1. Expanding Medicaid Through Non-Traditional Waivers: Michigan’s Bumpy Journey Jan Hudson, Senior Policy Analyst Email: jhudson@mlpp.orgjhudson@mlpp.org Health Action 2014 January 24, 2014

2. 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 48906-4369 (517) 487-5436 Fax: (517) 371-4546 Web site: www.mlpp.orgwww.mlpp.org A United Way Agency 2

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

4. 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. 5  Each chamber developed its own proposal and “Medicaid reforms.” Michigan’s Legislative Journey

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

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

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

9. 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

10. Healthy Michigan Plan 10

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

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13. Concerns 13

14. 14 Michigan’s Journey

15. More Information Is Available  Department of Community Health website www.michigan.gov/mdch www.michigan.gov/mdch  Expand Medicaid Coalition website www.expandmedicaid.com www.expandmedicaid.com  Enroll Michigan website www.enrollmichigan.comwww.enrollmichigan.com  Michigan League for Public Policy website www.mlpp.org/our-work/health-care-in-michigan www.mlpp.org/our-work/health-care-in-michigan 15