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medicaid

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Controversy of Medicaid reform is being debated

A bill is being debated in the Michigan house to reform Medicaid in the state.

"The federal government is offering to pay for an expansion of Medicaid that would add hundreds of thousands of Michiganders to the program. But Republican leaders in the state Legislature say they're not willing to expand the system without major changes." Michigan Radio's Jake Neher reports.

Michigan projected to get $542 million more than expected

The state of Michigan is projected to get nearly half a billion dollars more than expected in revenue.

"The state’s economic measurements remain mixed. Michigan still has one of the nation’s highest jobless rates. But Governor Snyder says improving revenue is evidence of confidence in the state’s economy," Michigan Radio's Rick Pluta reports.

The governor has suggested using the surplus to draw down federal transportation dollars, or cover a Medicaid shortfall.

Changes are imminent in Detroit

As of yesterday, Mayor Dave Bing will not be running for re-election, James Craig has been appointed Detroit Chief of Police, and more than half the incumbents on the Detroit City Council will not be seeking another term. The general elections will be held on November 5th. The Detroit News has more.

Governor Rick Snyder's administration is "encouraged" by a House Republican plan to overhaul Medicaid in the state. 

But it's concerned about language that would kick able-bodied adults off the program after four years.

Department of community Health director Jim Haveman says the House plan is "a good starting point" for negotiations.

"I'm really cautiously optimistic that, by the time this is done over the next two weeks, we'll have a bill that we all can be very supportive of and we can collectively go sell and get the waiver from the federal government."

The federal government is offering to pay for an expansion of Medicaid that would add hundreds of thousands of Michiganders to the program. But Republican leaders in the state Legislature say they're not willing to expand the system without major changes.

Washington would have to approve the state's alternative to the plan.

www.schoolbussafety.net

This week in review, Rina Miller and Jack Lessenberry discuss a bill to expand Medicaid, how school districts will no longer collect union dues from teachers, and the financial trouble with Buena Vista and Pontiac schools.

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Wolf hunt approved

"There will be a wolf hunt in the Upper Peninsula this fall. The state Natural Resources Commission OKed the hunt yesterday," Steve Carmody reports.

Pontiac and Buena Vista schools in financial trouble

"A Michigan report says the Pontiac School District's finances are in bleak shape and the district might not be able to make payroll soon. The district faces a  $37.7 million deficit. Meanwhile, the Buena Vista School District shut down this month after it ran out of money and couldn't pay teachers," the Associated Press reports.

Medicaid expansion proposed in House

"Republicans in the state House have introduced a bill to overhaul and expand Medicaid in Michigan. Among other things, it would limit able-bodied adults to four years in the program," Jake Neher reports.

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Republicans in the state House have introduced a bill to overhaul and expand Medicaid in Michigan.

Among other things, it would limit able-bodied adults to four years in the program.

The Republican-led state Legislature has balked at the idea of accepting money from the federal government to add hundreds of thousands of people to Medicaid.

House Speaker Jase Bolger says this is an alternative to that plan.

“If we are going to say ‘no’ to something, we must offer an alternative. We ask that all of the time from our colleagues across the aisle, and therefore we’re going to continue to live by that ourselves,” said Bolger.

The bill would also require the federal government to fund 100 percent of the expansion.

As you may know, the federal government has offered to expand Medicaid coverage to families whose incomes are less than one hundred and thirty three percent of the poverty level.

If you wonder how much money that is, I looked it up for you – slightly less than $26,000 a year for a family of three. The answer to the question: How do you support three people on that and afford health insurance? is that you don’t.

If Michigan accepts, an estimated 320,000 people who now have no health insurance would be immediately covered. That would rise to nearly half a million people within a few years. The cost to the state government would initially be zero.

After the year 2020, Michigan would have to pay 10 percent of the cost. This would still, health care experts say, be a mere fraction of what all these uninsured people currently cost the state.

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Gary Peters announces run for U.S. Senate

U.S. Representative Gary Peters, who represents the Detroit-based 14th Congressional District, is expected to announce his candidacy for the U.S. Senate today. As the Detroit Free Press reports:

"Peters has been considered a likely candidate for the seat being vacated by U.S. Sen. Carl Levin since Levin announced in March his intentions to retire at the end of the current term. Shortly after Levin’s announcement, Peters told the Free Press he was 'seriously considering' a run for that seat."

Corporate donations to help create "wraparound" schools in Detroit

"Detroit and other cities in Michigan are turning to businesses to help pay for schools that provide a wide variety of services to students and their families. Yesterday, JP Morgan Chase announced it will donate $1.5 million to pay for three 'wraparound’ schools in Detroit...Governor Rick Snyder says that could include help with managing household finances or finding a job, or parenting classes,"  Rick Pluta reports.

Law enforcement officials call for an expansion of Medicaid

A group of law enforcement officials is calling on state lawmakers to expand Medicaid coverage to more than 300,000 Michigan residents at an event in Lansing today.

"The group says Medicaid coverage for expectant mothers can help prevent children from being born with fetal alcohol syndrome or fetal alcohol effects. They will also advocate for Medicaid coverage for interventions such as substance abuse and mental and behavioral health issues as a way to cut crime," the Associated Press reports.

Medicaid expansion in trouble in Mich. Legislature

Mar 23, 2013
michigan.gov

Governor Rick Snyder and health advocates have their work cut out for them persuading the GOP-led Legislature to expand Medicaid coverage to hundreds of thousands more residents.

Steve Carmody/Michigan Radio

This “week in review” Rina Miller and Jack Lessenberry discuss a state house subcommittee’s rejection to expand Medicaid, how Michigan will be run under a federal health exchange, how universities are going under scrutiny for negotiating new, long term contracts before Michigan’s right to work law goes into effect, and how a city pension attorney in Detroit and a former trustee were indicted for bribery.

You probably know the old story about the man who kept hitting himself in the head with a hammer. When asked why, he grinned happily and said, “because it feels so good when I stop.”

Well, the Michigan Legislature reminds me of that, with two big differences. We have begun to regard their nutty behavior as normal, and unlike the guy with the hammer, they show no signs of stopping.

Politically, Michigan is a moderate to liberal state. The state hasn’t voted Republican for president in 25 years. Republicans have lost every U.S. Senate election except one over the last 40 years.

We aren’t right-wing extremists. Except in the legislature, which is controlled by ideologues out of touch with the reality the rest of us live in. I’m not talking about conservatives. Good intelligent conservatives from Arthur Vandenberg to Gerald Ford have helped make this state great. I’m talking about people who substitute ideology for common sense.

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Michigan lawmakers reject Medicaid expansion

A state House subcommittee has rejected an expansion of Medicaid to nearly 500,000 Michiganders. As the Detroit Free Press reports,

"The Appropriations subcommittee handling the Department of Community Health budget passed the funding document without the Medicaid expansion, as well as other Snyder proposals, including: dental services for low income children, health and wellness initiatives, mental health and substance abuse services for veterans and an infant mortality program."

However, according to Rick Pluta,  Governor Rick Snyder says he expects the Legislature will ultimately accept federal money to expand Michigan’s Medicaid program.

State House approves dredging funds

"The state House has approved more than $20 million for emergency harbor dredging. Governor Rick Snyder is asking for the money to address record-low water levels in the Great Lakes. He says ships and recreational boaters aren’t able to get in and out of harbors," Jake Neher reports.

March Madness tournament kicks off today

The basketball games leading up to the NCAA championship begins today. As the Detroit News reports, Michigan State University and the University of Michigan's mens' basketball teams have games tonight.

"No. 3 seed MSU will face Valparaiso at 12:15 p.m. and No. 4 seed U-M will take on South Dakota State at 7:15 p.m. Teams moving on in the next round will head to games on Saturday, also at the Palace [of Auburn Hills]."

A doctor with a stethoscope on a young boys naked chest (he's wearing pants though)
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Part of the Affordable Care Act (aka Obamacare) calls for an expansion of the Medicaid program, but some state legislators and governors are resisting the expansion.

Michigan Governor Rick Snyder is NOT one of those governors resisting.

When he announced his support for the expansion last month, he said it was about being "financially responsible."

Republicans in the Michigan Legislature, however, seem to disagree.

Steve Carmody/Michigan Radio

Expanding state Medicaid programs is part of the new national health care law.

Many Republican state lawmakers say it will cost Michigan taxpayers over a billion dollars during the next decade. But there’s a cost to large Michigan businesses if they don’t.

“Actually, taxes could go up on employers in states that don’t expand Medicaid,” says Brian Hale, the senior vice president for health policy at Jackson Hewitt Tax Service, “You need to factor that in to the decision about whether or not to expand Medicaid.”

Michigan Gov. Rick Snyder will unveil his budget this morning at 11 a.m.

Then the leaders in the Legislature will wrestle with the numbers and push their priorities for state spending and income.

Watch Snyder's budget unveiling here:

Governor Rick Snyder  yesterday cast a vote for common sense and pragmatism, by coming out in favor of  expanding Medicaid to what will, within a decade, include almost half a million  people.

Putting purely human considerations aside, the deal makes  enormous economic sense for Michigan. The federal government will pick up all  the costs of the Medicaid expansion for the first three years.  After that,  Michigan has to kick in a tiny amount which will never exceed ten percent. But  from day one, the feds will cover a lot of expenses Michigan pays for today.

The  governor’s staff says this will amount to $206 million dollars next year alone. His budget would prudently stick half those savings in a special  fund to save for the day when Michigan does have to pick up a tiny share of the  expanded Medicaid costs.

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Patient advocates and healthcare organizations are cheering Governor Rick Snyder’s decision to seek an expansion of Medicaid eligibility under the new federal healthcare law.

The expansion would eventually allow 450,000 people to be added to Medicaid, and sharply reduce the ranks of the un-insured in Michigan.

The governor says it would also reduce the overall cost of healthcare in Michigan. And part of the savings can be banked to cover Michigan’s future costs of the Medicaid expansion.

“This is about being financially responsible," said Snyder. "Just like you’d be setting up at home, let’s set up a health savings account here, to cushion for shocks, for unexpected events, and then to have a thoughtful stream of dollars to minimize costs for the long-term."

Health care groups, patient advocates, and some business groups also support the expansion.

They say unnecessary emergency room visits and people who wait to get treated are driving up the cost of care and the cost of health insurance.

Kris Nicholoff is with the Michigan Osteopathic Association. He says that would eventually almost cut in half the number of people in Michigan who don’t have health insurance.

“450,000 people will get coverage that don’t have it right now. Now, you’ve been to the University of Michigan’s football stadium? Four times that. Picture that right now – four times that full patients will receive care if we expand Medicaid," said Nicholoff.

The Medicaid expansion will be part of Governor Snyder’s budget proposal. It will be presented tomorrow. Then it has to be approved by the Legislature. The governor says the expansion will save money in the long-term.

Stethoscope
Adrian Clark / Flickr

Advocates for the uninsured are pressing Governor Rick Snyder to call for an expansion of Medicaid in Michigan. They delivered more than 4,000 petition signatures in favor of an expansion to the governor’s office yesterday.

Under the federal healthcare law, the state could let nearly 400,000 uninsured residents join the program. The federal government would cover the cost for three years. After that, the state would be responsible for up to ten percent. 

Liz Lamoste, with the group Medicaid Matters for Michigan, says the state should take advantage of the offer.

“If the offer’s on the table, we should be in a position to take advantage of it, especially because it makes financial sense for Michigan, and hundreds of thousands of people are relying on us to take prudent responsible action to provide people with more coverage," said Lamoste.

Many Republicans in the Legislature say they don’t trust the federal government to keep its promises. Governor Snyder will announce his plans for Medicaid on Thursday when he unveils his new proposed budget.

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The following is a summary of a previously recorded interview. To hear the complete segment, click the audio above.

Is the State of Michigan going to expand its Medicaid coverage? That's the question on the front burner at the Governor's office these days as he prepares to unveil his new budget to the Legislature this week.

Cyndy spoke with Detroit Free Press reporter Kathleen Gray who helped break down the Medicaid program in the state and talked to us about the pros and cons of expanding Medicaid coverage to another half a million people.

The Affordable Care Act will assist states in expanding their Medicaid eligibility limits for adults to 133 percent of the Federal Poverty Level, (that's and income of about $14,860 per year for one person).

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Snyder to decide this week whether to expand Medicaid

In his budget address this week, Gov. Rick Snyder will announce whether he'll expand Medicaid. Under the Affordable Care Act, the federal government would pay for the state to allow an additional 400,000 people in the state to receive Medicaid coverage. The state would eventually have to pay for a portion of the costs, Rick Pluta reports.

Snyder to propose adding $50 to $100 million to Rainy Day Fund

Gov. Rick Snyder is expected to recommend that the state add $50 to $100 million to its Budget Stabilization Fund, better known as the Rainy Day Fund. Some Democrats argue though that now is not the time to be saving. The Detroit Free Press quotes Gilda Jacobs, president and CEO of the Michigan League for Public Policy.

"For lots of families, it is raining right now," Jacobs said.  "There really is the opportunity to take a portion of the money that is in the Rainy Day Fund and use it for families that are experiencing hardship."

Chrysler pays tribute to troops, farmers in two Super Bowl ads

Chrysler's two Super Bowl ads were among the most well-received auto advertisements according to the Detroit Free Press. Chrysler's first ad, voiced by Oprah Winfrey, was a Jeep spot that paid tribute to the military. Their second commercial, an ad for Ram pickup trucks, featured the late radio personality Paul Harvey reading "So God Made a Farmer."

The ad took 9th place in MSU's annual Super Bowl Ad rankings.

- Joseph Lichterman, Michigan Radio Newsroom

 

Steve Carmody/Michigan Radio

Governor Rick Snyder decides this week whether he will call for expanding Medicaid in his new budget.

The federal government would pick up the entire cost at first, which would allow the state to add nearly 400 thousand people to the Medicaid rolls who are currently uninsured.

One of the goals of the federal health care law is to reduce the number of un-insured people and costly emergency room visits.

But, after the first few years, states will have to pick up part of the cost: 10% by 2020.

If Governor Rick Snyder decides he wants to expand Medicaid in Michigan, state House Republicans say they might not be on board.

State House Speaker Jase Bolger says he’s “cautiously skeptical” about the idea of expanding Medicaid.

Under the federal Affordable Care Act, the state has to decide whether to let more people into the program. If it does, Washington will pay for the expansion for the first three years.
    
Bolger says he’s not yet convinced.

“The federal government has quite a history of dangling carrots and abandoning states and leaving them to pay for those things.”

Governor Snyder says he wants to make sure health care providers in the state can handle an influx of hundreds-of-thousands of people into the program.
    
He’s expected to address his plans for a possible Medicaid expansion when he gives his budget proposal next week.

FLICKR USER THE COSUMERIST / Flickr

Gov. Rick Snyder says he hasn’t decided yet whether he wants the state to expand Medicaid eligibility.

Under the federal Affordable Care Act, the state has to decide whether to let more people qualify for Medicaid. If it does, the federal government will pay the costs of an expansion for the first three years.

Gov. Snyder says he still needs to get a clear idea of what that would mean for the state.

“I want to make sure we have access and high quality care if we’re to look into something like that, and say, ‘What’s the net cost to all of us?’”

Snyder also says he wants to make sure health care providers can accommodate adding hundreds of thousands of people to the program.

“The key issue on the Medicaid expansion that I want to do some research on, among others, is do we have enough capacity to put essentially 400,000 more people into a medical home model with a primary care environment, as opposed to having them simply go to an ER?”

Snyder also says he wants to make sure health care providers can accommodate adding hundreds of thousands of people to the program.

A possible expansion of Medicaid in Michigan will be a key part of Governor Rick Snyder’s budget address to state lawmakers next week.

A bill in the Senate would *prohibit* the state from expanding Medicaid. Supporters of the bill say it doesn’t make financial sense. They say there are better options for expanding coverage.

LANSING, Mich. (AP) - An audit has found that a Michigan agency made at least $3.3 million in improper payments for wheelchairs, ventilators and other medical equipment as part of the Medicaid program.

The report released Thursday flagged the Department of Community Health for paying claims without prior authorization, making duplicate payments and buying incontinence supplies from the wrong contractors.

State officials say they agree with the state auditor's recommendations for improvement, including setting lower rates to buy used equipment.

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Snyder pushes renewable energy and drilling for natural gas

Governor Rick Snyder gave a special address on energy and the environment Wednesday. Highlights of his address include a push for more renewable energy and more drilling for natural gas. As the Lansing State Journal reports,

"The Republican governor gave natural gas a central role in an energy policy that seeks greater efficiency and improvements to infrastructure such as pipelines and the electric transmission grid. It proposes establishing a “strategic natural gas reserve” designed to make the resource more affordable and defends the practice of hydraulic fracturing, or “fracking,” to extract gas from deep underground."

GOP pushing for right-to-work in lame duck

Republicans are still working to make Michigan a right-to-work state. This comes after voters rejected a ballot proposal to enshrine collective bargaining in the state constitution. As the Detroit News reports,

"Today could be the last chance to introduce a bill making union membership optional as a condition of employment in the private and public sectors to get it passed by Dec. 13. That's the day legislative leaders hope to head home for the holidays."

Sorry Michigan, no one won the Powerball jackpot in the state

"The Michigan Lottery says two Powerball tickets worth $1 million each were sold in the state. Officials say the tickets were sold at a liquor store in Kentwood and a CVS pharmacy in Dearborn. The Michigan tickets matched five numbers drawn last night, but not the Powerball number. Powerball officials said early Thursday that tickets sold in Arizona and Missouri matched all six numbers to win the $579.9 million jackpot," the AP repots.

A doctor with a stethoscope on a young boys naked chest (he's wearing pants though)
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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. 

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Secretary of State being sued over citizenship question

"A coalition of unions, voters, county clerks and civil rights groups is suing Secretary of State Ruth Johnson in federal court. The lawsuit challenges Johnson’s instruction that voters who show up on Election Day should be asked whether they are US citizens. But no one can legally be denied a ballot for refusing to check the box. The lawsuit was filed yesterday in US District Court in Detroit. Johnson’s office would not comment specifically on the lawsuit. But she has said the question is simply meant to remind people that only U-S citizens can vote in elections," Rick Pluta reports.

Medicaid tax falls $130-million short of projections

"The state could lose up to $260-million in federal funding for Medicaid this year. That's because of lower-than-expected revenues from Michigan's new one-percent tax on health insurance claims, which started in January. The tax will bring in $130-million less than originally projected for the current fiscal year. That means Michigan will have less money to qualify for federal matching dollars," Jake Neher reports.

CAW extends contracts with GM and Chrysler

The AP reports the Canadian Auto workers union says it has agreed to extend its current contracts with General Motors and Chrysler. Negotiations on new deals continue,

The union had set a midnight strike deadline. But President Ken Lewenza said talks would go past the deadline if there was progress. Earlier Monday the C-A-W reached a 4 -year deal with Ford that freezes pay and cuts wages for new hires. The union wants the deal to be the template for contracts with G-M and Chrysler. A CAW spokeswoman wouldn't say how long the contracts will be extended.

A new state tax to help pay for Medicaid is coming up $130 million short of projections.

The one-percent tax on health insurance claims was supposed to bring in $300 million this fiscal year. Now, budget officials say it’ll only generate about half that. Budget department spokesman Kurt Weiss said the state should be able to scrape together enough money to make up for the missing tax revenue. It is federal matching funds he is worried about.

“If you look at the way the match works, there’s the potential of losing up to $260 million in matching federal funds with this if we’re $130 million short. So, certainly that is part of the concern,” Weiss said.

Weiss said bad projections could be to blame for the gap, or health care providers simply might not be paying their share. He said his department is working with other state agencies to pin down the problem.

“It is a new tax, and it is something new to those that are paying it. So we’re really trying to reach out, do that education, and trying to make sure we’re getting the money from everybody we should be getting the money from,” he said.

Weiss said officials are looking for ways to try and make up the state’s shortfall. If shortfalls continue, he says lawmakers may have to make changes to the tax.

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.

Stethoscope
Adrian Clark / Flickr

Under a new law in Michigan, everyone who files a claim for a treatment or a checkup will pay a one percent tax to help fund Medicaid. The tax does not apply to co-pays or deductibles.

The new law got rid of a 6 percent use tax on Medicaid managed care organizations.

Governor Rick Snyder pushed for the one percent tax on health insurance claims to maintain medical coverage for low-income patients.

The tax was unpopular with fellow Republicans, but as the Michigan Public Radio Network Rick Pluta reported, Snyder said "he was committed to not rolling back health coverage for the poor during tough economic times."

He signed the tax into law last September.

Now the law is being challenged in court. From the Associated Press:

The Self-Insurance Institute of America Inc. filed a suit challenging the law Thursday in federal court. The suit says the Michigan assessment is pre-empted by federal law.

The suit seeks to block the assessment related to self-insured group health plans.

The Michigan assessment is scheduled to begin Jan. 1 to help fund Medicaid programs. It would be paid to the state by insurers or HMOs.

It's expected to raise about $400 million a year, helping the state draw roughly $800 million in federal funds for Medicaid.

The AP left a message seeking comment from Governor Snyder's office.

Photo courtesy of the Snyder administration

Governor Snyder has approved a one percent tax on health insurance claims to ensure that medical coverage for low-income families is not slashed by almost a billion dollars.

Everyone who files a claim for a treatment or a checkup will now pay the one percent tax. It will not apply to co-pays or deductibles.

It replaces a six percent tax on Medicaid HMOs. Michigan’s system for financing the Medicaid program for covering low-income families was on the cusp of being thrown out by federal authorities because it did not spread the burden wide enough.

Governor Snyder had a difficult time winning the votes for the health claims tax in the Republican-led Legislature. But he said he was committed to not rolling back health coverage for the poor during tough economic times. The Snyder administration has come under fire by human services advocates for rollbacks in other types of aid for low-income people, including new limits on cash assistance and food stamps.

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