Affordable Care Act

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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Get 'Em Now! Free Flu Shots Prevent Epidemics

A lot of people say ‘it’s just the flu.’ However, influenza is a serious respiratory illness. Nationally, it causes more hospitalizations and deaths than all other vaccine preventable diseases combined.
— Christina Zilke, Washtenaw County Health Department

What is the flu?

Symptoms of the flu can include fever, chills, cough, sore throat, runny or stuffy nose, muscle or body aches, headaches, and fatigue or tiredness.  Some individuals will report vomiting and diarrhea but these symptoms are more common in children than for adults.  Symptoms can last anywhere from a few days to about two weeks. 

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Some individuals are at a higher-risk of developing flu complications like sinus and ear infections, pneumonia, and bronchitis.  Pregnant women, young children, people living with chronic medical conditions, or people over the age of 65 are all at a higher-risk of developing flu-related complications.  In some cases complications can become severe and result in hospitalizations and can be life-threatening.

Flu across the country is widespread now. In Washtenaw County, the most recent data looks like this: 

To date (1/27/2018), 181 people in our county have been hospitalized this season and 4 adults have died. 

To date (1/27/2018), 181 people in our county have been hospitalized this season and 4 adults have died. 

More people are being hospitalized. 

I'm Healthy, Why Do I Need A Shot?

The Center for Disease Control (CDC) recommends that everyone 6 months and older should receive a flu shot during the year’s flu season.  

It is important for you to get the flu shot because it keeps yourself and your family safer. If you do get flu, you may be less affected. You are also less likely to transmit the flu. Keep your loved ones healthy!

Some strains of flu are stronger than others. In 1918, the flu killed tens of millions of people around the world. Read more about that in this Washington Post article

In 1968, my entire family got the “Hong Kong” flu. We were all sick for weeks. I still remember it. My mom set up cots in my parents’ bedroom. My grandmother wouldn’t come take care of us because she didn’t want to get sick herself.
— WHP staff member

I Got a Shot Last Year…Why Do I Need Another This Year?

The viruses that carry the flu are always changing.  Flu vaccines are made specifically for each season. Even when they are not completely effective, they still provide some protection. The second reason we get flu shots every year is that the antibodies from previous vaccine viruses will decline over time and no longer protect you from flu viruses.

It's Free, Thanks To The Affordable Care Act! Don't Delay!

Under the Affordable Care Act vaccinations are FREE for those with insurance--and that includes Medicaid and Marketplace coverage, as well as Medicare and employer coverage. Flu shots are given out at pharmacies, doctors, and even your local health department!

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It's Thanksgiving. We're Thankful for the ACA!

President Obama signs the Affordable Care Act. Sitting to his right is former Rep. John Dingell, who represented much of Washtenaw County. 

President Obama signs the Affordable Care Act. Sitting to his right is former Rep. John Dingell, who represented much of Washtenaw County. 


The Affordable Care Act. The Patient Protection and Affordable Care Act. 

It's easy to remember some of the things the Affordable Care Act has done.

  • 20 MILLION more people in the U.S. have health insurance. 
  • In Michigan, over 600,000 people are enrolled in the Medicaid expansion, the Healthy Michigan Plan which includes medical, dental and vision benefits.
  • Vaccines are FREE.
  • Need help quitting smoking?  Nicotine patches and medications are FREE.
  • You cannot be denied health care because of a pre-existing condition. It doesn't matter if you have asthma, cancer, or depression--you can still get health insurance.
  • Young adults can stay on their parent's health insurance until they are 26
  • Your annual physical (wellness) appointment is FREE
  • For 2017, your out-of-pocket maximum can be no more than $7,150 for an individual plan and $14,300 for a family plan.
  • Women don't get charged extra for health insurance, and pregnancy is a covered benefit.
  • There are no annual or lifetime limits for insurance. 



It's Open Enrollment from now until December 15, 2017. Don't miss a chance to get Marketplace coverage! Have questions?  Know someone who needs health care?  

We Help People - Like You! 

Call the WHP at (734) 544-3030

Come see us Monday - Friday between 9am - 4pm.  555 Towner St. Ypsilanti, MI (Except Thanksgiving and the day after Thanksgiving--we're closed.)

Want to read more about the impact of the ACA? 

Kaiser Family Foundation: The Effects of Medicaid Expansion Under the ACA

Medical geek?  From the New England Journal of Medicine, The Affordable Care Act at 5 Years

Data Geeky?  Reform by the Numbers from the Robert Wood Johnson Foundation.

Concerned about efforts to repeal the Affordable Care Act? Here is a way to keep up to date

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Six Things I Learned about Healthcare While Working at the WHP

Editors Note: This post was written by a wonderful summer intern, Madeline Higgins, as a reflection on her work over the summer. Madeline is a student in the MPH program at the University of Michigan School of Public Health, and we are sure she will go on to do great things!

I was lucky to intern at the Washtenaw Health Plan this past summer, where I got to observe the services that WHP provides and work with a new program involving Community Health Workers. Meanwhile, the federal government was attempting to greatly reduce the Affordable Care Act, which had the potential to negatively impact the health of residents in Washtenaw County. While I learned many facts, protocols, and systems, the items listed stick out most in my memory.



1. There is a significant gap in understanding of the reality of healthcare and policy impact from federal legislators.

I believe this stems from decision makers finding information that enforces their current worldview instead of looking at fact-based data. While watching and reading about the legislative process for healthcare reform, I was struck by the lack of listening and understanding from both sides of the aisle. While everyone utilized individual stories to demonstrate their points, there was little conversation about population-level health outcomes. After reading reports and statistics which utilized a population health framework, it is obvious to me that overall, the Affordable Care Act has positively impacted health in the US.


2. You can work minimum wage full time and not qualify for Medicaid (as a single individual household).

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I learned this towards the end of my time with WHP. I hadn’t done the math before, and it was hard for me to imagine living on the minimum wage in the Ann Arbor area in regards to housing costs, let alone health care. To me, this further demonstrates the need for a livable minimum wage.



3. Pre-existing condition protections help us all.

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At some point in our lives, we are likely to experience some health setback where we utilize the healthcare system. It is advantageous to us all to include people with pre-existing conditions in the insurance pool because one day that could be us!



4. Everyone has questions about healthcare- and it is important to find places to get good information.

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The Washtenaw Health Plan is a great place to ask for help! No matter your insurance plan, there seem to be terms and deadlines that won’t make a lot of sense until you ask an expert or seek reliable resources. I also wrote a blog post this past summer about reliable resources regarding health care access, and it totally changed the way that I look for information about health.


5. People who do direct service work can (and must) also do policy advocacy.

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Washtenaw County is organized and ready for action! I sat in on many meetings where people were putting their heads together to make sure they had the right information to talk to colleagues, legislators, and their clients about how federal policy change (for example, reduction in SNAP benefits) is detrimental to our community. This is vital to both keeping their jobs but also elevating the health status of the Washtenaw County population.


6. Above all, if healthcare was treated like a human right, the tone of this conversation would be very different.


People at the WHP recognize that healthcare is more complicated than having access to insurance. Health is about access to nutritious foods, opportunities to relax, space to exercise, and of course the occasional donut from Dom’s. Working in the county government showed the interconnectedness of the systems that comprise of people’s access to health. I believe if we are more inclusive to people’s needs we can work together to improve the health of Washtenaw County.

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Fight Repeal and Replace (Graham-Cassidy-Heller)! Support CHIP (Children's Health Insurance Program)!

Never let your guard down!  An effort to Repeal and Replace [the Affordable Care Act] has reared its ugly head again, threatening to take away healthcare from millions by ending Medicaid expansion (the Healthy Michigan Plan); raising costs for everyone; eliminating protections for pre-existing conditions; cutting coverage for low income seniors, children and the disabled; and attacking women's health and family planning.  

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The Congressional Budget Office (CBO) will not have time to fully score this bill before September 30th, 2017, and so there are not as many details about the costs and implications of this bill as there would be otherwise. However, the CBO has rated similar bills, and under those bills, 15 million people would lose Medicaid alone, and 32 million people might lose insurance. The Graham-Cassidy-Heller bill also privileges rural states over urban/suburban states, and Michigan is a clear loser. Large cuts to funding begin in 2020 but accelerate over time. Follow this twitter thread for a lot of details.

Under this bill, there would be huge premium increases for people with pre-existing conditions

Compare the bill to the ACA using the Kaiser Family Foundation comparisons web site.


But What About MIChild?

The Children's Health Insurance Program (CHIP), which provides coverage to children who do not qualify for Medicaid but whose families cannot otherwise afford health insurance, is also under attack.  In Michigan, CHIP is the MIChild program. CHIP funding is set to expire on September 30, 2017. Although there is, in principle, bipartisan agreement on extending the CHIP program, including MIChild, this agreement is being set aside while the Senate focuses on the Graham-Cassidy-Heller bill.

This piece from the Georgetown Center for Children and Families does a good job explaining the conflict between the two efforts. As Kelly Whitener writes,

For example, it would not be possible to have a good faith negotiation on extending CHIP funding (which covers 9 million children) while there is a live debate on gutting Medicaid (which covers 37 million children). This is not simply a matter of Congress learning to multi-task – you simply cannot work toward two totally different goals simultaneously.

Without CHIP renewal, MIChild will end when the state's reserve runs out (likely, early spring of 2018). This puts the health of over 40,000 of Michigan's children at risk. 

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Pre-existing conditions, the ACA and the AHCA

Under the Affordable Care Act (ACA) of 2014, health insurance companies can’t refuse to cover you or charge you more just because you have a “pre-existing condition” — that is, a health problem you had before the date that new health coverage starts. Health insurers can no longer charge more or deny coverage to you or your child because of a pre-existing health condition like asthma, diabetes, or cancer. They cannot limit benefits for that condition either. Once you have insurance, they can’t refuse to cover treatment for your pre-existing condition.
— U.S. Department of Health and Human Services

On May 4, 217 Republican Representatives voted to approve the American Health Care Act.  This Act is meant to repeal and replace the ACA.  One provision of this act is a change to the way pre-existing conditions are treated.  The bill in its current state does continue to cover pre-existing conditions under certain circumstances.  You must have continuous care.  Because this plan also removes the mandate that everyone must have health insurance, you can choose to not buy health insurance.  If you get cancer, you will have to pay a penalty and then you are allowed to get coverage.  The insurance company can CHARGE YOU whatever they want.  Let's just say that again.

Yes, you can have health insurance if you have a pre-existing condition but the health insurance company can charge you a lot of money. many people will not be able to afford that coverage.

High Risk Pools: We've been here before 

Click the image above to go to the video from Kaiser Health News 

Click the image above to go to the video from Kaiser Health News 

What about the high risk pools (HRP)?  What about them?  In the past, many states had high risk pools. They were extremely expensive, and many people did not get the care they need. Julie Rovner explains why this "sounds like a good idea" but isn't.  Sounds Like A Good Idea: High Risk Pools



If you are wondering what's included in the list of pre-existing conditions, so are we.  This is a partial pre-existing conditions list from CNN:  




Alzheimer's Disease

Amyotrophic Lateral Sclerosis

Anemia (Aplastic, Cooley's, Hemolytic, Mediterranean or Sickle Cell)


Aortic or Mitral Valve Stenosis





Bipolar disease



Cerebral Palsy (infantile)

Chronic Obstructive Pulmonary Disease

Cirrhosis of the Liver

Coagulation Defects

Congestive Heart Failure

Cystic Fibrosis

Demyelinating Disease





Esophageal Varicosities

Friedreich's Ataxia

Hepatitis (Type B, C or Chronic)

Menstrual irregularities

Multiple Sclerosis

Muscular Dystrophy

Myasthenia Gravis


Organ transplants


Parkinson's Disease

Polycythemia Vera


Psoriatic Arthritis

Pulmonary Fibrosis

Renal Failure



Sex reassignment

Sjogren's Syndrome

Sleep apnea



The Kaiser Family Foundation, a nonpartisan research group, has estimated that 27 percent of Americans younger than 65 have health conditions that would likely leave them uninsurable if they applied for individual market coverage under the system that existed before the Affordable Care Act. (New York Times, 5/6/17)  

One last point, this bill was passed by the House of Representatives and has a long way to go before it is signed by the President and becomes law.  Please make your voice and opinion heard by your elected officials.  It does make a difference. 

If you have questions, post them in the comments section and we will do our best to answer.  

-Meredith Buhalis

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#healthpolicyvalentines @coveragecounts #thanksACA


There are so many reasons to love the ACA!  

Here are our favorite #healthpolicyvalentines as part of our #thanksACA campaign.  If you have a #thanksACA or #healthpolicyvalentine, let us know and we will add it!  

Follow us on Twitter - Healthcare Counts @coveragecounts.

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Washtenaw County Opposes Repeal or Weakening of the Affordable Care Act

The Washtenaw County Board of Commissioners passed a resolution Feb. 1 to oppose any repeal or weakening of the Affordable Care Act (ACA). The resolution cited the vast number of county residents the ACA has helped, as well as the local economic opportunities it has provided.

“The Affordable Care Act is helping people – the uninsured rate in Washtenaw County has dropped by half since 2010,” says Andy LaBarre, chair of the Washtenaw County Board of Commissioners. “As a community, we want to support residents’ health and productivity. Maintaining what we’ve gained with respect to affordable health coverage is one clear way to do this.”

The Affordable Care Act is helping people – the uninsured rate in Washtenaw County has dropped by half since 2010.
— Andy LaBarre, Chair of the Washtenaw County Board of Commissioners

The Washtenaw County Board of Health also passed a similar resolution.

“A repeal of the ACA would be detrimental to Washtenaw County in so many ways.” says Felicia Brabec, Washtenaw County Commissioner and member of the Washtenaw County Board of Health. “More people have affordable coverage, and that coverage is not necessarily tied to their employer. This encourages entrepreneurship. It also promotes preventative health care and mental health in our community.”

The Washtenaw Health Plan sent a letter encouraging the continuation of the ACA, and supporting additional efforts to strengthen access to care, to federal legislators. The Board of Commissioners also resolved to send the resolution to the federal and state legislative delegations representing Washtenaw County.

Both the resolution and the letter outline how the Affordable Care Act has benefited Washtenaw County. For example, over 16,000 individuals in Washtenaw County have enrolled in the Healthy Michigan Plan (the Medicaid expansion), and 13,500 have enrolled in Marketplace insurance. That is nearly one in ten Washtenaw County residents who now have insurance due to the Affordable Care Act.

The Affordable Care Act also benefits those who are self-employed or whose employers do not offer them insurance, young adults up to age 26 who can stay on their parents’ health plans, and individuals with pre-existing conditions. A University of Michigan study found that the Medicaid expansion has created 30,000 jobs, and has provided $2.3 billion in economic activity across the state.

For personal testimonies of how the ACA has helped individuals locally, watch these two videos, created by the Washtenaw Health Plan and Washtenaw County Public Health, about a dance instructor and a graduate student who were able to find insurance through the ACA. 

Want to tell your story of how the Affordable Care Act helped you? Email us directly!

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Preparación de Impuestos Gratuita or Get (Free) Help With Your Taxes!



Usted puede obtener ayuda gratuita si tiene ingresos bajos (menos de $53,000 / año).
La gente necesita ayuda para presentar sus impuestos por muchas razones. Cualquiera que sea su razón, aquí hay algunos grandes recursos.

La Ley del Cuidado de Salud a Bajo Precio (The Affordable Care Act) requiere que la mayoría de las personas tengan cuidado de la salud o paguen una multa (pago de responsabilidad compartida) al menos que califique para una exención. Si usted tenía cuidado médico a través del Mercado de Salud ( asegúrese de traer su formulario 1095-A con usted cuando vaya a presentar sus impuestos. Su 1095-A está disponible en la sección Mensajes de su cuenta de Mercado de Salud ( También, puede llamar al Mercado de Salud(1-800-318-2596) y ellos le pueden dar al titular de la cuenta, la información por teléfono.


Si usted es un inmigrante indocumentado que presenta impuestos usando un número ITIN, o si su ingreso es muy bajo, o si su seguro de empleador es demasiado caro, pueda que no tenga que pagar una penalidad. Si usted no está seguro sí califica para una exención, use la herramienta Exenciones de cobertura de salud. La Herramienta de Exenciones utiliza sus respuestas para encontrar exenciones que pueden funcionar para usted. Le ayuda a ver si puede calificar y le dice cómo aplicar. Si califica, hable con su preparador de impuestos sobre como recibir una exención. Ningún preparador de impuestos le debe cobrar dinero por no tener seguro de salud, sólo el IRS puede recoger el pago de responsabilidad compartida.



Aquí hay una lista de documentos para llevar con usted a cualquier cita de preparación de impuestos o lo que necesita reunir antes de comenzar su declaración de impuestos en línea. Asegúrese de ponerse en contacto el preparador de impuestos acerca de los requisitos necesarios para recibir ayuda.


  • Números de Seguro Social para todos los miembros de la familia, identificación con foto
  • Formularios W-2 para todos los trabajos en el año anterior
  • Comprobante de pago de alquiler o hipoteca y pago de impuestos sobre la propiedad
  • Nombre, dirección y número de identificación fiscal federal del proveedor de cuidado infantil
  • Cheque en blanco, anulado o cheque de depósito para establecer el depósito directo del reembolso
  • 1099 formularios para otros ingresos, incluyendo desempleo, jubilación, contrato de trabajo
  • Carta (s) de Seguro Social o W-2s
  • 1095-A, si usted tenía cuidado médico del Mercado de Salud (
  • Copia de la declaración de impuestos del último año (si está disponible)
  • Una factura de calefacción de noviembre de 2015 a febrero de 2016 o el acceso a su factura de energía en línea
  • Cualquier otra carta o documento relacionado con impuestos


Ayuda gratuita para la preparación de impuestos de United Way del Condado de Washtenaw para residentes que ganan hasta $ 53,000 en 2016.

Llame al 734-677-7235 para programar una cita o llene este formulario. Encuentrenos en United Way, 2305 Platt Rd. Ann Arbor, 48104.

Muchas otras áreas en Michigan tienen VITA u otra ayuda de impuesto - utilice este enlace para encontrar ayuda en su área.


¿Usa una computadora? ¿Tiene acceso a una computadora? ¿Su familia gana $64,000 o menos? es un servicio en línea gratuito para la preparación y presentación de impuestos de United Way y H & R Block. ofrece correo electrónico, chat en vivo y asistencia telefónica en inglés y español. El 80% de las personas que presentaron sus impuestos usando este servicio terminaron en menos de 1 hora. Si no tiene una computadora o prefiere ayuda en persona, hay computadoras disponibles durante las horas abiertas de la clínica VITA. Computadoras y asistencia voluntaria son disponibles por orden de llegada.


La Oficina de Vivienda para la Clínica de Impuestos para Personas Mayores está tomando citas. La asistencia tributaria es proporcionada por voluntarios capacitados y abierta a individuos de todas las edades. Los voluntarios le puede ayudar con las formas 1040 y créditos Federales y estatales de MIchigan, y las devoluciones enmendadas. La asistencia para completar las exenciones de la pobreza y los aplazamientos de impuestos para disminuir las facturas del impuesto sobre la propiedad también están disponibles.

  • Llame al 734-998-9341 para programar una cita. Disponibilidad limitada.
  • Las citas están disponibles los viernes del 3 de febrero al 7 de abril y los siguientes miércoles; 8 de febrero, 15 de febrero, 15 de marzo y 5 de abril.
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Birth Control? You're Covered! #thanksACA

Let's talk about birth control. Under the ACA...


Need some birth control pills? COVERED.


An implant like Implanon or Nexplanon? COVERED. 

A shot like Depo-Provera? COVERED.

Under the Affordable Care Act, contraception is covered as a preventive service. Plans may cover, but are not required to cover, medications to induce abortions and services for male reproductive capacity, like vasectomies or condoms.

As says: 

Plans in the Health Insurance Marketplace must cover contraceptive methods and counseling for all women, as prescribed by a health care provider. Plans must cover these services without charging a copayment or coinsurance when provided by an in-network provider — even if you haven’t met your deductible. FDA-approved contraceptive methods prescribed by a woman’s doctor are covered, including:
  • Barrier methods, like diaphragms and sponges
  • Hormonal methods, like birth control pills and vaginal rings
  • Implanted devices, like intrauterine devices (IUDs)
  • Emergency contraception, like Plan B® and ella®
  • Sterilization procedures
  • Patient education and counseling

But What If You Want To Get Pregnant?

There's good news on that score as well. 

Pregnancy, maternity, and newborn care is COVERED!

Want To Breastfeed? 

Breastfeeding support, counseling, and equipment--including the cost of a breast pump--are COVERED.

Throughout the reproductive lifespan, the ACA has women covered. #thanksACA!

P.S. Need help getting covered? Call us at (734) 544-3030 or find some help here

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