Michigan s top health care priority insuring the uninsured
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Michigan’s top health care priority: Insuring the uninsured. Rick Murdock Michigan Association of Health Plans. Michigan Association of Health Plans. Industry voice for 19 health care plans Members cover over 2.4 million Michigan residents Our mission: Advocate for health care that is

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Michigan’s top health care priority: Insuring the uninsured

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Michigan s top health care priority insuring the uninsured

Michigan’s top health care priority:Insuring the uninsured

Rick Murdock

Michigan Association of Health Plans


Michigan association of health plans

Michigan Association of Health Plans

Industry voice for 19 health care plans

Members cover over 2.4 million Michigan residents

Our mission: Advocate for health care that is

High quality

Affordable

Accessible


Mahp agenda for michigan

MAHP Agenda for Michigan

  • Don’t fix what’s not broken

  • Don’t fix what people don’t want fixed

  • Fix what people do want to fix

  • Fix what policymakers agree needs to be fixed


Don t fix what s not broken

Don’t fix what’s not broken

  • How would you rank the quality of your health insurance today?

    • Excellent35%

    • Good37

    • Fair15

    • Less than fair 4

    • Poor 3

      Statewide MAHP commissioned phone survey, 600 likely voters, 9/13-17, 2009

72 percent of people consider their health insurance excellent or good


Fix what people want fixed

Fix what people want fixed

  • Do you support or oppose making it a priority to give every single Michigan citizen quality and affordable healthcare?

    • Strongly support47%

    • Somewhat support24

    • Somewhat oppose13

    • Strongly oppose13

71 percent support giving all quality health care


Fix what policymakers know needs to be fixed

Fix what policymakers know needs to be fixed

  • About 1.1 million uninsured

  • Drives up health care cost for all

  • Still get health care

    • Often at expensive emergency rooms

    • Uncompensated care = Cost shifting

    • Average family paying $1,000/year due to uncompensated care

  • Getting more people into managed care can mean lower costs for all


Who benefits by covering uninsured

Who benefits by covering uninsured?

  • The uninsured

  • Businesses who are paying $1,000/covered family in hidden taxes for uncompensated care caused by state and federal policies

  • Hospitals and physicians who are covering the uninsured today


Far more uninsured than in individual market

Far more uninsured than in individual market


Characteristics of smart expansion of insurance to uninsured

Characteristics of smart expansion of insurance to uninsured

Create a level playing field for all insurers

More competition is good for all consumers

Consumer-centric

Serving greater public good not one interest

Take pressure off of other insurers (cross-subsidy, uncompensated care)


Characteristics of smart expansion of insurance to uninsured1

Characteristics of smart expansion of insurance to uninsured

All interest groups have a stake in its implementation (Pay/Play)

Advances competition on quality and performance

Must provide certainty of coverage, costs, and responsibility.


Characteristics of smart expansion of insurance to uninsured2

Characteristics of smart expansion of insurance to uninsured

Maximize use of Medicaid/MiChild (Preserving safety net)

Established programs

History of working well

Need to ensure all people who are eligible are in these programs

Let’s federal government share costs


Mahp and consumer groups agree

MAHP and consumer groups agree

Standard benefits package

All carriers required offer, limited by market share

Low income subsidized in some fashion

Consistent treatment of pre-existing conditions by all carriers

Goal is to limit gaming of system

But still ensure those in need can get care


Mahp and consumer groups agree1

MAHP and consumer groups agree

  • Subsidize by combination of government & private sector

  • Reinsurance options/pools


Policy changes needed

Policy changes needed

Boost Medicaid coverage by maximizing federal support

Need to increase state match substantially

Use existing $ now allocated toward uninsured

Establish consensus on other revenue sources including self insured and insured

Small investment to dramatically cut $1,000 “hidden tax” that all commercial subscribers paid today


For those not eligible for medicaid

For those not eligible for Medicaid

Require all carriers to offer the same basic benefit packages

Include doctor visits

Some level of hospitalization

Smart use of pharma

Smart use of copays

High copay for ER

No copay for maintenance drugs (Value based purchasing)


For those not eligible for medicaid1

For those not eligible for Medicaid

Subsidize so not pay more than 10 percent of income for coverage

Subsidy comes from same sources used for Medicaid full funding


For those not eligible for medicaid2

For those not eligible for Medicaid

Provide for key consumer protections

Guaranteed issue proportional to market share

6 month limit on pre-existing conditions and other consumer protections agreed to in both House and Senate discussions


Number of technical issues

Number of technical issues

Must have level playing field on provider payments

If companies can negotiate different rates, system falls apart

Need reinsurance plan—what level or attachment point

How much hospitalization?

Annual cap?

These can be worked out if broad plan adopted


This plan can work

This plan can work

Creates competition

Many companies offering similar product

Maximizes federal dollars

Feds willing to pay $1.71 for every $1 state pays

Provides consumer protections

Lessens problems of individual market

Cuts cost of uncompensated care

Cuts hidden tax now imposed on all insured


Concepts being explored by legislature

Concepts being explored by Legislature

Sen. Tom George, Rep. Marc Corriveau issue their plans—both Chairs communicating issues with each other

Many pieces of MAHP/consumer proposal in both

Helping them to work out differences

Hope to see resolution this year


Other reforms

Other reforms

Recognize some regulatory reform needed

Make it easier for carriers to bring products to market

Accelerated rate approval process for all carriers

This prevents rate shocks

Increases competition

Preserving appropriate regulatory oversight


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