Expanding Medicaid Through Non-Traditional Waivers: Michigan’s Bumpy Journey Jan Hudson, Senior Policy Analyst Health Action 2014 January 24, 2014

The League’s Mission To foster economic opportunity, independence and security of Michigan’s economically vulnerable population by shaping public policy through objective data-driven research, education and advocacy 1223 Turner St. Suite G-1, Lansing, MI (517) Fax: (517) Web site: A United Way Agency 2

Michigan’s Legislative Journey  The Governor supported Medicaid Expansion.  His colleagues in the Legislature did not. 3

Michigan’s Legislative Journey  The process did not go smoothly … 4 Call your Senators and tell them to “Take a Vote, Not a Vacation!”

5  Each chamber developed its own proposal and “Medicaid reforms.” Michigan’s Legislative Journey

 Finally in early September, legislation was passed and sent to the Governor for signature – with a caveat… 6 Michigan’s Legislative Journey

 Conservative legislative champion moved from “hard no” to “yes.”  Intensive legislator education. 7 How We Got There Representative Shirkey

Healthy Michigan Plan Legislation 8  Healthy Michigan Plan – focus on wellness.  Requires federal waivers to implement.

Healthy Michigan Plan  Contribute up to 2% of income for individuals between 100% and 133% of poverty.  Copays for all enrollees at the current Medicaid amounts.  “Healthy behaviors” can reduce cost sharing.  Does not allow termination of coverage for non-payment of contribution or copays. 9

Healthy Michigan Plan 10

Outreach and Enrollment  Transition as many people as possible from current programs.  Search, find, educate, enroll the remainder. 11

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Concerns 13

14 Michigan’s Journey

More Information Is Available  Department of Community Health website  Expand Medicaid Coalition website  Enroll Michigan website  Michigan League for Public Policy website