Gov. Rick Snyder Says Healthy Michigan 'not Affordable' Under Gop Plan

[+Malamute]

Gov. Rick Snyder says Healthy Michigan 'not affordable' under GOP plan

 

http://www.mlive.com/news/index.ssf/2017/03/gov_rick_snyder_says_healthy_m.html

 

 

The Healthy Michigan plan paid for by the Affordable Care Act's Medicaid expansion likely wouldn't be sustainable under the expansion phase-out included in the repeal and replace proposal being pushed by House Republican leadership, Gov. Rick Snyder said Friday. 

 

Snyder, who co-wrote a letter this week with Ohio Gov. John Kasich, Nevada Gov. Brian Sandoval and Arkansas Gov. Asa Hutchinson regarding the American Health Care Act, said he has serious concerns with the proposal on several fronts, including its plan to deal with the insurance marketplace and its potential to impact Michigan's traditional Medicaid program.

 

But the changes, if implemented, could have the biggest immediate impact on the Healthy Michigan program, which currently enrolls more than 650,000 Michigan residents. Snyder said the additional costs of paying for any new entries after 2020 under the American Health Care Act would cost the state $800 million more a year, "and that's not affordable." 

 

"Essentially what you'd find is Healthy Michigan sort of winding down, where probably over 90 percent of the people on it would move out of the program within three years," Snyder said in an interview with MLive Friday. "That's a huge number, and it's difficult to see where that would come from" in the state budget.

 

That estimate is in line with a state Senate Fiscal Agency report released March 8, which found that if the Healthy Michigan statute was changed to continue the program if the American Health Care Act was implemented, the increased cost to the state would grow to $532.6 million in Fiscal Year 2020-21 and $738.9 million in Fiscal Year 2021-22.

 

Included in the letter to House and Senate leadership are suggestions Snyder and the other governors made to improve upon the American Health Care Act, including giving states more leeway to set up per capita systems, block grants or maintaining the current structure, depending on the needs of individual states. 

 

Snyder said he believes Michigan's program so far has been successful, and said some reform options could "make Healthy Michigan even better than our traditional Medicaid program."

 

"We have people that are better off today - I clearly believe that's the case," Snyder said. "Instead of being in the emergency room, they're now getting primary care. If you think about it, that's a better answer for them in terms of their quality of life, and it's a better answer for society, because in the long term that should save us resources."  

 

Although Snyder said he did not have time to discuss health care with the president when he visited the American Center for Mobility in Ypsilanti Wednesday, he said President Donald Trump, his administration and Republican members of Congress have been good about reaching out and hearing the concerns of governors.

 

He said he's hopeful some of the recommendations made by he and the other governors make it into the final proposal at the federal level: "I think there's good dialogue going on, but I would hope they could incorporate it if not in the House plan, than in the Senate plan," he said. 

 

The GOP plan, dubbed the American Health Care Act, would phase out the Medicaid expansion and switch to a new funding Medicaid formula in which states get a set amount of dollars instead of the federal government guaranteeing to cover a certain percentage of Medicaid costs.

 

The plan also would change the current insurance subsidies based on income to one based on age, which means younger people would get more help to buy insurance but many older people would see higher out-of-pocket costs.

 

In addition, the GOP plan would eliminate the requirement for Americans to purchase insurance, although they would have to pay a 30 percent penalty on premiums for a year if they go more than two months without coverage.

[+Malamute]

Getting rid of Medicaid expansion will really hurt medical cannabis patients.  Likely tens of thousand of medical cannabis patients will have their insurance stripped.

 

This is the most successful program under the Affordable Care Act. The exchanges, on the other hand, have their problems. They should have offered Medicare buy-in.  O wait, they did, but the republicans filibustered it with Joe Lieberman.  Anyhow,...

 

If you support medical cannabis patients, please call your congress critter and ask them not to repeal Medicaid Expansion. 

 

For those that don't know, Medicaid expansion is for low wage working Michiganders. You pay a small portion of your income and you are given insurance through the Medicaid Expansion plan known as Healthy Michigan Plan in Michigan.  It has very basic coverage and you still pay some small copays etc not to exceed a certain percentage of your income.  It was proudly supported by Michigan Republicans who asked for a waiver to set up the program in a fashion they liked, it was approved by the Obama administration, and as shown, has allowed 650,000 Michiganders to have insurance.

 

Even Rick Snyder and many many republican governors do not want to see this removed.  It is one of the main targets of Republicans in Washington.

 

Please support Medicaid Expansion and call your congress critter.

[+Malamute]

The Healthy Michigan Plan provides health care benefits to Michigan residents at a low cost so that more people can have health care coverage. Individuals are eligible for the Healthy Michigan Plan if they:

• Are age 19-64 years
  
• Have income at or below 133% of the federal poverty level* ($16,000 for a single person or $33,000 for a family of four)
  
• Do not qualify for or are not enrolled in Medicare
  
• Do not qualify for or are not enrolled in other Medicaid programs
  
• Are not pregnant at the time of application
  
• Are residents of the State of Michigan
  

 

Basically, most fast food workers, department store employees, main street stores, gas stations etc etc.

[+Malamute]

Just a small factoid about insurance I see people not understand.

 

For those that are getting Employer based insurance,... do you realize the Federal government subsidizes that insurance to the tune of almost $300 billion a year? About 20%, possibly more, of your insurance policy is paid for by the Federal tax payer.

 

So,  basically, everyones tax dollars subsidize your insurance; are you willing to allow your tax dollars to subsidize other peoples insurance in the form of Medicaid expansion?  And these are people that work whose employers are unwilling to pay for their insurance.

 

:-)

[+Malamute]

No One?

 

Anyone?

 

Over 600,000 people to be  thrown off healthcare in Michigan alone and no one called?

 

'sigh'

[cristinew]

I think no one called is because the think trump is going to keep them insured.  I for one will be cut... Now who is going to hire a me with my heath conditions  Nobody..

[dutchfarm]

From what I have read my wife and I are most likely going to lose our med. insurance too. A lot of these politicians are just plain mean as a junkyard dog and they call themselves Christians. I will be 63 (my wife 61)this year and hope the both of us can skate through until we become eligible for Medicare, I really feel for the people that are no lnger going to have coverage. Maybe some of the R's will balk.

[briefcasejoe]

insurance is a scam. how about we just lower the cost of heathcare instead of relying on insurance companies...Have you seen how much they charge for stuff in a hospital? a bag of salt water is like $100 and it cost's them pennies. 

[semicaregiver]

insurance is a scam. how about we just lower the cost of heathcare instead of relying on insurance companies...Have you seen how much they charge for stuff in a hospital? a bag of salt water is like $100 and it cost's them pennies. 

 

 

Agreed.  I have been saying this for years, but it seems like no one is listening.   In fact not only are they not listening, it is obvious that they look at me like an idiot.  All very confusing.   

 

I am on medicare so alot of the discussion does not affect me, but my wife is on a ACA policy.  She currently pays about 200/month for her policy.   Looks like this will go to 800 under Trumpcare.

[shishka]

My policy under the ACA is $920 a month and that is the cheapest plan offered! Deductible is $12000!

 

That is for my wife and I, two non smokers in our 50's and 40's respectably.

 

Something needs to be done because the affordable act is quickly becoming unaffordable.

 

It's not just the Medicare and Medicaid, it's everyone.

[+Malamute]

Do you know how much your subsidy is on that shiska?

 

And is it a silver or bronze plan?  You typically get better cost sharing under the Silver plans.  Which are still crazy expensive and I am with ya on this.

 

I am guessing your subsidy is around the same per month. Maybe about $800 ish.

 

So your yearly government subsidy is probably about $9600 ish a year.  Under this republican plan, your monthly costs will go up that $9600/yr and you will recieve a $4000 tax credit.  So your plan, if kept the same, will raise your monthly bill about $140.  Or, they will lower the coverage you get and move towards allowing only catastrophic coverage.

 

If we were to simply get rid of private insurance, your costs would drop about 15% right off the top. We need caps. We need to reign in physician pay. We need to reign in many costs. Medicaid does the best job of reigning in costs.

 

Not an easy topic, but healthcare is very expensive for sure.

 

And yes, the exchanges are too expensive under the ACA. I wish they had allowed a public option(medicare buy in basically). That would have created a not for profit marketplace competition. Would have squeazed the private insurance market.

[+Malamute]

Agreed.  I have been saying this for years, but it seems like no one is listening.   In fact not only are they not listening, it is obvious that they look at me like an idiot.  All very confusing.   

 

I am on medicare so alot of the discussion does not affect me, but my wife is on a ACA policy.  She currently pays about 200/month for her policy.   Looks like this will go to 800 under Trumpcare.

 

But she should get a $4000 tax credit on the republican plan. Which basically increases your total cost by about $300/month.

 

These are very general numbers though. :-)

[+Malamute]

The hidden tricks are in what it covers.  ACA requires a minimum of covered healthcare. Prices/premiums are usually lowered by covering less stuff, increasing out of pocket, lifetime caps, and denying certain procedures.

 

When republicans speak of lowering premiums, that is what they are talking about. A race to the bottom for "cheaper" plans without any baseline requirements.

[+Malamute]

I did forget to add in the costs for age the republican plan allows. Instead of up to 3x the amount of their lowest plans for older adults, it will be up to 5x.

 

So, the quotes I kinda made there , due to age, could go up even higher. 

 

Hahaha,.. I said "could".  Silly me.  "Will" go up higher.  Or coverage will be lowered.

 

The republican plan removes much of the required coverage levels from the ACA.

[Restorium2]

My policy under the ACA is $920 a month and that is the cheapest plan offered! Deductible is $12000!

 

That is for my wife and I, two non smokers in our 50's and 40's respectably.

 

Something needs to be done because the affordable act is quickly becoming unaffordable.

 

It's not just the Medicare and Medicaid, it's everyone.

If your deductible is $12000 you can put $6500 (pre tax) in a Health Savings Account, HSA, and deduct that from your taxable income. If you don't spend it you can roll it over into a retirement account that you can invest in the stock market. If you are in a high tax bracket that can really help. 

Edited March 21, 2017 by Restorium2

[+Malamute]

Most people cant afford it Resto.

 

People who can afford it can afford their insurance anyway.

 

Also, the HSA's are much more complicated than you lead to.

 

And for most people, the excise taxes can outweigh their tax bracket.

 

Basically, its an IRA that the government can take when your health goes bad. Whereas now, they can't take your retirement account. And when you have to declare bankruptcy due to health reasons, they take all your money whereas a retirement account can be protected.

 

It helps those that can already afford their deductibles, which is generally not including the bottom 60% of the country.

[Restorium2]

Most people cant afford it Resto.

 

People who can afford it can afford their insurance anyway.

 

Also, the HSA's are much more complicated than you lead to.

 

And for most people, the excise taxes can outweigh their tax bracket.

 

Basically, its an IRA that the government can take when your health goes bad. Whereas now, they can't take your retirement account. And when you have to declare bankruptcy due to health reasons, they take all your money whereas a retirement account can be protected.

 

It helps those that can already afford their deductibles, which is generally not including the bottom 60% of the country.

My advice was for (obviously) the people who can afford it. It's good advice for someone who can save money pre tax. It's part of the way you can improve your tax position. Nothing wrong with it for the people who fit the advice.

[Restorium2]

[+Malamute]

My advice was for (obviously) the people who can afford it. It's good advice for someone who can save money pre tax. It's part of the way you can improve your tax position. Nothing wrong with it for the people who fit the advice.

 

Well, I agree for those that make over around $50,000/yr as an individual will likely find benefit. I think a Roth is still a better long term plan. But, it can save people money due to paying co pays pre tax and such.

 

But it does nothing to solve the problems with healthcare.

 

It drives me crazy when they say healthcare can be fixed with HSA's.

 

:-)

[Restorium2]

Fixed? No. I'm giving advice for people to deal with what we have now. When someone says they have a $12000 deductible I'm thinking they might be higher income. 

 

Here's what has been proposed to help the HSA be more effective. 

https://www.shrm.org/ResourcesAndTools/hr-topics/benefits/Pages/excise_tax_HSAs.aspx

[+Malamute]

Sorry, I didn't mean you were saying it would fix it,...I was referencing people like Paul Ryan.

 

But, when I see someone who has a $12,000 deductible, I see someone who cant afford insurance so they take the cheapest monthly cost. Everyone wants a gold plan, but most cant afford it so they get stuck with huge deductibles(and pray they don't get sick nor make regular visits for healthcare). I think high deductible plans are for poor people(under 44,000/yr).

[shishka]

Subsidy? I wish.

 

No that is $920 out of my pocket every month for a bronze plan, yes the cheapest plan offered. I believe subsidies end if you make more than $62,000. Three years ago I got a subsidy and paid $165 a month and was happy, until I ended up going over 62k in income and had to pay back my subsidy to the tune of $5400.

 

Last year it went to $700 a month and then this year yeah, $920. I don't have any answers but I know I can't keep covering 20% increases every year.

 

Silver plans were around $12-14 and gold plan? Over $2000 a month.

Edited March 21, 2017 by shishka

[Restorium2]

Another important thing to mention is that a lot of preventative care, like cancer screening, is paid for before you hit your deductible. 

[shishka]

This is true we don't pay much for visits for preventive but it won't add up to the $11,000 we pay out for premiums.

[Restorium2]

 I believe subsidies end if you make more than $62,000. Three years ago I got a subsidy and paid $165 a month and was happy, until I ended up going over 62k in income and had to pay back my subsidy to the tune of $5400.

 

That HSA I recommended would help with this exact situation.