Governor Proposed Michigan First Healthcare Plan to Provide Health Insurance to Half the State's Uninsured Population
Governor Proposed Michigan First
Healthcare Plan to Provide Health
Insurance to Half the State's Uninsured Population
by Alison Hirschel, MPLP Elder Law Attorney
Governor Granholm recently announced her administration is developing a proposal to provide health insurance to approximately 550,000 Michiganians, about half of the state's uninsured population. The program will be targeted at uninsured individuals at or below 200% of the federal poverty level. The proposal involves what the administration describes as a public/private partnership and a market based approach rather than an expansion of the traditional Medicaid program. Although none of the details of the proposal have been finalized or approved by the federal government, the administration anticipates that participants with incomes at or below 100% of poverty will be asked to contribute minimal out of pocket costs and that there will be a sliding scale for cost sharing for those with incomes between 100% and 200% of the FPL.
Under the proposal, the state will establish guidelines for a minimum benefit package and a cost-sharing structure. Health insurers, HMOs, and Blue Cross will then design a variety of plans that will be available at an "exchange." Consumers who are eligible for the program will then be able to select the insurance product they prefer from the exchange. Currently, the Administration anticipates that the benefit package will include preventive and primary care, hospital care, emergency room care, mental health services, and prescription drug coverage. Other benefits are under discussion but Medicaid Director Paul Reinhart has stated that the benefit package will not be as "robust" as traditional Medicaid.
The proposal can only be implemented if the federal Centers for Medicare & Medicaid Services (CMS) approves a Section 1115 waiver. Similar waivers have been approved for a number of other states. The Administration has had a series of conversations with high level CMS officials and is working with the consulting firm that was instrumental in obtaining approval for similar proposals in other states. The Administration has announced it is optimistic about the likelihood of obtaining CMS approval and hopes to implement this plan next spring.
While the Administration has made considerable progress in determining the financing mechanism for the proposal, it has not yet fully developed the details of the proposals including what the benefit package will include, what cost sharing will be required, how the plan will be implemented, etc. Administration officials have stated they will seek considerable public in-put regarding these aspects of the program that will have the greatest impact on potential program participants.
Further details of the proposal are available at http://www.michigan.gov/documents/Michigan_First_Healthcare_Plan-SOS_149754_7.ppt