Michigan

2019 OPEN ENROLLMENT ENDS (most states)

Time: D H M S

Michigan was pretty much Ground Zero for the 2018 Blue Wave midterm elections. In addition to Democrats flipping the Governor's seat (and holding onto Debbie Stabenow's U.S. Senate seat), they also flipped the Attorney General, Secretary of State, one of two state Supreme Court seats, both of the state Board of Education seats which were up and all six state University Board seats which were up. In addition, they picked up two U.S. House seats, five state Senate seats and five state House seats.

It was a complete and utter repudiation of both Republican governance and their agenda.

You might expect the Michigan GOP to accept the clear will of the voters. You would be very, very wrong.

As Democratic candidates prepare to take three statewide offices on Jan. 1 — governor, attorney general and secretary of state — Republican lawmakers introduced bills Thursday to challenge their authority.

This is about as minor a rate filing update as I've had, but I'm posting it separately in the interest of completeness.

Insurance carriers in my home state of Michigan originally submitted their requested 2019 ACA individual market rate filings back in June. At the time, the average premium increase being asked for was pretty nominal, around 1.7%, with a smaller-than-average #ACASabotage factor of around 5% due to the ACA's Individual Mandate being repealed and #ShortAssPlans being expanded by the Trump Administration.

Today, just two days before the 2019 Open Enrollment Period actually begins, the Michigan Dept. of Financial Services finally posted the approved 2019 rate filings...and practically nothing ended up changing.

There's so many Republican candidates running around trying to gaslight America into completely ignoring their relentless, repeated attempts to strip away protections for people with pre-existing conditions that I've alread stopped bothering to try to keep up with them (I think my Rogues Gallery post stops at around 24 or so at the moment).

Here in Michigan, while I'm pretty sure all nine of our Republican members of Congress who voted for the AHCA last year are lying through their teeth about how they suddenly support "protecting coverage of pre-existing conditions", the one which seems to be getting the most attention is Mike Bishop (MI-08). Part of this is no doubt because Bishop is embroiled in one of the two closest races in the state (the other is MI-11, where Dave Trott also voted for the AHCA, but he's retiring so it's an open seat).

 

As I've written about many times before, my home state of Michigan is, unfortunately, among the states which are trying to institute work requirements for ACA Medicaid expansion for 680,000 Michiganders. As I've also written about many times before, work requirements for Medicaid are not only burdensome and cruel, they're counterproductive in terms of efficiency, economics and even in the stated goal of such programs, which is supposedly to "inspire" low-income people to get a job.

Michigan’s Medicaid Proposal Would Harm Low-Income Workers — And Can’t Be Fixed

Specifically, the Michigan bill, or any similar proposal, would:

UPDATE 3:50pm: OK, it sounds like you can completely disregard all the Medicaid-related stuff below; apparently there was a communication error. I've confirmed with the Whitmer campaign that the proposed reinsurance plan would not be tied in with Michigan's ACA Medicaid expansion program at all, nor would it have any impact on the Medicaid eligigibility threshold, which means this would indeed be a standard ACA individual market reinsurance program after all...which is what I assumed in the first place, and which would be perfectly fine!

Note that Chad Livengood has revised his article and headline accordingly, with a note at the bottom regarding the correction.

 

(Note: I uploaded Livengood's video clip to YouTube because it's the only way I could embed it within the blog post)

VIDEO: Today, I attempted to pin down @SchuetteOnDuty today on whether he will keep @onetoughnerd’s expanded Medicaid program intact if he’s elected governor.
I think I’ll try again next week... pic.twitter.com/hu6ejM2vpt

— Chad Livengood (@ChadLivengood) August 15, 2018

Transcript:

Livengood: "Attorney General, if you're elected governor, are you gonna keep the Medicaid program that the governor's established, the Healthy Michigan plan?"

 

Note: Most of this isn't limited to Michigan...nearly all of the items listed here could/should be applied in other states as well.

Dear Democratic nominees for Michigan State House and State Senate:

Hi there, and congratulations on your primary victory!

If you're familiar with me and this site, you probably know three things about me:

  • 1. I strongly support achieving Universal Healthcare coverage, and I'd ideally prefer to utilize some sort of Single Payer system as the payment mechanism to do so.

 

Last month I posted a lengthy, deep-in-the-weeds analysis of Michigan Gubernatorial candidate Abdul El-Sayed's state-based Single Payer healthcare proposal, dubbed "Michicare" (later changed to simply "MichCare").

Later I noted that his primary opponent, former State Senator and County Prosecutor Gretchen Whitmer, has far thinner responses posted on her website when it comes to healthcare policy. I also noted that there are some good reasons for this which likely have nothing to do with being "a tool of the insurance lobby", a "neoliberal sellout" bla bla bla and so forth.

However, for the record, yes, Ms. Whitmer does indeed support universal healthcare coverage, as shown in the Q&A video clip above from one of her town hall appearances (thanks to Mary Bernadette Minnick Weatherly for the clip and the OK to repost it).

Below is a verbatim transcript of the whole exchange:

On November 8, 2010--right after the "Red Wave" midterm election in which Republicans picked up a jaw-dropping 63 seats in the U.S. House of Representatives, 6 Senate seats and 680 state legislative seats--Paul Waldman wrote, in The American Prospect:

In charting the last two years, from the euphoria of election night 2008 to the despair of election night 2010, I keep returning to Mario Cuomo's famous dictum that you campaign in poetry but govern in prose. The poetry of campaigning is lofty, gauzy, full of possibility, a world where problems are solved just because we want them to be and opposition melts away before us. The prose of governing is messy and maddening, full of compromises and half-victories that leave a sour taste in one's mouth.

...All else being equal, this means Republicans have an easier time getting elected and a harder time legislating the things they really want to do (other than tax cuts, which are never a hard sell), while Democrats have a harder time getting elected but ought to have an easier time legislating.

Welp. There you have it. Via Jonathan Oosting of the Detroit News:

Snyder signs 80-hour Medicaid work requirement law

Most adult Medicaid recipients who receive health care insurance through the state’s Healthy Michigan plan will be required to work at least 80 hours per month or risk losing coverage under a new law signed Friday by Republican Gov. Rick Snyder.

Five years after he led the push to expand Medicaid eligibility under the federal Affordable Care Act, Snyder signed the new work requirements over protests from Democrats and advocacy groups who decried it as a legislative effort to strip health insurance from low-income residents.

...“The original estimates were that 400,000 people without health care would be able to obtain it after the creation of Healthy Michigan, and today more than 670,000 people have coverage. I am committed to ensuring the program stays in place and that Michiganders continue to live healthier lives because of it.”

NOTE: I originally missed two carriers (McLaren and Molina); thanks to Louise Norris for calling attention to my error. The entire post, along with the table, has been updated to reflect the updated numbers including all 11 carriers.

Also note that while the headline originally reflected what the average rate change would be without the CSR load sabotage factor introduced in 2017, I've decided to be consistent with other states and only include 2018 sabotage impact.

My home state of Michigan just posted their preliminary requested rate changes for the 2019 Open Enrollment Period, and unlike most of the other states which have released their early requests so far, Michigan is a pleasant surprise: An overall average requested premium increase of just 1.7%!

Also noteworthy: According to the filings, eight of the carriers are specifically projecting exactly a 5% mandate repeal factor, which is remarkably consistent (usually the projections are all over the place). HAP is slightly lower (4.4%) while Molina is higher (7.2%). Priority Health didn't mention this at all, but it's safe to assume it'd be roughly 5% for them as well.

NOTE: The original post was getting to long/unwieldy so I've separated out my initial analysis of the proposal into this separate post.

Yesterday, Michigan Democratic Gubernatorial candidate Abdul El-Sayed publicly rolled out his vision for a state-based Single Payer healthcare system. I wrote up an overview yesterday. Below are my initial thoughts, based on reading both the summary and full version of the proposal as presented on El-Sayed's website.

UPDATE 4:30pm: (sigh) As I expected, the stripped-down version of SB897 passed the state House

SB 897, to impose Medicaid work requirements, passed the House 62-47. #mileg

— Lindsay VanHulle (@LindsayVanHulle) June 6, 2018

The revised version of the bill still has to be kicked back over to the state Senate for a final vote, but that's almost certain to pass, so the only thing stopping it at this point is the possibility of Gov. Rick Snyder vetoing it, which is what I figured it would come down to in the the first place.

UPDATE 6/11/18: So much for that prospect:

UPDATE: OK, it looks like El-Sayed's campaign has already released his plan details after all. I'm reading it over now and will update with my thoughts later today.

UPDATE Midnight Wednesday: Scroll down for my initial thoughts (more tomorrow)

Later today, Michigan Democratic gubernatorial candidate Abdul El-Sayed is expected to release his plan for a state-level single payer healthcare system for my home state of Michigan:

A Democrat running for governor in Michigan is supporting a tax increase to pay for a statewide government-run health-care system, going further than his party’s candidates in other parts of the country who are also calling for expanded coverage.

Sadly, this is pretty much exactly what I've been expecting:

Sen. Mike SHIRKEY (R-ClarkLake) said today he's hammered out an agreement with the administration and the House on creating work requirements for Medicaid recipients.

Speaking during a taping of "Off The Record," Shirkey said, "We have a deal." All sides have signed off on the exemptions to the work requirement, but he didn't get into all fo them pending a formal announcement coming as soon as later this week.

From the wording of this, it sounds an awful lot like "all sides" appears to refer to Republican Senator Shirkey, the rest of the Republican State Senate, the Republican State House and the Republican Governor.

Shirkey confirmed that the 29-hour job requirement in the Senate bill has been pared back to 20 to which he says, "I was hoping Michigan could take a leadership position and set a new standard for that." But rather than jeopardize the entire package, he compromised.

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