MCH Launches New Website and Blog

Today Michigan Consumers for Healthcare launched a new website, www.consumersforhealthcare.org!

We’ve also moved our blog to www.consumersforhealthcare.org/blog, please join us there for continued coverage, insight and analysis of the Affordable Care Act in Michigan!

MCHA Project Director and Policy Advisor Testify Before Senate Committee

This week MCHA Project Director Don Hazaert and Policy Advisor Jan Hudson from the Michigan League for Human Services testified before a joint meeting of the Michigan State Senate Health Policy and Insurance committees.

You can read their full remarks online and an excerpt of their tesimony is also included below:

“While there is always a degree of uncertainty in implementing such sweeping changes as prescribed under ACA, we are fortunate in that there is a similar exchange model already in place in Massachusetts.  Thanks to former Governor Romney’s leadership, less than 2% of the citizens of Massachusetts last year were without health insurance, compared to a national average of 15.4%.  According to analysis done by MIT, 60 percent of those gaining coverage under the Massachusetts plan had been previously uninsured.  The 1.9% who remained uninsured were predominantly undocumented immigrants or persons provided with an affordability waiver.

The Massachusetts model also provides state policymakers some guidance as far as costs.  Despite some hyper-partisan rhetoric regarding runaway program costs bankrupting its state’s treasury, the non-partisan 410(c)3 group FactCheck.org determined that costs stemming from the Massachusetts health care reform initiative were in line with initial expectations.  The conservative watchdog group the Massachusetts Taxpayers Foundation concluded in their own analysis that the net added cost to Massachusetts taxpayers was $353 million in 2010, or roughly 1.2 percent of the state budget.  Much of this cost was due to the fact that the initial Massachusetts legislation did not attempt to tackle the critical cost-control issue, something the federal legislation emphasizes.

I would like to add one final point regarding the Massachusetts model.  The program is and always has been popular with the public.  Boston Globe polling, conducted when the legislation was first enacted, placed public support at 61 percent.  Three years later public support remained steady at 59 percent with opposition at only 28 percent.  Additionally, a New England Journal of Medicine poll found 85 percent of practicing physicians in the state believed the law either had no impact or had a net positive impact on the quality of care being delivered.

I share this data on the Massachusetts exchange model simply to make the point that “what one state can do, another can do.” By working together as stakeholders and policymakers we can develop an effective and competitive healthcare marketplace that works for all consumers.   I would add we also have the decided advantage of being able to learn from Massachusetts mistakes- such as a lack of cost control efforts and effective planning for the small business market- as we work together to build a state exchange that works for all consumers.

MCHA looks forward to being a partner in that critical process.”

Health Insurance for People Who Can’t Get It

If you’ve been turned down for health insurance because of a pre-existing condition, or offered coverage only at an unaffordable price, you may have another option: the Pre-Existing Condition Insurance Plan called HIP Michigan.

HIP Michigan is available to children and adults who’ve been locked out of the health insurance market because they have cancer, heart disease, diabetes, HIV/AIDS, asthma, or some other pre-existing medical condition.

With HIP Michigan, you’ll be insured for a wide range of benefits, including primary and specialty physicians’ services, hospital care, and prescription drugs. You won’t be charged a higher premium because of your medical condition and your eligibility isn’t based on your income.

Like commercial insurance plans, HIP Michigan requires you to pay a monthly premium, a deductible, and some cost-sharing expenses.

To qualify for HIP Michigan, you must:

• Be a Michigan resident;
• Be a U.S. citizen or Lawfully Present in the United States;
• Within the past six months, have been denied coverage due to health conditions or have been offered coverage with a rider excluding certain health conditions;
• Have been uninsured for six months prior to submitting your application.

With HIP Michigan, a person in his or her 60s can pay about $400-$600 a month in premiums for health care instead of paying an expected $27,000 or more for medical bills and potentially facing bankruptcy. Monthly cost are based on age and deductible and are available online.

Copays are $20 for a primary care doctor’s office visit, $30 for a specialist, and $100 for emergency room visits. Generic prescription copays are $10. Brand-name drug copays are $30 or $50. There’s no lifetime cap on the amount that PCIP pays for your care.

Pre-Existing Condition Insurance Plans like HIP Michigan were created under the Affordable Care Act. It’s a transitional program until 2014, when all Americans—regardless of health status—will have access to affordable health insurance as the nation shifts to a new marketplace.

If you would like to learn more or apply visit the HIP Michigan website!

Debt Negotiators Focusing on Medicaid

Courtesy The Washington Post

This is what a lot of health-care advocates were afraid of. Social Security has, to the surprise of many, been untouchable in this year’s various deficit talks and plans. Republicans reached out to touch the third rail of Medicare and got zapped. But Medicaid? Well, the program primarily serves the very young, the very poor and the very disabled. Those aren’t constituencies known for meting out iron-fisted vengeance at the ballot box. And sure enough, Janet Hook and Janet Adamy are reporting that “officials familiar with the talks in both parties say they expect Medicaid to be the biggest source of cuts in federal entitlement programs in whatever compromise emerges.”

Click Here for More From Ezra Klein of The Washington Post

Gov. Snyder Declines to Sign GOP Governors’ Medicaid Letter

From The Detroit News and mLive.com

Gov. Rick Snyder said he declined to join 29 other Republican governors in asking Congress to repeal last year’s federal health care overhaul and to provide more flexibility in providing Medicaid health care to the poor because, “I’m focused on Michigan.”

“My role is not to be a large advocate on the national scale. I was hired to be governor of Michigan,” Snyder told a news conference today. “We’re focused on Michigan issues. We’re doing a major message in September on health and wellness. The focus right now is education, government reform, all the other good activities we’re working in partnership with the Legislature.”

The letter to Rep. Fred Upton, R-St. Joseph, and Sen. Orrin Hatch, R-Utah, presented on the Republican Governors Association website, called on Congress to revamp Medicaid to give states more leeway in crafting state-specific health plans for the poor and to give the poor more choices in the insurance they have.

But the governors said the first step toward Medicaid reform was “full repeal” of President Obama’s federal health care overhaul. “Time and again, states have been caught in more intensive federal constraints that add little to the value or quality of services being delivered and thwart the creativity of the states,” the letter said.

In a separate letter to Upton, Snyder said the state had been able to balance its budget without cutting eligibility, optional services or provider payments. He also referenced the September message on health and wellness.

Snyder has not called for repeal of the federal health care law and his Department of Community Health is proceeding with its implementation, which includes the establishment of a state-level insurance exchange that would give consumers personal insurance market greater choice and access to coverage.

 

Scoreboard Tool from Kaiser Tracks Affordable Care Act Legal Challenges

Kaiser Health News (KHN) is tracking the status of 26 federal lawsuits seeking to overturn the Patient Protection and Affordable Care Act and has created a central “scoreboard” page to update and track those and other new cases on their website.

On June 8, a panel of three judges in the 11th U.S. Circuit Court of Appeals in Atlanta heard oral arguments in the most watched of all the legal challenges to the new health care law:  The lawsuit was brought by the state of Florida and 25 other states.  This is the fourth case to reach an appeals court, an important step on the way to the U.S. Supreme Court. More information on the case is available on the KHN website.

How Pre-Existing Insurance Plans Are Helping to Bridge the Coverage Gap

Courtesy The Commonwealth Fund

When fully implemented, the Affordable Care Act will prohibit insurers from denying coverage to individuals because of preexisting health conditions. However, this provision of health reform will not go into effect until 2014. In the meantime, the law created Pre-Existing Condition Insurance Plans (PCIPs), state-based, temporary high-risk pools that make health insurance coverage available to individuals who have been unable to obtain it because of their health status or conditions. In Michigan our PCIP,  HIP Michigan, is administered by Physicians Health Plan of Mid-Michigan.

A new issue brief from The Commonwealth Fund examines PCIP enrollment trends, benefits and premiums, and out-of-pocket costs. Enrollment has been more modest than expected, with approximately 21,000 people enrolled as of April 30, 2011, but the PCIP program is of critical importance, the authors say. By providing a temporary safety net for the “uninsurable,” PCIPs have allowed thousands of people to get the care they need and prevented some people’s conditions from progressing to disabilities. Recent federal and state reductions in premiums and deductibles will help make the plans more affordable.

Read the brief, part of the Realizing Health Reform’s Potential series, to learn more about how PCIP plans are helping to bridge the coverage gap until health insurances exchanges are operational.

Graduation gifts from the Affordable Care Act

Courtesy MLHS “Factually Speaking” Blog, by Jan Hudson

Last month, we celebrated Mother’s Day gifts from the Affordable Care Act (ACA). This month we celebrate graduation gifts from the ACA.

Effective Sept. 23, 2010, employer-sponsored insurance plans that offer dependent coverage were required (beginning with their new plan years) to extend that coverage to young adults up to age 26 on their parents’ plans. Young adults no longer have to be students, IRS-defined dependents, or even living with their parents to qualify. This provision of the law allows young adults to maintain critical health care benefits while they establish themselves in a job or career.

This is great news for young adults graduating from high school and not going to college who might not otherwise have access to health care coverage. This is also great news for college graduates who have not yet landed that first job, or have a waiting period before they are eligible to participate in their new employers’ health care coverage, or found jobs that do not include health care benefits. These young adults can remain (or re-enroll) on their parents’ employer plans until they reach age 26.

Read More Here

Changes to the Pre-Existing Condition Insurance Plan

From the U.S. Department of Health and Human Services, Courtesy HealthCare.gov

The Pre-Existing Condition Insurance Plan (PCIP) was created under the Affordable Care Act to ensure more Americans with pre-existing conditions have access to affordable health insurance and serves as a bridge to 2014 when insurers will no longer be allowed to deny coverage to people with any pre-existing condition, like cancer, diabetes, and asthma.  In 23 states and the District of Columbia, the PCIP program is federally-administered.  The remaining states, including Michigan, operate their own PCIP programs using federal funds provided by the Affordable Care Act.

Reducing Premiums and Easing Eligibility

On May 31, 2011, the U.S. Department of Health and Human Services (HHS) announced new steps to reduce premiums and make it easier for Americans to enroll in federally-administrated PCIP programs:

• Premiums will drop as much as 40 percent in 17 states and the District of Columbia.  These premium decreases help bring PCIP premiums closer to the rates in each state’s individual insurance market; in the six states where PCIP premiums were already well-aligned with state premiums, premiums will remain the same.
• Eligibility standards will be eased in all 23 states and the District of Columbia where PCIP is federally-administered to ensure more Americans with pre-existing conditions have access to affordable health insurance. Starting July 1, 2011, people applying for coverage can simply provide a letter from a doctor, physician assistant, or nurse practitioner dated within the past 12 months stating that they have or, at any time in the past, had a medical condition, disability, or illness.  Applicants will no longer have to wait on an insurance company to send them a denial letter.  Applicants will still need to meet other eligibility criteria, including that they are U.S. citizens or residing in the U.S. legally and that they have been without health coverage for six months.

Fighting Unreasonable Health Insurance Premium Increases

New Fact Sheet / Feature Article from HealthCare.gov

Health insurance premiums have risen rapidly, straining the pocketbooks of American families and businesses for more than a decade. Since 1999, the cost of coverage for a family of four has climbed 131 percent.[1] These increases have forced families and employers to spend more money, often for less coverage. Many times, insurance companies have been able to raise rates without explaining their actions to regulators or the public or justifying the reasons for their high premiums. In most cases, consumers receive little or no information about proposed premium increases, andaren’t told why companies want to raise rates.

The Affordable Care Act brings an unprecedented level of scrutiny and transparency to health insurance rate increases. The Act ensures that, in any State, large proposed increases will be evaluated by experts to make sure they are based on reasonable cost assumptions and solid evidence. This analysis is expected to help moderate premium hikes and provide those who buy insurance with greater value for their premium dollar. Additionally, insurance companies must provide easy to understand information to their customers about their reasons for significant rate increases, as well as publicly justify and post on their website any unreasonable rate increases. These steps will allow consumers to know why they are paying the rates that they are.

Learn more about the final HHS  regulation to implement this important consumer protection from the Affordable Care Act