Healthy Michigan Plan Waiver: Compromise needed for continued success

Posted: September 2, 2015

Written by Alan Essig, executive director of Michigan Consumers for Healthcare

With the submission of the Healthy Michigan Plan waiver request by the state to the Center for Medicaid and Medicare Services, the clock is officially ticking as to whether the Healthy Michigan Plan remains in place. According to state law the waiver must be approved by December 31, 2015 or the Healthy Michigan Plan will end for all beneficiaries on April 30, 2016. The health and well-being of over 600,000 Michiganders hangs in the balance.

The Healthy Michigan Plan has been a great success. Thanks to the leadership and vision of Governor Snyder and the hard work of the Department of Health and Human Services, over 600,000 previously uninsured Michiganders now have access to affordable health care. Not only are individual citizens benefitting but the state budget and broader Michigan economy are benefitting as well. The increased federal funds are resulting in a saving to the state budget of $220 million yearly, while thousands of jobs are being created and retained.

This great success could be in jeopardy due to the legislatively required waiver submission. State law mandates the state submit a waiver to the federal government to require Medicaid expansion enrollees with incomes between 100-133% of the poverty line who receives 48 cumulative months of Medicaid coverage to do one of two things:

• Move to health insurance coverage through the Federal Marketplace and pay premiums consistent with the Affordable Care Act; or

• Stay in Medicaid managed care and be subject to increased cost-sharing of up to 7% of income and an increase in contributions up to 3.5% of income. These contributions can be reduced if the beneficiary engages in “healthy behaviors."

The Michigan Department of Health and Human Services (MDHHS) and the federal Center for Medicaid and Medicare Services (CMS) will now be engaged in ongoing negotiations over the details of a waiver. With good faith on both sides agreement is possible. CMS has shown a willingness to approve creative approaches to various states Medicaid expansion ideas. With flexibility on the state side, a mutually beneficial solution could be reached.

It is ultimately the state’s responsibility to ensure that the Healthy Michigan Plan survives. The health and welfare of over 600,000 Michiganders depends on it.