Open Enrollment Question: Do I Have To Take My Employer Healthcare Coverage? (Usually, Yes)

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For many employees, Open Enrollment period for employer insurance comes in the fall, and is a short two or four week period where you have to make important decisions about health care for the coming year. This can be a lot of pressure, and so it turns out that a little preparation can go a long way. If you are a new employee at a job, you may be offered insurance right away, or after a period of 90 or 180 days.

Know your options, because if this were a relationship on Facebook, you might say, "It's Complicated!" What follows is a series of questions that will hopefully help you figure it out.

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If you are going to turn down your employer insurance, you want to make sure you are clear about the alternatives. Although it doesn't matter to Medicaid if you have an offer of employer insurance, it does matter if you were hoping to get subsidies on the Marketplace. Don't turn down your offer of coverage without studying your options!

1. Does your employer coverage meet Minimum Essential Coverage guidelines?

This would mean the the employer coverage covers:

  • Ambulatory patient services(Appointments and procedures in a doctor's office);

  • Emergency services;

  • Hospitalization;

  • Maternity and newborn care;

  • Mental health and substance use disorder services, including behavioral health treatment;

  • Prescription drugs;

  • Rehabilitative and habilitative services and devices;

  • Laboratory services;

  • Preventive and wellness services and chronic disease management and Pediatric services, including oral and vision care.

If the answer is yes, continue. If the answer is no, consider Marketplace and Medicaid eligibility and enrollment.

BEWARE: Some employers offer very inexpensive medical plans that do not cover hospitalization or emergency services. These do not meet Minimum Essential Coverage guidelines.

 

2. Does your employer coverage meet Minimum Value standards? 

Minimum value standard is a standard of minimum coverage that applies to job-based health plans. If your employer’s plan meets this standard and is considered “affordable,” you won’t be eligible for a premium tax credit if you buy a Marketplace insurance plan instead.

A health plan meets the minimum value standard if both of these apply:

  • It’s designed to pay at least 60% of the total cost of medical services for a standard population

  • Its benefits include substantial coverage of physician and inpatient hospital services

If you are unsure, ask your employer to fill out the Employer Coverage Tool.  

If the answer is yes, continue. If the answer is no, consider Marketplace and Medicaid eligibility and enrollment. 

NOTE: If the answer is no to EITHER the minimum essential coverage or minimum value standard, and you are income-eligible, you should be eligible for advance premium tax credits.

 

3. Is your family income low enough for some or all of your family to qualify for Medicaid?

Look here for the income eligibility tables for Medicaid. If you (or some members of your family) are income-eligible for Medicaid, you can apply for Medicaid instead of or in addition to your employer coverage. Because the income cutoffs for children are higher than for adults, often children can be enrolled in Medicaid or MIChild while the parents enroll in employer coverage. You can also have both Medicaid and your employer insurance--Medicaid will pay co-pays and deductibles not covered by your employer coverage, and this can be useful if you have a high-deductible plan. 

 

4. What is the cost of your insurance, relative to your income? 

To figure this out, look at the lowest-cost plan your employer is offering that meets the minimum standards (see #1 and #2 above), and the cost for the health coverage for the employee alone. 

Example 1: The cost is $100/month for the employee alone, and the employee makes $1000/month. $100/$1000=10% of income.

Example 2: The cost is $100/month for the employee alone, and the employee makes $2000/month. $100/$2000=5% of income.

Generally, if the cost is more than 8% of family income but less than 9.69% of family income, you are exempt from having to take the insurance, but you are not eligible to get advance premium tax credits on the Marketplace. [You may, however, be eligible for Medicaid!]

If the cost is more than 9.69% of family income, you don't have to take your employer insurance, but you can buy on the Marketplace and qualify for advance premium tax credits.

 

5. What about the rest of the family?  The Family Glitch

The Affordable Care Act looks primarily at affordability for the employee only. Different people in a family can get covered in different ways. 

If the cost of insurance for the employee is affordable, and the cost for the rest of the family is not affordable, you fall into what is called the "family glitch." The rest of the family is probably not going to be eligible for subsidized plans on the Marketplace. At this point, help from someone familiar with insurance options can be a big help. You may very well be exempted from the mandate to have health insurance, but that doesn’t help with getting health care. On the other hand, other family members may get covered differently. Possibilities may include: 

  Thanks to healthinsurance.org for the image.

Thanks to healthinsurance.org for the image.

Don't forget: in many cases, different people in a family are covered in different ways. For example, each parent may be covered by his/her own employer, and the children may be covered by MIChild.

 

6. What if employer coverage gets offered or dropped in the middle of the year?

Changes in employer coverage in the middle of the year create Special Enrollment Period opportunities. If employer coverage is offered, you should evaluate it. If you have Medicaid and will continue to qualify for Medicaid, you may not want to take it. If you have a Marketplace plan and the employer coverage meets minimum standards, you may need to take the employer coverage because you will no longer be eligible for APTCs. If you take it and have a Marketplace plan, make sure to let the Marketplace know!

If you lose employer coverage during the middle of the year, you may be eligible for Marketplace or Medicaid plans. The Special Enrollment Period on the Marketplace after you lose employer insurance is good for 60 days. Medicaid is open year-round.

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If you have questions, call or walk in to the WHP office.

Washtenaw Health Plan, where We Help People like you!

Monday through Friday from 9am to 4pm

555 Towner, Ypsilanti, MI 48198

 

Resources

Employer Coverage Tool:  Use this tool to gather answers about any employer health coverage that you’re eligible for (even if it’s from another person’s job, like a parent or spouse). You’ll need this information to complete your Marketplace application. Complete one tool for each employer that offers health coverage that you’re eligible for.

Healthcare.gov: Apply here for Marketplace insurance. 

MiBridges: Apply here for Medicaid insurance. 

HealthSherpa:  Use this tool to compare health plans. 

Healthcare.gov Estimator: Compare or preview plans and rates with this estimator. Plans for 2019 should be available during the last week of October.

 

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2019 Medicare Open Enrollment Runs October 15 through December 7

Medicare is a program for people who are 65 or older and people with disabilities. You can read more about Medicare here. If you have Medicare now, then...

It's time to review your Medicare Plan!  

October 15, 2018 to December 7, 2018 is the annual Medicare Open Enrollment Period. During Open Enrollment you may:

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  • Change from original Medicare to a Medicare Advantage Plan

  • Change from a Medicare Advantage Plan back to original Medicare

  • Switch Medicare Advantage plans

  • Join a Medicare Part D Prescription Drug Plan

  • Switch Medicare Part D Prescription Drug Plans

IMPORTANT: Review your coverage--especially Part D and Medicare Advantage Plans--every year!

Premiums, co-pays and the drugs covered can change from year-to-year, even within the same plan.  Your current plan should send you an "Annual Notice of Change" before Open Enrollment that outlines any changes for the next year.  Medicare Part D plans are sold and managed by private companies and vary greatly in terms of monthly premiums, annual deductibles, drugs covered and prescription prices.  

Insurers tweak Medicare Advantage Plans every year, and those changes could mean that you can't see your favorite doctor or that you might need to pay more. 

So--review, review, review!

Note: Low-income individuals on Medicare may be able to change their plans more frequently. A MMAP counselor can explain your options.

MMAP Counselors Are There For You--For Free!

Every state has people who will help you figure out your Medicare options. In Michigan, these people--paid staff, and volunteers--work with the Medicare/Medicaid Assistance Program. In Michigan, you can find your local MMAP program here. Nationally, the SHIP (State Health Insurance Assistance Program) can help you find assistance locally. 

MMAP Counselors can help explain how Medigap and Medicare Advantage programs work, and can help you sift through your options for Part D plans. They can help you figure out if you can defer taking Medicare because you are still working. They can help you figure out if you qualify for extra help!

Some People Qualify For Extra Help

If your income is low, you may qualify for extra help. For instance, the Medicare Savings Program may help you pay your Medicare premium, or you may qualify for Medicaid and Medicare which together will cover all your health care costs. To qualify for the Medicare Savings Program you must be low-income and not have many assets.  For married couples, your combined income must be less than $1871.75/month and you must have less than $11,340 in assets (excluding a house and car).  For single people, your income must be less than $1391.67 and you must have less than $7560 in assets.  

If you think you may qualify for Extra Help, talk to a MMAP (Medicare/Medicaid Assistance Program) counselor. 

Just MMAP It!

Washtenaw County is in a MMAP region that includes Livingston, Monroe, Macomb, St. Clair and Oakland counties. There are multiple ways to meet with MMAP counselors and MMAP and the Area Agency on Aging 1B have multiple events scheduled for Open Enrollment.  Call 1-800-803-7174 to schedule an appointment.  Call now because availability is limited!


 

 2019 Open Enrollment Washtenaw County Events - Medicare beneficiaries can make an appointment to meet one-on-one with a MMAP Counselor and review their 2019 Medicare coverage options.  Call 800-803-7174 to schedule an appointment.  Appointments are required.

Washtenaw ISD 1819 S. Wagner Rd. Ann Arbor, MI 48103

  • Tuesday, October 16 9am - 4pm,

  • Monday, November 12 9am - 4pm

  • Thursday, December 6 9am - 4pm

Milan Seniors for Healthy Living 45 Neckel Ct. Milan 48160

Call 734-508-6229 for appts

  • Thursday, October 18 9am-3pm

  • Thursday, November 15 9am - 3pm

Pittsfield Twp. Senior Center 710 W. Ellsworth Rd Ann Arbor 48108

Call 734-508-6229 for appts

  • Wednesday, October 24 9am - 2pm

  • Wednesday, November 14 9am - 2pm

Printable schedule of events for Southeastern Michigan  including Washtenaw, Livingston, Monroe, Macomb, St. Clair and Oakland.

New Medicare Cards

A quick note about Medicare cards. Medicare is no longer using your Social Security number as your Medicare number. Everyone (all 55 million people on Medicare!) will receive a new card before May 2019. You do not need to call to receive your card and no one will call you asking for your Medicare information to receive a new card. Read 10 Things to Know About Your New Medicare card.

 Medicare cards will no longer include your Social Security number. Everyone should have a new cared before May 2019.   Read more.

Medicare cards will no longer include your Social Security number. Everyone should have a new cared before May 2019. Read more.

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Medicaid: A State By State Program

Medicaid differs state by state. The income limits for children’s Medicaid, Medicaid for low-income parents, and Medicaid for adults vary. Even some of the rules for immigrants vary. Most of the advice on our website is specific to Michigan. This blog post attempts to give you some more resources if you are located in a different state. But if the relationship between different states on Medicaid were a Facebook relationship status, it would be: “It’s Complicated.”

Find Your State—What Does Your State Offer?

Are you looking for information about your state? This map links to information about each state including eligibility, expansion, CHIP (Children’s Health Insurance Program) and enrollment. The map does not include links to enrollment sites.

State Overviews from Medicaid.gov

Covering Adults: Medicaid Expansion

The Affordable Care Act offered states the option to expand Medicaid to cover adults between the ages of 19 and 64 who are making up to 138% (133% + 5% disregard) of the Federal Poverty Levels. States voted to expand Medicaid and the federal government agreed to pay for 100% of the program from 2014 to 2016, dropping to 90% of the program after 2020. Currently 34 states including DC have expanded Medicaid, 3 states are considering expansion and 14 are not expanding. Low-income adults who previously had no healthcare could now be covered by Medicaid.

If you are from another state, find out the status of the Medicaid expansion in your state below.

Different states have given their Medicaid expansion different names. In Michigan, expanded Medicaid is called Healthy Michigan Plan. In Illinois, the program is called HealthChoice Illinois, and it is Medi-Cal in California. These plans do differ from state to state but must cover the essential health benefits set in the Affordable Care Act of 2010. Under the current administration, some states are requesting and being approved for waivers that include work requirements and other restrictions. Read more about current and pending waivers here. If you are really interested in waivers, check out the Kaiser Family Foundation’s (KFF) Waiver Tracker.

Need Help With Figuring Out Eligibility?

If you have questions about your eligibility, your child, your parent or someone else’s eligibility, call us at 734-544-3030 if you are in Michigan. If you are not in Michigan and need information about eligibility or enrolling, there are two resources.

The first is Federally Qualified Health Centers (FQHC). FQHCs are federally funded health centers that provide medical (and sometimes other) services. If you are looking for information about healthcare, an FQHC is a good place to start. Because they provide sliding fee scale services, they usually have information about Medicaid for adults, families and children, as well as patient advocates who can help you navigate the system.

FQHC Locator

The second resource for finding out about healthcare is the Marketplace’s Find Local Help (https://localhelp.healthcare.gov). This lists organizations and individuals who can help with the Marketplace and sometimes Medicaid. Choose your contacts wisely, brokers and agents are paid to sell insurance and may or may not be familiar with Medicaid programs and eligibility. Assisters are certified to enroll you on the Marketplace and should be familiar with Medicaid/CHIP eligibility in your area.

 The Washtenaw Health Plan (left) is listed as an Assister; on the right, you find an Agent or Broker.

The Washtenaw Health Plan (left) is listed as an Assister; on the right, you find an Agent or Broker.

What If You Are Traveling and Need Emergency Care?

If you have Medicaid but need to go to an Emergency Room in another state, show them your Medicaid card and make sure to talk with the billing department before you leave. Most states have reciprocal agreements for emergencies for Medicaid clients—you cover mine and I’ll cover yours. Medicaid does not cover routine care in other states.

Planning A Move? Figure Out Your Health Care Options First!

If you are moving, make sure to cancel your Medicaid and apply in your new state. If you are wondering what your healthcare options are in your new state, use one of the tools above or go to this directory to find Medicaid contact information for any state.

Because different states have different rules, you may or may not be eligible for Medicaid in your new state. For instance, currently Texas has not expanded Medicaid. If your income is $1100/month (single person) in Michigan you could get Medicaid, but in Texas, you could not. Move from Texas to Michigan, and you’d be in luck.

For people who are in a state that did not expand Medicaid, if your income is below 100% of the poverty level, and especially if you are not a parent of minor children, you may need to rely on charity care programs. If you are above 100% of the poverty level, you may be able to go on the Marketplace. So when you are moving, don’t forget about the special enrollment period—it’s time-limited!

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Help! My Child Is Turning 26 And Will Lose My Employer Insurance. What Now?

One of the popular provisions of the Affordable Care Act is the piece that says that children can stay on their parents' employer-sponsored insurance up until they turn 26. Of course, many youth ages 18-26 have already gotten offers of employer-sponsored insurance--and taken them. But in other cases, youth turning 26 are working part-time jobs and/or going to school and/or parenting themselves. Parents who have spent their whole lives with employer-sponsored insurance are often confused and worried.

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Don't Panic. 

Part of the Affordable Care Act means that there *are* options, even if your child has Type 1 Diabetes or a history of asthma.  

Help your child evaluate their options and make sure to include them in all discussions.  They are over 18 and in most cases you will not be able to make healthcare decisions for them, even if you still take them as a dependent. 

Household?

Take a look at who is in their household.  Are they married?  Are they single?  Do they have children of their own?  Do they claim any dependents on their tax return?  In most cases, your child is a household of one until they have dependents to claim or file jointly with a spouse.

Income?

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Take a look at their expected household income.  Is their job seasonal?  Do they work part-time or full-time?  Take a look a the Federal Poverty Guidelines (FPL) and figure out where your child falls. What is your child's income?

Healthcare Options

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Their choices for healthcare are Medicaid, Marketplace or Employer Sponsored Insurance.  If their job offers insurance, they will be able to enroll when their current insurance ends (read about special enrollment periods below).  If your child's last 30 days of income is below 138% of the FPL ($1396/month gross in 2018  for a single person), they will qualify for Medicaid.  Applying online is easy at MI Bridges.  If their income is above 138% FPL and their employer does not offer insurance, the Marketplace is where they will get their healthcare coverage.   

Plan Ahead! 

When your child turns 26, your employer may terminate their coverage on their actual birthday, at the end of their birthday month, or--rarely--at the end of the calendar year.  It is important to find out what the exact date is for the loss of coverage because they have a limited time to enroll in other coverage.  It is also a good idea to get a letter from the insurance company showing the date coverage ends for your child.

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The loss of the parents' insurance creates a special enrollment period which enables your child to enroll in health care outside of open enrollment.  Medicaid enrollment is always open and your child can apply anytime. 

For employer insurance, the special enrollment is 30 days from the date of insurance ending.  Occasionally employers are not aware that loss of coverage creates a special enrollment period for an employee.  If the employer is unaware, please direct them to this explanation from the US Department of Labor.  The Marketplace special enrollment period is 60 days from the loss of coverage.  You can apply online at healthcare.gov

Start Early!

To avoid a gap in healthcare coverage, you should start this conversation before the coverage ends.  For Medicaid, employer and Marketplace insurance, you can complete the application or submission of paperwork before coverage ends.  

If you have any questions about eligibility or timing, please ask in the comments below or call us 734-544-3030.  We are always happy to help. 

Washtenaw Health Plan - We Help People!

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Breastfeeding - Good for Babies and Moms!

Join MDHHS-WIC and The Michigan Breastfeeding Awareness Network for the Breastfeeding Awareness Walk on August 8, 2018 from 11:30am-2pm in Lansing on the Capitol Lawn. Help normalize breastfeeding!

There are so many great reasons to breastfeed! And so much research to support how healthy it is! 

Good for Babies!    

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Breastfeeding is good for babies. In the first few days after baby is born, mothers make colostrum, a thick yellowish milk filled with antibodies and protein that are "liquid gold" for baby's first few days. Breastfed babies are less likely to get sick and have fewer digestive problems. When baby's immunities are at their lowest between 2 to 6 months, it's especially important that mom's antibodies and anti-viruses are passed along through breastfeeding. Breastfed babies are smarter and do better in school. There are so many good reasons for your baby to breastfeed. 

Good for Mothers!

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Breastfeeding is also good for mothers. Breastfeeding helps new mothers relax.  When nursing, a hormone called prolactin, known as the mothering hormone, is produced. Another hormone, oxytocin, released shortly after birth, helps the uterus contract and return to its pre-pregnant size. Breastfeeding helps mom and baby bond and feel close. Breastfeeding helps reduce a mother's risk of developing certain cancers. And breast feeding is cheap. At one year, a breastfed baby will save between $900 and $2,160 dollars on formula.  

There's Help Available!

WIC (Women, Infants and Children)

Here in Washtenaw County, WIC is an excellent resource for breastfeeding. WIC (Women, Infants and Children) has many breastfeeding support programs for moderate to low income families. WIC's programs for pregnant women and families with children up to age 5 include:

  • Peer to Peer breastfeeding counselors 
  • Lactation consultants for breastfeeding support
  • Free breast pumps for mothers returning to work or school 
  • Food as food packages or Project Fresh booklets ($25 to spend at local farmer's markets)
  • Nutrition counseling including health care referrals and immunizations
  • WIC Connect app to help you connect with WIC services 

To contact WIC (?should this clarify that this is contacting the WIC peer counselors, not the main WIC number?), you can call 734-544-2995, email yourbreastfriends@gmail.com or connect through their Breastfeeding support facebook page @WashtenawWICBF.  

 

Marketplace (healthcare.gov) and other ACA-Compliant Insurance

Health insurance plans must provide breastfeeding support, counseling, and equipment for the duration of breastfeeding. These services may be provided before and after birth.  This applies to Marketplace plans and all other health insurance plans, except for grandfathered plans.

These health insurance plans must also cover the cost of a breast pump. It may be either a rental unit or a new one you’ll keep. Your plan may have guidelines on whether the covered pump is manual or electric, the length of the rental, and when you’ll receive it (before or after birth). It’s up to you and your doctor to decide what's right for you.

 

La Leche League of Ann Arbor

La Leche League of Ann Arbor provides support and education for breastfeeding moms. Check out their facebook page! 

 

Washtenaw County Breastfeeding Coalition

Washtenaw County Breastfeeding Coalition is a group of volunteers made up of doctors, hospital based IBCLCs, WIC breastfeeding coordinators, peer counselors, private practice IBCLCs, La Leche League Leaders, birth and postpartum doulas, Certified Lactation Counselors, public health workers, dieticians, nurses, mothers, fathers, caregivers, business owners, and anyone else who is interested in promoting and supporting breastfeeding in the local area.

 

Maternal Infant Health Program (MIHP)

Maternal Infant Health Program (MIHP) is a home visiting program for pregnant women and infants with Medicaid. Services include education, service coordination, support, breastfeeding and nutrition support and referrals. To enroll, call 734-544-2984 or 734-544-9749 or ask your doctor for a referral.

 

 

As always if you have questions or need help with healthcare coverage, please call the Washtenaw Health Plan 734-544-3030. Or you can leave a comment/question below! 

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WHP Staff Profile: Tonya South Peterson

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Tonya South Peterson is celebrating 20 years as a county employee.  For the last two years, Tonya has been an enrollment specialist at the Washtenaw Health Plan.  Tonya started her career after being noticed by a former nursing director.  Tonya worked at a photography lab where the director had her photos developed and noticed the excellent customer service Tonya provided.  After seeing her interact with a particularly difficult customer, the director mentioned a job opening in the Maternal Infant Health Program and the rest is history!  Tonya spent two and a half years as a Maternal Infant Health Advocate before moving to Women, Infants and Children (WIC) to become an eligibility and enrollment specialist for 15 years.  

Tonya loves working with children and families.  Her work at Washtenaw County Health Department gives her a "great sense of satisfaction in helping others."  At WIC, she got to know many families and is always happy to see them at the WHP office.  Through her years at WIC, Tonya had many roles in addition to enrollment and eligibility but enjoyed the families and children the most.  At WHP, Tonya enjoys helping clients with their healthcare and many other issues.  Tonya expertly assists people with utility assistance through the state assistance programs and Barrier Busters.  Tonya enjoys the camaraderie and walk-in atmosphere at WHP.  Spending more time with clients and helping with a wide range of problems is just one of the things she loves about her job.  

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In 2002, Tonya became a union steward and continues to work protecting employee rights and job security.  Tonya is also trained in medical insurance billing, procurement, expenses and inventory, and while at WIC she performed quality assessments and trainings for the WIC office.  After attending Washtenaw Community College years ago, Tonya has returned to pursue a degree in Social Work. She received the highest grade ever achieved in her psychology class!  She is looking forward to learning and having more opportunities as she completes her degree.  

Tonya is celebrating 25 years with her husband, has four children and two grandchildren. She has lived in Washtenaw County since she was six years old and considers herself a Michigander.  In her free time, she loves to spend time celebrating holidays with her family.  She loves to read suspense thrillers--Dean Koontz is a favorite.  She also loves the writings of Toni Morrison and Richard Wright.  Her favorite movie is Forrest Gump, but she enjoys a good thriller too.  She loves listening to music, everything from A to Z. 

WHP is so happy to have Tonya as part of our staff.  Considerate, calm, knowledgeable  and very helpful, clients love her and she helps them tremendously.  Lucky us!   

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Adiós Frania and Ingrid!

Buena Suerte!

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Ingrid Fonseca and Frania Mendoza, both bilingual (Spanish/English) enrollment specialists, are leaving the Washtenaw Health Plan to pursue their passions.  The WHP staff (and clients) are very sad to see them go but are so grateful for their expertise, knowledge and care they both shared with us.

Ingrid Fonseca will be taking her side business to the next level.  Ingrid’s incredible style, clothing, and jewelry put the rest of us WHP staffers to shame.  Originally from Ecuador, Ingrid also lived in Japan and Colombia developing her international style.  Ingrid sells both handmade (by her!) and vintage jewelry along with hand-selected clothes with an eco-bohemian style.  Good luck!  

Find Unique Vintage Jewelry & Boho Accessories at Ingrid’s Hippy Happy Shop on Etsy and on Instagram @hippyhappyshop

Find Eco-friendly & Eco-fashion Jewelry and Accessories at the IngridFonseca Shop on Etsy. 

We wish Ingrid smashing success!

 

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Frania Mendoza Lua is leaving us for the Windy City.  After getting her MSW at the University of Michigan, Frania has been splitting her time on both applied work and research. She has been working with the WHP;  doing research, writing grants and developing a smartphone app for a UM research project; and working with Latino/a adolescents in Washtenaw County. This led Frania to decide to pursue a PhD! Frania has been accepted into the University of Chicago’s PhD program at the School of Social Service Administration (with funding to support her studies!).  Before letting the wind whip her hair around in Chicago, Frania will be spending part of the summer at a super statistics program at the ICPSR at UM.  As if all this was not enough--she recently got engaged. 

Ingrid and Frania, let’s not say farewell, but rather—good luck in your coming adventures!

Come Work With Us!

Meanwhile--do you think you have the stuff to fill their shoes?  Take a look at the WHP Outreach Worker position posted here (link: https://secure.ewashtenaw.org/hrjobs/AppJobPostingList.do). The job posting requires fluency in both English and Spanish, and the job posting closes July 6, 2018.

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Medicaid Work Requirements Signed--What Next?

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On Friday, June 22nd, Governor Snyder signed SB 897, the Medicaid work requirements bill. (Read about its details here. Read the full bill here.) We have been getting phone calls about what this means for individuals. For now, nothing has changed.

What happens next? The Michigan Department of Health and Human Services needs to submit a request for a waiver to the federal Centers for Medicare and Medicaid Services (CMS), and they need to approve the waiver, before any work requirements will be in place. In the meantime, if you are eligible for Medicaid, you should apply. (Figure out if you are income eligible here.)

Remember that Medicaid is open year-round, so a change in circumstances (losing a job or losing insurance, getting married, getting pregnant, etcetera) can mean you are now eligible when you were not before. If that is the case, please give us a call at 734-544-3030 or come into our offices at 555 Towner in Ypsilanti, Michigan, Monday-Friday from 9 a.m. to 4 p.m.

We will be helping people learn how to comply with Medicaid work requirements once they are in place, but for now, the Medicaid program is the same as it was yesterday. Keep Calm! Apply On!

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Four Reasons (Aside From The Work Requirement) To Ask Governor Snyder To Veto The Medicaid Work Requirements Bill

As if the Medicaid work requirements, discussed more fully in our last blog post, are not enough, there are four other problems with the Medicaid Work Requirements bill, also known as SB 897. This analysis quotes a FamiliesUSA blog post, written by Eliot Fishman, Senior Director of Health Policy. Read his full blog post here.

Read the House Fiscal Agency Legislative Analysis here. You can find a lot of the details in the House Fiscal Agency Legislative Analysis.

As Fishman notes:  

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1. The Bill Gives the Trump Administration and Washington Bureaucrats the Power to Kill the Healthy Michigan Program: As of now, with the Affordable Care Act surviving in Congress, the only people who can take Healthy Michigan coverage away or Michiganders and their state officials. But the new bill gives the Federal government one year to approve Michigan’s waiver request or the Healthy Michigan program goes away, leaving all of its enrollees with no health insurance...
2. The Bill Includes a Bizarrely Punitive Premium for Near-Poor Working People: People with incomes just over the poverty line come in for particularly harsh treatment in the bill. Anyone with an income between 100% and 138% of the poverty level for four years or more are forced to pay 5% of their income—far higher than any premium in Medicaid in any other state—or lose their coverage. This would create a strong incentive to REDUCE income to under the poverty line...
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3. The Bill Would Lock People Out of Coverage for a Year for Paperwork Discrepancies: The bill creates a broad mandate on Michigan Medicaid to take coverage away from people in the Healthy Michigan program for a year if they are found to have “misrepresented their compliance” in required monthly reporting of their work hours...
4. The Bill Creates a Crazy, Rushed Timeline for the Snyder Administration to Write and Submit a Waiver: The Snyder administration is required to submit a waiver to the Trump administration by October 1, 2018.  But federal and state law require the waiver to be submitted for public and tribal consultation starting 60 days before federal submission—so no later than the end of July. That gives Michigan Medicaid just a few weeks to lay out their plans to implement this complex mess of a bill.

You can ask Governor Snyder to veto this bill. Contact Governor Snyder here.

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Medicaid Work Requirements Pass The House

The Medicaid work requirements bill, Senate Bill 897, passed the House Appropriations Committee on Wednesday, June 6, 2018 on a party line vote, 17-10.  The bill was approved by the Michigan House of Representatives by a vote of 62-47.  The House-amended bill heads back to the GOP-controlled Senate, where it is expected to pass as soon as Thursday.  Next up is the Governor's office

The Washtenaw Health Plan remains opposed to Medicaid work requirements. We believe that healthcare is a human right, and that Medicaid work requirements will keep people from getting necessary healthcare. 

The proposed bill has many improvements over previous versions. Here are a few changes:

  • It requires an average of 80 hours/month of qualifying work activities, down from the earlier proposal of 29 hours/week. 
  • It exempts individuals age 63 and 64, who may have retired early and be drawing social security.
  • It only applies to Healthy Michigan Plan Medicaid recipients, and no others
  • It includes educational activities, job training, and vocational training, as well as unpaid internships, to meet the requirements.
  • it would allow recipients to have 3 months of noncompliance in a 12-month period, and after that, the recipient would lose coverage for at least 1 month (reduced from 1  year) and would need to be compliant to re-enroll.
This bill does one thing: it takes healthcare away from some of our state’s most vulnerable residents. We strongly urge the House to defeat the bill and if not, we call on the governor to veto this harmful piece of legislation.
— Gilda Z. Jacobs, Michigan League for Public Policy

There's more...Much more

Read the House Fiscal Agency Legislative Analysis here.

You can still oppose the bill. If you would like, you can send your comments to the governor, requesting his veto.   

Email:  governorsoffice@michigan.gov 

Phone: 517-373-3400 or 517-335-7858 (Constituent Services) 

From the Michigan League for Public Policy:  Bill takes healthcare away from people and families, does nothing to address barriers to employment.

We wrote about how Medicaid was helping and improving our state:  The Benefits of the ACA Go Beyond Health #thanksACA.

 

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