Working Together For Michigan Consumers To be Healthy

People with Disabilities

The Affordable Care Act (ACA), which became federal law in 2010, includes vital protections and benefits for Michiganders with disabilities. Some of these protections are being phased in, and some have already taken effect.

Expanding Medicaid and eliminating the denial of coverage based on pre-existing conditions

Q: Will health reform help Michigan residents with disabilities?

A: Yes, it will. The ACA will expand the Medicaid program to more Americans, including people with disabilities. It is estimated that an additional 600,000 Michigan residents will be newly eligible for Medicaid in 2014, when the new eligibility guidelines allowing for the expansion take effect. Health reform now prohibits insurance companies from denying children coverage based on pre-existing conditions. Going forward, the ACA will prohibit insurance companies from denying coverage or charging more to any person based on their medical history, including genetic information.

Long-term supports

Q: What about long-term supports and services?

A: The ACA provides people with disabilities with a new, voluntary, self-insured insurance program (CLASS Act) that helps families pay for the costs of long-term supports and services if a loved one develops a disability.

Healthcare reform offers a long list of general benefits to consumers. Keep reading for a few examples.

Getting more out of your healthcare coverage

Q: How much of my dollars are actually going toward my care?

A: That’s a great question! Thanks to health reform, 80 cents out of every dollar in healthcare premiums must be paid out to for a policyholder’s medical care. If the full 80 percent is not paid out, the Affordable Care Act (ACA) stipulates that your insurance company must send you a refund check every year. Here in Michigan, Michigan Consumers for Healthcare have already made a difference on this front! When the state of Michigan asked for a waiver to divert more than $53 million in consumer rebates back to the insurance industry, our coalition members fought that ruling and won! Because of the Michigan Consumers for Healthcare members, a federal ruling denied the waiver request – meaning less of your healthcare dollars go to insurance industry salaries and bonuses. This rule is referred to as the “medical loss ratio” provision of the Affordable Care Act.

Community Health Centers

Q: How does the ACA help Community Health Centers?

A: Health reform will help nearly double the number of patients seen by the centers over the next five years. The funding could not only help the 184 Community Health Centers in Michigan, but also support the construction of new centers.

Choice and access

Q: Will Michigan consumers have more choices?

A: Yes. Patients’ choice of doctors will be protected by allowing plan members in new plans to pick any participating primary care provider!

Affordable insurance for uninsured with pre-existing conditions

Q: What about pre-existing conditions.

A: $141 million federal dollars are available to Michigan to provide coverage for uninsured residents with pre-existing medical conditions through a new transitional high-risk pool program, funded entirely by the federal government. The program is a bridge to 2014 when Americans will have access to affordable coverage options in the new health insurance exchanges and insurance companies will be prohibited from denying coverage to Americans with pre-existing conditions. If states choose not to run the program, the federal government will administer the program for those residents.

Lifetime limits

Q: What does the new law Insurance companies are no longer be able to place lifetime limits on the coverage they provide, ensuring that the 6 million Michigan residents with private insurance coverage never have to worry about their coverage running out and facing catastrophic out-of-pocket costs.

>>Learn more about how Michigan consumers benefit from healthcare reform.