michigan Radio

LANSING, Mich. (AP) - Delaying Medicaid expansion in Michigan is having another side-effect besides forcing low-income adults to wait three months longer for health insurance under the federal health overhaul.

It also means there could be $73 million less for deteriorating roads at a time lawmakers are funneling more money there in part to avoid raising gasoline taxes and vehicle registration fees.

Steve Carmody / Michigan Radio

Michigan’s new online healthcare exchange went live today, meaning Michiganders would now have the opportunity to check out healthcare plans and subsidies available to them under the Affordable Care Act.

But the launch didn’t go without a couple of hiccups.

As the exchanges went live on the web, consumers encountered error messages, saying the high traffic to the exchanges would mean delays with actually looking at the plans.

Adrian Clark / Flickr

As Medicaid expansion is coming, we’re starting to get a better picture of who will be covered. Much of Medicaid now is spent on people in nursing homes. But the expansion will include a lot of younger people, low-income workers.

A new study from the University of Michigan Medical School looks at the likely demographics and Tammy Chang, the lead author of that study, joined us in the studio to discuss the new faces of Medicaid. 

Listen to the interview above. 

User: cncphotos / flickr

This week in Michigan politics Jack Lessenberry and Christina Shockley discuss the Medicaid expansion, crime rates in Detroit and Flint and the mediation of Detroit’s bankruptcy.

Gov. Snyder / Facebook

After months of political wrangling and debate, Governor Snyder has signed the Medicaid expansion into law. The expansion will provide Medicaid services to hundreds of thousands of working-poor in Michigan through the federal Affordable Care Act.

Chris Gautz, Capitol Correspondent for Crain's Detroit Business, and Chad Livengood, Lansing reporter for the Detroit News joined us today to talk about what we can now expect. 

Listen to the full interview above.

Medicaid expansion has become the latest battlefield over the Affordable Care Act ever since the U.S. Supreme Court ruled that states are not bound to follow through on that ACA provision.

Some Republicans in Michigan fought hard to keep the state from enacting Medicaid expansion. But they lost.

Republican Gov. Rick Snyder signed Medicaid expansion into law today - his office then sent this tweet:

So Michigan is colored blue in this map of states that have passed Medicaid expansion vs. those states that have not (red states):

chrt.org

We've been flooded with news coverage of the Medicaid expansion in Michigan, the Affordable Care Act (aka "Obamacare"), and the soon-to-be unveiled health care exchanges.

But it's all confusing and challenging, even to those who work in the field of healthcare coverage.

We wanted to see if we could get a firmer grasp on what all of this means in real world terms. Who's in, who's not? What does it mean for you, the consumer?

Marianne Udow-Phillips is the director of the Center for Healthcare Research and Transformation. It's a non-profit partnership between the University of Michigan and Blue Cross/Blue Shield of Michigan. She joined us today from Ann Arbor.

Listen to the full interview above.

Andrian Clark / Flickr

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.

Steve Carmody/Michigan Radio

Governor Rick Snyder says extending Medicaid to more working poor people will save the state a lot of money – maybe $130 million next year. That begs the question of what to do with the budget windfall.

   The Snyder administration says the Medicaid expansion to 320,000 working poor people will help reduce uncompensated hospital care and other things that drive up the cost of health care. But the state should also see direct savings by shifting costs like prisoner mental health services to the Medicaid program.

Gov. Rick Snyder
Rick Snyder for Michigan / Facebook.com

LANSING, Mich. (AP) — Michigan lawmakers are looking to give final approval to a Medicaid expansion bill by day's end.

Gov. Rick Snyder secured a big victory last week when the state Senate voted to implement a key part of the federal health care law.

But the Republican-controlled chamber on Tuesday is expected to reconsider the issue of when the legislation should take effect. For newly eligible low-income residents counting on the medical coverage next year, it's the difference between waiting until late March instead of qualifying as early as Jan. 1.

The House is expected to send the legislation to Snyder's desk after receiving it.

In response to conservative critics, Snyder says Michigan's plan isn't a "generic" expansion of Medicaid and instead includes Republican-driven provisions that will need approval from the Obama administration.

Steve Carmody/Michigan Radio

The Labor Day weekend signals an end to summer, and this week the Legislature returns to a full-time schedule.

The first order of business is final votes on expanding Medicaid.

Legislative leaders hope to wrap up the controversial question of expanding Medicaid to thousands of working poor people. The Senate has to vote on whether the coverage will begin January first, and a House vote is needed to send the bill to Governor Rick Snyder.

The Michigan State Capitol.
Steve Carmody / Michigan Radio

LANSING, Mich. (AP) - The Michigan Senate's months-long debate over Medicaid expansion isn't over, even after the vote to provide health insurance to hundreds of thousands of low-income residents.

Republican senators on Tuesday will reconsider the issue of when the legislation should take effect. While the Senate passed the bill 20-18 in dramatic fashion this past week, it fell two votes short of giving it immediate effect.

"War." That was the headline on the conservative blog “Right Michigan” following the state Senate’s vote this week to approve the Medicaid expansion. The GOP right, the Tea Party, say this is a vote that will not be forgotten – political collusion with the loathed and dreaded Obamacare by eight Republicans who voted with Democrats to get it passed.

Make that nine Tea Party targets if you count Lieutenant Governor Brian Calley, who was not forced to but stood ready to cast a tie-breaking vote if it was needed to get the expansion passed.

Last week, we outlined the political challenges facing Calley and, since then, a Tea Party opponent emerged. Wes Nakagiri says he is putting together a campaign to oust and replace Calley next year at a Republican state convention.

Calley, meanwhile, has gone on counter-offense, adopting the vernacular of the Tea Party, and sending out communications heavily laden with words like “freedom,” “liberty,” and “conservative.” He is also touting the endorsement of Congressman Justin Amash, a favorite of the “liberty” wing of the Republican coalition.

All of this is an effort to begin to re-set the conversation after the Senate vote. But there is still more road to travel before the Medicaid expansion is complete. The state House must adopt the Senate version to get it to Governor Rick Snyder’s desk.  The governor is actually delaying a trade-building mission to China and Japan to be on hand. (Remember, he rushed back from Israel after the Medicaid expansion stalled in the Senate earlier this summer.) It’s a good bet he’d like to sign the bill before joining the trade trip later in the week.

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