Working Together For Michigan Consumers To be Healthy

Children & Families

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


Q: How does healthcare reform benefit Michigan children right now?
A: Insurance companies are no longer able to exclude children from coverage because of a pre-existing condition, such as asthma, diabetes, cancer, kidney failure or a birth defect. This gives parents across Michigan peace of mind. This new rule took effect for children in 2010, and it goes into effect for everyone in 2014. What’s more, all new insurance plans must cover preventive services without a copay or deductible.


Q: How does healthcare reform benefit Michigan children as they get older?
A: Today’s kids won’t have to face annual or lifetime benefits as they grow older. Healthcare reform has already eliminated the ability for a health insurer to place yearly or lifetime benefits on coverage.


Q: What about dental and vision care for Michigan’s kids?
A: Starting in 2014, the health reform law will require coverage of not only basic pediatric services under all new health plans, but also dental and vision care

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


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.


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.


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!


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.