Michigan

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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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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Who Is DHHS And What Do They Do?

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The Michigan Department of Health and Human Services is the largest state department. The department was created by a merger of the Michigan Department of Community Health and the Department of Human Services in the spring of 2015. 

DHHS has several important departments that affect many of the people of the state of Michigan. 

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These programs include financial and health assistance programs, foster care and protective services, health statistics, and community health interventions. In many cases, the Washtenaw Health Plan and the Washtenaw County Health Department work closely with DHHS. Even though we may help people apply for Medicaid, it is DHHS that determines eligibility. 

Medicaid and Financial Assistance (cash assistance, food assistance)


Washtenaw Cty WIC office staff. 

Washtenaw Cty WIC office staff. 

Women Infants and Children (WIC)--policies are set at the state level, but of course you can visit the Washtenaw County Health Department for WIC services.  WIC services include Food Packages, Nutrition Education, Breastfeeding Promotion and Support and more.  


Foster Care and Adoption Services: Washtenaw County is looking for additional foster care families. Interested? Follow the link!


Michigan Rehabilitation Services provides specialized employment and education-related services and training to assist teens and adults with disabilities in becoming employed or retaining employment.


Native American Affairs provides a broad range of social services to protect, preserve and strengthen Native American families both on and off tribal lands.


Child and Adult Protective Services: Have a concern about someone? Call 855-444-3911 to trigger an investigation.


Chronic Diseases: The State of Michigan chronic disease team works closely with the Washtenaw County Health Department and other county health departments around the state.


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Communicable Diseases: The state works closely with health departments around the state to track diseases like Hepatitis A. Find Washtenaw County data here


Epidemiology and Statistics: Learn about infant mortality, cancer statistics, and other vital statistics.


Policy and Planning: Here is where you can find policy manuals that guide much of the state's work.

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For These Four Working Households, Medicaid--Without Work Requirements--Matters

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The idea of work requirements for Michiganders on Medicaid is rather abstract. Unfortunately, it would have significant negative consequences. Here are some real stories of people that we have worked with in the past year. (Names have been changed.)

What unites these families is that--even though, in each case, someone in the household is working--under the proposed work requirements for Medicaid, they wouldn't qualify for Medicaid. Here are their stories.

Marsha and Will: Bad Luck and Poor Health Means Medicaid is More Important Than Ever

Marsha and WIll are a married couple in their fifties, and their kids are now all grown. In 2016, they were both working low-wage jobs in the service industry. Their combined income was around $28,000/year. They could afford their rent, and their car, and they qualified for tax credits on the Marketplace. In early 2017, WIll lost his job. He was looking for a job, but now they were living on Marsha's job at Subway, which was averaging about 28 hours/week. Paying for rent was tough, but at least they now qualified for Medicaid. After about six months of being unemployed, Will had a heart attack and was in the hospital for five days. 

Under proposed Medicaid work requirements, Marsha's work was less than 30 hours/week and Will wasn't working at all--they would not have qualified for Medicaid. When Will had his heart attack, what would have happened?

Virginia: Medicaid is Vital to Mental Health

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Virginia is a single woman in her 20s. She has a history of depression and anxiety, and had been helped by Community Mental Health. When she started working 33 hours/week, her income was too high for Medicaid, and as a result she lost her relationship with Community Mental Health. Without medications and support, her anxiety got so bad that she couldn't work at all. Then Virginia became eligible for Medicaid--and Community Mental Health--again. Now, with the support of Medicaid and CMH, she is able to work. Virginia now keeps her work hours at about 25 hours/week, in order to stay eligible for Medicaid and--therefore--CMH. 

With Medicaid work requirements, Virginia might not be able to keep her hours below 30 hours/week. And if her income goes above 30 hours/week, at $11/hour she won't be eligible for Medicaid--or CMH services.

Maria and Jose: Medicaid Keeps The Family Healthy

Maria and Jose have two children, ages 3 and 5. Jose works two jobs so that Maria can stay home with the kids--childcare costs are so high. Jose is offered (and takes!) insurance from his work, but while it would be affordable for him ($100/month), if he were to add the rest of the family it would cost $600/month. So Maria and the kids are on Medicaid, which is a good thing, because Maria and her youngest child have asthma. 

With Medicaid work requirements, Maria wouldn't be eligible for Medicaid unless she were working 30 hours/week. In order to do that, though, they would have to pay for childcare. Without the asthma medication, Maria might end up in the emergency room. 

Jasmine and Mark: Medicaid Allowed Them To Take A Chance And Start A Business

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In 2015 Jasmine and Mark decided to start their own business in Washtenaw County. Investing their life savings, they quit their jobs and started spending long hours on their business. Without income, they and their two kids got Medicaid. In the first year, they did not turn a profit. In their second year, they started making a little bit of money, but were still Medicaid eligible. By year 3, they were over income for Medicaid and went on the Marketplace.

With Medicaid work requirements, in the first two years of their business, their income did not reflect the work they were putting in. How could they prove they were working? Would they qualify for Medicaid?

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Ten Reasons To Oppose Medicaid Work Requirements

Printable pdf of this blog post here.

You may have heard that there are some proposals in the Michigan legislature to require individuals on Medicaid to work in order to continue to qualify for Medicaid  (Proposed in March 2018: Senate Bill 897 and House Bill 5716). The Washtenaw Health Plan and Washtenaw County are opposed to any efforts to impose work requirements on Medicaid recipients. Here's why: 

1. Most people on Medicaid are already working.

Those who are not working, are most likely to be found taking care of young children, elderly relatives, to be living in high unemployment areas, or to be in poor health themselves. The vast majority of individuals in Medicaid are in households with at least one working person (Kaiser Family Foundation, 2016). 

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In December 2017, a team of University of Michigan researchers did extensive research on individuals in the Michigan Medicaid expansion, called the Healthy Michigan Plan, population.

  • Nearly half the individuals are working (48.8%)
  • 5% are students
  • Nearly 5% are home taking care of children
  • 11% reported being unable to work because of their health
  • Over one fourth are out of work, many of them because they are in fair or poor health. Three-quarters of those who were out of work reported having a chronic health condition.

NOTE: This study was the first peer-reviewed study from the formal evaluation of Michigan's expansion, called the Healthy Michigan Plan. The evaluation, funded by a contract with the Michigan Department of Health and Human Services, was required under Michigan's federal waiver. 

As Renuka Tipirneni, lead author of the study notes, "'Is it worth the cost to screen and track enrollees when only a small minority isn't working who are potentially able to work?"

2. The Medicaid expansion has helped improve individuals' health.

Health improvements mean it is more likely that they will be able to work--now or in the future. 

According to the UM IHPI study, "In all, nearly half of the newly covered Michiganders said their physical health improved in the first year of coverage, and nearly 40 percent said their mental or dental health got better. Those who said their health improved also had the most chance of experiencing an effect on their work life. As a group, they were four times more likely to say that getting Medicaid coverage helped them do a better job at work. And those who felt their health had improved, but were out of work, were three times as likely to say that their coverage helped them look for a job."

3. Work requirements can worsen (or externalize) other problems. 

For instance, a person with epilepsy who loses access to seizure medications could have a seizure while driving and have a car accident. The cost, then, is to the individual (who is injured by the car accident and seizure), to the costs to the insurance system, and potentially to other individuals involved in the car accident.

4. Work requirements cost the system more.

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Work requirements drive people to more expensive care. Rather than a person getting preventive care, and a prescription, from a primary care doctor for an easily treated problem like high blood pressure, they are more likely to end up in the emergency room, where they know they will not be turned away. Rather than getting a free flu vaccine, they are more likely to get the flu--ending up infecting others, requiring time off work, and perhaps risking a hospitalization. 

5. Work requirements place a huge administrative burden on Department of Health and Human Services (DHHS) staff.  

DHHS staff already struggle under enormous caseloads. The administrative burden of this additional work is significant. The true number of people who could work but aren't is small. Yet requiring people to show that they are working, or cannot work, requires a lot of time on the part of DHHS staff.

Paperwork photo by Tom Ventura

Paperwork photo by Tom Ventura

6. Work requirements place a huge administrative burden on individuals with Medicaid.

In addition, they are likely to affect many others. For instance, if one person in a family does not return proof they are working, others in the family may be wrongfully cut off. This policy is another bureaucratic obstacle intended to keep poor people from getting healthcare.

7. We are in the midst of an opioid epidemic and a surge in suicides.

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Mental health and substance use disorder services are essential; suicide is preventable. Work requirements make it difficult for individuals getting mental health or substance use treatment to continue to get treatment. In 2015, the State of Michigan's Prescription Drug and Opioid Abuse Task Force report recommended " exploring ways for the State to increase access to care, including wraparound services and MAT [Medication-Assisted Therapy], as indicated by national and state guidelines for treatment. (p. 20)" Work requirements would surely reduce access to care. 

8. Work requirements put physicians and nurses in an untenable position.

Physicians take the Hippocratic oath, to do no harm, but if people are cut off of Medicaid and physicians are unable to get paid for patient visits, their organizations will find it financially untenable to take care of these patients. That is one reason that the American College of Physicians, the American Academy of Family Physicians, the American Congress of Obstetricians and Gynecologists, the American Osteopathic Association, the American Psychiatric Association and the American Academy of Pediatrics have taken a position against Medicaid work requirements. Read their statement here.

9. Work requirements threaten the health of people with disabilities.

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As the IHPI study indicates, many individuals who have Medicaid and are not working are doing so because they are in poor or fair health. In the experience of staff at the Washtenaw Health Plan, in many cases the access to health care allows people to either a) get better, and start working or b) get the necessary evidence from competent physicians to show that they are disabled. Without Medicaid, many individuals would not be able to collect the medical evidence to prove that they are disabled. In 2016, the Kaiser Family Foundation found that 36% of people on Medicaid who are not working are disabled.

10. The Washtenaw Health Plan and the Washtenaw County Health Department believe that healthcare is a human right.

We oppose efforts to reduce access to coverage, and believe in healthcare for all. The Washtenaw County Board of Commissioners agrees with us. Read their resolution here

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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.

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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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Coming Together for Our Communities: Welcoming Michigan and Welcoming America Celebrate Welcoming Week

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http://welcomingmichigan.org/create-basic-page/welcoming-michigan-statewide-convening

September 14-23, 2018

Welcoming Week began in Michigan with a Welcome Michigan Statewide Convening on Friday, September 15, 2017 at Washtenaw Community College in Ypsilanti, MI.  Participants from all over the state came together to continue work making Michigan a welcoming state for all immigrants.  Highlights include the keynote speaker, Tracy Keza, discussing her photographic work, Hijabs and Hoodies, and workshops addressing legal issues, responding to bias and hate crimes, advocacy and community engagement.  

Washtenaw County government, as well as the cities of Ann Arbor and Ypsilanti, are committed to being welcoming to immigrants. Recently the Washtenaw County commissioners have committed funding and resources to supporting immigrants. Read more here.The City of Ann Arbor and Washtenaw County join other Michigan municipal governments that have signed on as a “welcoming city,” including Detroit, Lansing, Kalamazoo and Macomb County.       

Agencies and community organizations across Michigan have many events planned as part of Welcoming Week.  Here are some highlights:

Michigan-wide events

Local events:

Welcoming Week events hosted throughout Washtenaw County (September 15-24):

  • Fri., 9/15: Welcoming Michigan Symposium showcasing municipal initiatives across Michigan, Washtenaw Community College, Morris Lawrence Building (8:30am-4pm)

  • Sat., 9/16: International Dance Day, Riverside Park, Ypsilanti

  • Sun., 9/17: Many Faiths One Voice: Prayers for Unity, West Park Band Shell, Ann Arbor

  • Sun., 9/17: Community Resource Fair, Ann Arbor YMCA

  • Fri. & Sat. 9/22 & 9/23: Futsal Tournament, Ann Arbor YMCA. Futsai is an informal five-on-five soccer game bringing together people of different ethnic, racial, and national origins.

  • Sun., 9/24: International Family Festival and Potluck Celebration, Pinckney

Follow Welcoming Michigan on twitter and facebook to find out more about what's happening in our state.   

Welcoming Michigan is part of Welcoming America, which leads a movement of inclusive communities becoming more prosperous by making everyone feel like they belong. Welcoming America believe that all people, including immigrants, are valued contributors who are vital to the success of our communities and shared future.  

See our Immigrant Info page to read more about immigrants and healthcare.  

Organizations and Resources 

The Michigan Immigrant Rights Center has lots of resources and information. If you or someone you know needs help with an immigration issue, they may be able to help you or refer you to someone who can help you. Right now, they have a lot of information about the ending of the DACA program.

The National Immigration Law Center also has many resources and a lot of information on their website.

 

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What Are Cost Sharing Reductions And Why Do They Matter?

Under the Affordable Care Act, there are subsidies for insurance. Both parts of the subsidies--the Advance Premium Tax Credits (APTCs) and the Cost Sharing Reductions (CSRs)--are part of the law. To cover those costs, the government pays the insurance companies that participate in the Marketplace for these subsidies. President Trump has proposed just not paying the CSRs, BUT--as Vox explains--

If CSR payments were not paid, insurers would still be required to reduce cost sharing, but they would now have to do it without the government’s help. They would have to raise premiums dramatically to make up the lost revenue. The irony is that if plans do raise premiums, the federal government would be on the hook for much of those costs. The government absorbs premium increases through the tax credits that help people afford coverage. The law is designed to keep premiums manageable for people, so it falls on the government to cover any excess increases.

Some Background: Two Parts Make The Subsidies Work

There are two parts to the subsidies that people who get health insurance through the exchanges may receive.

Part 1--which most people are familiar with--is called the Advance Premium Tax Credits (APTCs). They assist people who are up to 400% of the poverty level ($98,400 for a family of 4), to help afford monthly premiums.

Part 2--which most people are not familiar with--are Cost-Sharing Reductions (CSRs). These support families whose income is between 138% of the poverty level (Medicaid cut-off) and 250% of the poverty level ($61,500 for a family of 4), by reducing what they would pay for co-pays, co-insurance, and deductibles.

 

For Consumers, Cost-Sharing Seems Like Magic

For households that qualify, cost-sharing applies to silver plans (only), and transforms them into something better--often much, much better. 

The truth is, if not for the CSRs, low-income families might be able to afford the premiums, but visits to the doctor could be cost-prohibitive, and high deductibles and maximum out-of-pocket costs would mean that getting sick could still turn a family's life upside down.

More than half of the people in the U.S. who got health care on an exchange got cost-sharing reductions (7 million out of 12 million)! 

Actuarial Value

Actuarial value is an estimate of the percentage of costs that--on average--a plan will cover. (For any one family, this might be a bit higher or lower.) Under the ACA, a household with income below 150% of the poverty level can get a silver plan that covers 94% of their costs; a household with income between 151%-200% of the poverty level can get a silver plan that covers 87% of their costs; and a household with income  between 201%-250% can get a silver plan that covers 73% of their costs.

Summary

Basically, taking away Cost Sharing does not save the government any money and will contribute to Marketplace insurers opting out of the Marketplace.  The only people who will be hurt are people who are low income but not low enough for Medicaid. Republicans were eager to eliminate cost-sharing when the repercussions would be seen as Democrat's fault but now that the the White House and Congress are Republican, we hope they do not want this cut to be seen as their responsibility. The ACA's solvency relies on Cost Sharing Reductions and Advanced Premium Tax Credits. #savetheACA

-Ruth Kraut 

Have a question?  Type it in the comments section and we will get back to you.

More Information:

Republicans are begging Trump not to sabotage Obamacare - Vox

What are cost-sharing reductions, and what happens if Trump ends them? - Michigan Radio

ACA Cost-Sharing Subsidies: How One Decision Could Disrupt Obamacare Marketplaces - Kaiser Family Foundation

Larry Levitt Tweets 

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Who Is The WHP And What Do We Do?

Who is the Washtenaw Health Plan?

The simple answer to the question of who is the Washtenaw Health Plan goes like this:

We are a non-profit. We are a public-private partnership supported with the help of Washtenaw County, our local health systems, University of Michigan Health System and St. Joseph Mercy Health System, and other local healthcare providers. We started as a safety net health program for low-income Washtenaw County residents who didn't have access to insurance, and we still run that program. [Read about our history here.]

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But now, thanks to the Affordable Care Act, more people have other options--Medicaid, the Marketplace, employer insurance. So the WHP's Plan B safety net program still exists, but first we'll see if you qualify for insurance that meets the Affordable Care Act mandate. We believe in healthcare coverage. We have seen it save lives. The Affordable Care Act is not perfect, but we believe it moves us in the right direction--toward healthcare for all

So nowadays, we spend most of our time helping people figure out their healthcare options

The WHP staff at our holiday celebration!  Come meet us in person! 

The WHP staff at our holiday celebration!  Come meet us in person! 

We help you assess your healthcare coverage options. We advocate with and for you if you need help with DHHS or the health insurance Marketplace. We have learned a lot about the systems and policies that make the healthcare systems run, and sometimes what might seem like magic to you is just us having done this application hundreds of times before. 

We explain unfamiliar terms like deductible and maximum out-of-pocket costs. We listen to what you need. We explain what kind of proofs you need to provide for income or immigration verifications. We write this blog, and maintain this website.

All of this work is motivated by a deep and abiding belief that everybody deserves access to health care. Yes, everyone. So we'll help people who are parents or kids, tall or short, fat or thin, employed or unemployed, single or families, immigrant or citizen, happy or sad. We'll help you if you know exactly what you are eligible for, or if you have no idea what your options are. We'll speak English, Spanish, French or Arabic in the office, and if you speak a different language--we'll call for interpretation help. We'll help you if you live in Washtenaw County, and we'll help you if you don't. 

In Other Words: We Help People--Like You!

And, in fact, the tagline of our new advertising campaign is: We Help People--Like You!

Our hope for 2017 is that we will help even more people like you.

With our new ad campaign, we've got ads running on buses with our friends over at the Ann Arbor Area Transportation Authority (also known as The Ride). We are distributing posters around town as well. Thanks to The Ride for donating the advertising space on the buses, and thanks to Pete Sickman-Garner for his graphics design work.

Look for these posters on The Ride!

Look for these posters on The Ride!

We've shown you some of the advertising posters in this blog post, but here's how you can help us!

1. Download some poster copies here (they print in 8-1/2" x 11" or 11" x 17"). Post them where you work or play! You can also share them electronically or on social media. 

2. Ride the bus? Take a picture of one of our posters on the bus. Tag us on social media, and we'll send you a prize pack! You can find us on facebook, instagram, and twitter @coveragecounts. 

3. Have you been helped by us? Word of mouth works--tell your friends! (Also--reviews work too. Feel free to review the Washtenaw Health Plan on Yelp or Google+.)

Here's to 2017! Help Us Help More People--Like You!

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Updated** Understanding A Medicaid Deductible, or "Spenddown"

En Espanol - Actualizado ** Entendiendo el Deducible de Medicaid, o "Spenddown"

Most Medicaid programs cover all essential health benefits, like doctor and hospital visits, dental care and vision services. However, some programs only cover limited benefits. For example, Emergency Services Medicaid and the MOMS program (information here) provide partial services to immigrants. Another "partial" program is called the Medicaid Deductible program (previously called Medicaid Spenddown).

The Medicaid Deductible program is available to people with disabilities, the elderly, children and parents of children who are over the income limit for full Medicaid. In order to qualify for a deductible, you also would have to meet an asset test (which takes into account your assets, excluding a house and car). An individual who is over the income limit for full Medicaid and has very few assets may be approved for the Deductible program. Department of Health and Human Services (DHHS) will specify the amount of the deductible, a number ranging from less than one hundred dollars to several thousands of dollars. This number is based on your household income.

The Idea Is Simple, But The Action Is Complicated

With a monthly Medicaid deductible, for Medicaid to become fully active, bills amounting to the deductible must be reached in a given month. The individual is then responsible for the deductible and DHHS pays the remainder. For example, let's say Martha's deductible was set at $800, and Martha has a hospital bill in May for $5,000. Martha is responsible for paying the $800 to the hospital and DHHS pays $4,200. In order to get DHHS to pay, a deductible report has to be submitted.

If the bill was incurred on May 1, and a deductible report was submitted, then for the rest of the month Martha has full Medicaid, and Medicaid would pay for any necessary medical service, such as  glasses, a dental cleaning, or prescriptions. Starting on June 1, Martha does not have Medicaid, but again would have to meet a deductible.

If Martha went into the hospital on May 31, and didn't have medical expenses before then, she wouldn't meet the deductible until May 31. Starting on June 1, the deductible/spenddown resets, so she probably wouldn't be able to get her teeth cleaned in May! Some people, particularly people living in nursing homes, do meet their deductible each month, but most people do not.

Remember: In order for Medicaid to become active, the bills and a Deductible Report must be sent to the DHHS caseworker. The deductible must be reached again each month for Medicaid to become active.

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Medicaid Deductibles can help, but they don't count as FULL health coverage

Important: The Medicaid Deductible program does not meet the mandates of the Affordable Care Act. That means that if this is the only coverage you have, you may be assessed a tax penalty when filing taxes at the end of the year.

The good news is that you can have a Marketplace plan or employer insurance coverage along with a Medicaid deductible. (Remember, Medicaid can be a secondary insurance!) 

Did you get the right coverage?

Sometimes an individual is approved for the Deductible program but really should have full Medicaid. If you think you should have full coverage, the Washtenaw Health Plan offers a free assessment. For help submitting bills for your Medicaid deductible or if you think you should have full Medicaid, stop into the Washtenaw Health Plan. Walk-in hours are Monday through Friday from 9am to 4pm. We are located at 555 Towner, Ypsilanti, MI. 

Questions? Call (734) 544-3030.

--Haley Haddad and Ruth Kraut

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