Medicaid Work Requirements Are Coming…What Does It Mean?

Medicaid work requirements were written into state law in June of 2018 and were approved by the federal government over a year ago. Now the Michigan Department of Health and Human Services (MDHHS) is preparing to implement work requirements, and IF things continue, people who have the Healthy Michigan Plan may lose their health care if they do not meet the work requirements.

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People who may be subject to Medicaid work requirements:

  • Enrolled in the Healthy Michigan Plan (HMP)

  • Current Michigan resident

  • Age 19-62

  • Not disabled, pregnant, or qualifying for another exemption (listed below)

What are the changes?

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  • Requirement to work or participate in other qualifying activities for at least 80 hours per month.

  • HMP beneficiaries must report to MDDHS on a monthly basis and are allowed 3 months of non-compliance (not reporting, or reporting but not participating in qualifying activities) within 12 months.

  • Loss of eligibility for non-compliance. After 3 months of non-compliance, beneficiaries will lose their healthcare coverage (HMP).

What counts as work or a qualifying activity?

  • Employment or self-employment

  • Education directly related to employment (school, college, etc.)

  • Participation in a substance use disorder treatment program

  • Community service with a 501(c)(3) or 501(c)(4) for 3 months only every 12 months

Who qualifies for an exemption?

  • Caretaker of a family member under 6 years old

  • Beneficiaries receiving temporary or permanent long-term disability benefits

  • Full-time students

  • Pregnant women

  • Individuals who have a medical professional’s order stating they are medically frail or have a medical condition that limits their ability to work

  • Beneficiaries who have been incarcerated in the last 6 months

  • Beneficiaries receiving Michigan unemployment benefits

  • Individuals who are receiving SNAP (food assistance) or TANF (cash assistance) benefits.

What is the timeline for work requirements to begin?

  • September 2019

    DHHS is sending Exemption Forms and Letters to HMP members who need to tell DHHS they qualify for an exemption. If you qualify for an exemption, fill out the form and FAX it to 517-432-6079. Do not mail it.

  • October 2019

    DHHS will send letters to people who are listed as having an exemption (see above). A separate letter will also be mailed to HMP members who are 62 or older because they are also exempt.

  • January 2020

    HMP members who have not qualified for an exemption will need to start reporting their work to MDHHS. When there is more information about how to report, there will be a new blog post. Until then, stay tuned…

Unless…

State advocates are hoping to stop Medicaid work requirements with a lawsuit. And they NEED PLAINTIFFS! They are looking for current Healthy Michigan Plan members who will be adversely affected by the new requirements.

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Examples of people who would be good plaintiffs include:

  • single working parents with children between the ages of 6-11;

  • people whose hours per week are highly variable or dependent on factors outside their control;

  • people who may not be medically limited but have jobs that are less than 3 hours/day. This might include school lunch supervisors or school bus drivers, part-time home healthcare workers or restaurant workers who may have reduced hours when business is slow.

  • People with sporadic hours like substitute teachers, recently incarcerated people who are looking for a job, and seasonal job workers are also good candidates.

If you have a good candidate, please have them contact Mario Azzi at the Center for Civil Justice: 800-724-7441 or mazzi@ccj-mi.org OR Lisa Ruby at Michigan Poverty Law Program 734-998-6100 ext. 617 or lruby@mplp.org. Click here for a flyer to print.

If you have any questions or concerns about Medicaid work requirements, ask us in the comments below or you can always call the WHP office at 734-544-3030. We are also open for walk-ins 9am-4pm Monday through Friday at 555 Towner, Ypsilanti, MI.

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The Times They Are A-Changing: WHP Executive Director Ellen Rabinowitz Retires

Ellen, 2001.

Ellen, 2001.

Before the Washtenaw Health Plan was created in 2001, there was the Washtenaw County Health Care program, which began in 1995 and was run by the Washtenaw County Health Department. Who better than an urban planner to plan a brand new program? Ellen Rabinowitz, the WHP Executive Director, has managed the Washtenaw Health Plan from its inception as a program of the health department to its metamorphosis into a nonprofit. [Read more about the history and development of the WHP here.]

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Five years ago, Ellen added the job of Health Officer for the Washtenaw County Health Department to her position as the WHP Executive Director. While some people might have left one big job to take another big job, Ellen wanted to stay connected to the WHP—her first (work) love. And now, after working for Washtenaw County for over 30 years, Ellen is retiring. [And as she retires, two people will take her job! Jeremy Lapedis will become the WHP Executive Director and Jimena Loveluck will be the WCHD Health Officer.]

Ellen’s vision, as described in 2010, was simple: “We want to serve the most vulnerable members of our community, and we want to expand healthcare access to all.”

We want to serve the most vulnerable members of our community, and we want to expand healthcare access to all.
— Ellen Rabinowitz

Nearly 10 years later, a lot has changed. With the advent of the Affordable Care Act, the work of the WHP changed dramatically. Many more people were eligible for Medicaid, Marketplace, or employer insurance—but low-income individuals still need help accessing services. And the work of the WHP has expanded—into not only helping people access health care, but also into case management, training, and emergency room diversion.

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As Ellen noted at her retirement party, “I have been so lucky in my career to be surrounded by the most dedicated, passionate staff. I’ve tried to lay out a vision of health for all, and then I’ve tried to get out of the way and let the staff do their work. And boy have they done an amazing job! Thank you to the WHP staff. They changed the name from WHP—Washtenaw Health Plan—to WHP: We Help People—because that’s their approach. That’s their ethic. No problem too big or too small. They will do what it takes to get our clients everything they need.”

One of Ellen’s last acts? Making sure that the WHP has a strategic plan to guide us in the next few years. And although we will miss her, we know she will continue to do good work in the community. In Ellen’s own words: “There is still so much work to do, for all of us, to create the kind of community we all believe in. A community where everyone has a fair and just opportunity to achieve optimal health and well-being. So, like I’ve been saying, you have not heard the last of me. I’m leaving full of gratitude for the opportunity I’ve had to work at the WHP and Washtenaw County, the opportunity to work with all of you.”

Ellen with WHP staff, 2006.

Ellen with WHP staff, 2006.

Ellen Rabinowitz—the feeling is mutual. Good luck, and may you be blessed with good health and exciting opportunities in the years to come.

—Ruth Kraut




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Welcome Jeremy Lapedis to the Washtenaw Health Plan!

Jeremy Lapedis Named New Washtenaw Health Plan Executive Director

The Washtenaw Health Plan (WHP) is happy to announce Jeremy Lapedis will be the organization’s new executive director. Lapedis has a strong background in connecting health and social services in Washtenaw County and beyond.

“Health is more than just the care you get at the doctor’s office,” says Lapedis. “The Washtenaw Health Plan assists county residents with access to healthcare, but they don’t stop there. If clients have any problem, WHP helps them. I’m thrilled to work with this staff that supports people so holistically.”

Jeremy Lapedis at the WHP office.

Jeremy Lapedis at the WHP office.

Lapedis recently earned his doctorate in public health from Harvard. He also has a master’s degree in public health from Johns Hopkins and a bachelor’s degree from the University of Michigan. 

For several years, Lapedis has worked at the Center for Health and Research Transformation (CHRT) as a program manager for the local State Innovation Model (SIM), a Washtenaw Health Initiative demonstration that helps individuals with complex health needs access the medical, behavioral, and social services they require. He will continue to support the regional SIM on a limited basis through a contract between CHRT, backbone organization to the Washtenaw Health Initiative, and the WHP.

“After being away from Washtenaw County for a while, I’m excited to continue working in the place I call home,” says Lapedis, who grew up in Ann Arbor. “I want my work to focus on reducing inequities and valuing diversity in Washtenaw County. I hope to lend a hand in creating a more just place for all residents in the county.”

Lapedis will be taking over for current Executive Director Ellen Rabinowitz, who will retire later this summer after decades of public service with Washtenaw County. Lapedis will begin as executive director on September 3, 2019.


“We are so excited to have Jeremy in this role,” says Rabinowitz. “His work on the State Innovation Model gives him a keen understanding of our community’s need for access to care. His familiarity with community partners will bring great value to his role at the Washtenaw Health Plan.”

WHP is a private non-profit organization that is closely aligned with the Washtenaw County Health Department. The organization is a public-private partnership with key partners including Michigan Medicine, St. Joseph Mercy Health System and Washtenaw County. The organization helps people access health care coverage, including Medicaid, Medicare, Marketplace, employer insurance, and more. In addition, staff can help clients with a variety of issues related directly or indirectly to health, from immigration to housing. WHP has English, Spanish, and Arabic-speaking staff and interpreting services are available for most other languages. Walk in for help Monday through Friday 9 a.m. to 4 p.m. at the Washtenaw County Human Services building at 555 Towner Street, Ypsilanti. Or call 734-544-3030.

Washtenaw Health Plan

The Washtenaw Health Plan works directly with people to assess their eligibility for health coverage and to secure coverage. Visit healthcarecounts.org or call 734-544-3030. Walk in for help Monday through Friday from 9am to 4pm. Spanish-speaking and Arabic-speaking staff members available. WHP is located the Washtenaw County Human Services building at 555 Towner Street, Ypsilanti.

Washtenaw County Health Department
The Washtenaw County Health Department promotes health and works to prevent disease and injury in our community. Our mission is to assure, in partnership with the community, the conditions necessary for people to live healthy lives through prevention and protection programs.

The Washtenaw County Health Department has achieved national accreditation through the Public Health Accreditation Board. Visit us at washtenaw.org/health or call 734-544-6700.

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United Way's VITA Extension and Financial Coaching

VITA Services are extended!

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The United Way VITA (Volunteer Income tax Assistance Program) program has reopened their services until August 30, 2019. What does this mean for you? It means if you haven’t filed your 2018 taxes yet or if you need to file an amended return, you can do it! Maybe you filed 2018 but have not filed 2017 or 2016, VITA can help. If you received a letter from the IRS and need help responding to it, they can also help with that. At WHP, we have people who didn’t reconcile their tax credits either because they didn’t know they were supposed to or their tax preparer didn’t understand the forms. If you didn’t reconcile your tax credits, you need to file an amended return. If you need help with the Homestead Property Tax Credit, they can also help with that.

You still need to meet the same requirements for the regular VITA help.

  • income below $54,000 (single or joint)

  • need to have necessary documents to complete a return (e.g. W-s2, 1099s, etc.)

  • must provide photo identification and federal document with SSN visible

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Since you are reading this online, you have access to a computer and can schedule your appointment online. That is the best way to schedule an appointment. Click here. You will also need to bring all the documents listed here. Some documents may not be relevant to your situation but if you aren’t sure, bring anything you think would be useful. If you have questions before your appointment, call 734-677-7235.


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Myfreetaxes.com is free to anyone whose income is below $66,000. You can file an extension through MyFreeTaxes and finish filing by October 15, 2019. If you owe taxes, the IRS may charge you interest.


Financial Coaching at United Way

In addition to free tax help, United Way staff also provide another financial stability resource, One-on-One Financial Coaching. This service helps people eliminate or reduce debt, improve credit scores and save more money. Answer the questions below to determine if their service is a good fit for you.

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There is a good list of financial resources on their website. Check it out! Here is the flyer you can print out for VITA extended services.

Filing taxes and managing your money are important and your healthcare may depend on being financially responsible and knowledgeable.

United Way of Washtenaw County is located at 2305 Platt Rd. Ann Arbor, MI 48104. You can call 734-971-8200 or email liveunited@uwwashtenaw.org.

As always, if you have questions call us at the Washtenaw Health Plan. 734-544-3030 #WeHelpPeople

Ask a question in the comments and we will answer it right away!

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Free Health Coaching: A Wise Choice!

Are you looking for a way to improve your health? Don’t know where to start?

People need help with taking care of their health. This is hard to do when you have a busy schedule and don’t know where to start. Washtenaw County Health Department has a free health coaching program that can offer one-on-one support to help you meet your health goals. The health coaches will work with you and your schedule to set small achievable goals that will help improve your health.

You also receive a free gift after your first appointment. This might be a yoga mat, a blood pressure monitor, or a cookbook!

What is the program and do I qualify?

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Wise Choices is a free health screening and health coaching program run by the Washtenaw County Health Department and funded by the State of Michigan’s Getting to the Heart of the Matter grant. The goal of this program is to help reduce negative health events like a stroke or heart attack, and help people live an overall healthier life style.

Notes Health Educator Kim Collom, "The great thing about this program is that you are in control--you decide if you want to set a goal, and what kind of goal to set. We just provide a bit of support!"

How do you know if you qualify?

There are only three requirements for this program:

  1. You must live in Michigan

  2. You must be 18 + years old

  3. Your income must be below 400% of the poverty level—see the guidelines below!

  • Household of 1…$49,960

  • Household of 2…$67,640

  • Household of 3…$85,320

  • Household of 4…$103,000.

Add $17,680 for each additional person. All income information is self-reported. (No paystubs required!)

How does the program work?

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Step 1: Call to make an appointment

You start the program with an in-person appointment. In this appointment the health coach will measure your blood pressure, cholesterol, blood sugar, and more! You will receive your results during the same appointment and talk about the results with your health coach. During this first appointment, you will also receive a gift of your choice. The gift could be a yoga mat, pedometer, water bottle, and more!

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Step 2: If you are ready, set goals

Are you ready? Whatever your results, if you are ready to work on your health, you can work with your coach to set small, specific goals based on your needs and abilities. Your coach will then follow up with you regularly. It’s that easy!

If you aren’t ready, you can stop after the screening. The choice to work with a coach is always yours. YOU are in control.

How long does the program last?

The program lasts for a year, with an opportunity to re-enroll once your year is done. Over the next year, you and your coach will continue to check in, set small goals, and track your progress with improving your health. Improving your health is hard, and you do not have to do it alone. Let us help you—for free!

Who do I call to schedule my appointment?

To learn more, or to make your appointment call:

Kim Collom, Washtenaw County Health Educator

734-544-6700

This blog post was written by Kate Worthington, a University of Michigan School of Public Health student and a summer intern for the Washtenaw County Health Department.

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Our Courtyard Transforms! It's Now...Built To Play!

A couple of years ago, WHP staff took a photo in the courtyard between our building and the Department of Health and Human Services. What was then benches and rosebushes is now…a playground!

This project was funded by the Ralph C. Wilson Jr. Foundation Initiative, Built to Play.

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For parents coming in and out of the Washtenaw Health Plan, Washtenaw County WIC or the Michigan Department of Health and Human Services, this could be a nice break in a day of errands! Maybe next time, the kids will not just “tolerate” coming to our campus, but will actually look forward to it!

The transformation was quick (it just took a few days!), and we will still have the nice trees turning colors in the fall.

For more details about why the health department applied for the grant, read this conversation on the Built to Play website with WCHD Communications and Community Health Promotion Manager Susan Ringler-Cerniglia.

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Getting Medicare? Do You Qualify for Help Paying for Prescriptions?

Extra Help? Part D? Low-Income Subsidy? Prescriptions?

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Medicare prescription coverage is called Part D and if you are enrolling in Medicare, you have to enroll in Part D to get prescription coverage. Medicare can help you pay for some or all of your out of pocket prescription costs through a program called Extra Help or the Part D Low-Income Subsidy.

What is Extra Help?

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Extra Help provides a Low-Income Subsidy to help pay for out of pocket costs for Part D prescription plans. Extra Help will help pay for monthly premiums, annual deductibles and prescription co-payments. Extra Help can save you up to $4900 a year depending on your medications and on your income and assets. If you have low assets and are working, you may qualify even if your income is over the limit below. If you are struggling to pay for prescriptions, apply.

To qualify for Extra Help, your income and assets must be below:

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How do I get Extra Help?

You must apply for Extra Help, it is not usually automatic. Social Security will need information about your income and assets. Assets include your savings, investments and real estate (other than your home). If you are married, you will need information for yourself and your spouse.

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You may have received an Extra Help application in the mail when you first received information about starting Medicare. If you filled it out and mailed it back, you have already applied. If not, you can apply online at SocialSecurity.gov.

Some people automatically qualify for Extra Help and will receive a notice from Medicare. The notice will be purple, yellow or green or possibly orange. The purple notice says you qualify for Medicaid and Medicare and will receive the maximum Extra Help benefit. The yellow notice indicates you qualify for Extra Help and have been auto-enrolled unless you are already enrolled in a Part D plan. The orange notice states your Extra Help amount is changing for the coming year.

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How do I know if I already have Extra Help?

You can call Medicare at 1-800-633-4227 or log in to your account at medicare.gov.

In addition to Extra Help with Part D, you may also be eligible for help paying your Part B premium or be eligible for Medicaid with your Medicare.

At the WHP office, we help people who have Medicare apply for Medicaid. We can help you get an appointment with a Medicare Medicaid Assistance Program (MMAP) counselor to choose your Part D prescription plan. If you have questions, call us at 734-544-3030.


Resources:

Medicare 1-800-MEDICARE (1-800-633-4227)

Social Security Administration 1-800-772-1213

Find your Level of Extra Help (Part D) from Medicare.gov.

Understanding the Extra Help With Your Medicare Prescription Drug Plan from Social Security.

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Measles Outbreak - Washtenaw County

Confirmed Cases of Measles in Washtenaw County

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YPSILANTI, Mich., April 9, 2019 – The Michigan Department of Health and Human Services has confirmed measles in Washtenaw County as of April 8, 2019. Washtenaw County Health Department is providing additional information to local residents because of potential exposure to measles in public areas. Measles is very contagious, potentially serious and vaccine preventable.

Check and Update Your Measles Vaccination

Everyone is encouraged to check and update their measles vaccination, if needed. Anyone at any of the following Washtenaw County locations during the dates and times provided should monitor themselves for rash with fever or other symptoms consistent with measles for 21 days. If you suspect measles, seek immediate medical treatment. Residents are urged to call their doctor or emergency room before arriving so they can take precautions to prevent exposure to other individuals.

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 Vaccine Information

The MMR vaccine is available through primary health care providers and at some local pharmacies. Individuals should contact their health care provider for advice.

Washtenaw County Health Department is offering the MMR vaccine. Call 734-544-6700 to schedule an appointment. Visit www.washtenaw.org/health for any updates.

Vaccine given within 72 hours of exposure can prevent illness. Immune globulin (Ig) treatment is effective within six days of exposure for high-risk individuals. Talk to your healthcare provider to determine if immune globulin is right for you. You cannot get measles from the vaccine.

Because measles can be spread through the air by an infected person, Washtenaw County Health Department is alerting the public to the potential exposures. A person with measles is contagious for four days before and four days after the rash appears. An individual who was in the same location up to two hours after an individual contagious with measles is considered potentially exposed.

Having two doses of MMR vaccine at least 28 days apart is fully protective. Having only one dose of MMR vaccine is approximately 93 percent protective. The first dose is routinely given to children after their first birthday. Vaccination is not necessary if an individual has a prior history of measles illness. Individuals born before 1957 are assumed to have natural immunity, according to the Centers for Disease Control and Prevention (CDC).

 For updates, please visit www.washtenaw.org/health.

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Happy 50th Birthday to the AAATA. Are YOU Falling off Medicaid?

Happy 50th Birthday to  The Ride ! Cake picture from  sayitwithcake.ca .

Happy 50th Birthday to The Ride! Cake picture from sayitwithcake.ca.

The Ann Arbor Area Transit Authority, also known as The Ride, is celebrating its 50th birthday in 2019! People who ride the bus come from all over the county and have all kinds of insurance. But some bus riders may be losing Medicaid, and not know it.

That is why we are so excited to be partnering with The Ride on our Are You Falling off Medicaid? Campaign.

Through their generosity, we have placed posters in all buses starting March 1, 2019! We have timed this campaign to coincide with the mid-March increase in the minimum wage. Our hope is that we will be able to get people to visit or call us before their special enrollment period runs out. If done in time, people who lose Medicaid can get Marketplace or employer insurance.

Want a prize?

Snap a selfie of yourself with our poster and tag @coveragecounts on twitter, @healthcarecounts on facebook or @healthcarecounts on instagram!

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John Dingell and the Pursuit of Healthcare for All

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This photo shows former President Obama signing the Affordable Care Act. What you might not notice is the gentleman sitting in the right-hand corner of this photo. That was former Congressman John Dingell Jr., who represented much of Washtenaw County for many years. Dingell--who died yesterday--introduced a health care bill into Congress every year from his start as a legislator until the passage of the ACA, and he served for 59 years. Thank you, Congressman Dingell, for your devotion to healthcare for all.

A Little Bit of History

John Dingell’s father (also John Dingell!) was in Congress before John Dingell. John Dingell Sr. began cosponsoring a national health insurance bill (what we would now call “single-payer” legislation) and fighting for universal health care when the issue was less about cost and more about health care as a right. John Dingell Sr. was also active in the fight for social security.

John Dingell Jr. enjoyed the world of twitter, and here is a bit of history—in Dingell’s own words.

John Dingell Sr. is at the back wtih the mustache as President Franklin Delano Roosevelt signs the Social Security Act into law.

John Dingell Sr. is at the back wtih the mustache as President Franklin Delano Roosevelt signs the Social Security Act into law.

When John Dingell Sr. died, John Dingell Jr. ran for his congressional seat and took up the mantle, introducing a single-payer bill into Congress every year. But John Dingell Jr. was practical, and also worked for extending health care incrementally when the opportunities arose.

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John Dingell Jr. said the honor was given to him because the speaker had been great friends with Dingell’s father, and Dingell’s father had worked hard to make Medicare a reality. Note the gavel at bottom left.

John Dingell Jr. said the honor was given to him because the speaker had been great friends with Dingell’s father, and Dingell’s father had worked hard to make Medicare a reality. Note the gavel at bottom left.

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John Dingell Jr., July 8, 1926 – February 7, 2019

We thank John Dingell for his relentless support of health care through his entire career and for his dedication to working for the people of the United States.

Read more details about John Dingell’s role in fighting to extend health care to all here.

John Dingell’s NYTimes Obituary

From the Detroit Free Press:

John Dingell: In love with his life, in awe of his luck

Barack Obama: John Dingell made life better for Americans

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