BNA’s Health Care Daily Report™ sets the standard for reliable, high-intensity coverage of breaking health care news, covering all major legal, policy, industry, and consumer developments in a...
By Nora Macaluso
Nov. 9 — Michigan and federal CMS officials are still in talks about the state's request for a waiver that would allow the state to continue to expand its “Healthy Michigan” program for low-income adults as an alternative to traditional Medicaid expansion, the head of the state's health department said.
The two “stumbling blocks” involve cost-sharing provisions included in Healthy Michigan, Nick Lyon, director of the Michigan Department of Health and Human Services, said at a health policy conference at Michigan State University.
The plan requires copayments from some enrollees, and includes an amendment requiring those with incomes of 100 percent to 133 percent of the federal poverty level who have had Healthy Michigan coverage for 48 cumulative months to either purchase private insurance or contribute as much as 7 percent of their income to an account to pay for covered benefits (171 HCDR, 9/3/15). “We're really trying to push back towards the factors that drive health,” encouraging plan participants to adopt healthy behaviors through giving them “skin in the game,” Lyon said.
The Centers for Medicare & Medicaid Services has a “hard red line they don't like to cross” when it comes to cost sharing, Lyon said. “I continue to push that what we're doing is not a hard cutoff,” he said, as those who pass the 48-month mark have the opportunity to buy coverage elsewhere or contribute to Medicaid coverage, he said. “One common goal we all have is we want to maintain coverage for the 580,000 people receiving these benefits,” he said.
“We're making significant progress” with the CMS, Lyon said. “I'm quite comfortable with where we are today.”
Assuming a waiver is received by the Dec. 31 deadline, the next hurdle for the plan is funding, Lyon said. The state is facing budgetary pressures, and “we've got to keep continuing to push that the investment [in Healthy Michigan] is worth it,” he said.
To contact the reporter on this story: Nora Macaluso in Lansing, Mich., at firstname.lastname@example.org
To contact the editor responsible for this story: Brian Broderick at email@example.com
All Bloomberg BNA treatises are available on standing order, which ensures you will always receive the most current edition of the book or supplement of the title you have ordered from Bloomberg BNA’s book division. As soon as a new supplement or edition is published (usually annually) for a title you’ve previously purchased and requested to be placed on standing order, we’ll ship it to you to review for 30 days without any obligation. During this period, you can either (a) honor the invoice and receive a 5% discount (in addition to any other discounts you may qualify for) off the then-current price of the update, plus shipping and handling or (b) return the book(s), in which case, your invoice will be cancelled upon receipt of the book(s). Call us for a prepaid UPS label for your return. It’s as simple and easy as that. Most importantly, standing orders mean you will never have to worry about the timeliness of the information you’re relying on. And, you may discontinue standing orders at any time by contacting us at 1.800.960.1220 or by sending an email to firstname.lastname@example.org.
Put me on standing order at a 5% discount off list price of all future updates, in addition to any other discounts I may quality for. (Returnable within 30 days.)
Notify me when updates are available (No standing order will be created).
This Bloomberg BNA report is available on standing order, which ensures you will all receive the latest edition. This report is updated annually and we will send you the latest edition once it has been published. By signing up for standing order you will never have to worry about the timeliness of the information you need. And, you may discontinue standing orders at any time by contacting us at 1.800.372.1033, option 5, or by sending us an email to email@example.com.
Put me on standing order
Notify me when new releases are available (no standing order will be created)