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:  

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...
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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Open Enrollment Tips, Part 2: How Much Will I Pay? Best and Worst Case Scenarios

You know what you might pay for your health insurance premium--a fixed, monthly cost.  But what about the rest?  What will you actually pay for health care next year?  Will you pay just your Monthly Premium or will you pay your full Maximum Out Of Pocket Cost?  $1200, $5200, or something in between? 


Best Case Scenario

One way to think about health insurance is to imagine the Best Case Scenario. Imagine that you have a year where you are healthy, and nothing goes wrong. 

In this scenario, you pay:

Your Premium: $100/month for a subsidized silver plan

Annual doctor's visit (preventive care, covered 100%): $0

Flu shot (preventive care, covered 100%): $0

Birth control pills (covered 100% under the ACA): $0

TOTAL COSTS FOR THE YEAR: $100/month premium x 12 months=$1200


Worst Case Scenario

Now imagine that you have a year where everything goes wrong. You start out the year with appendicitis, then you fall and break your arm, you have a cancer scare, Lyme disease, and you are hospitalized for pneumonia. You might be wondering--if you have a year like that--what is it going to cost? What is the Worst Case Scenario--not for your health, but for your budget?


Actually, it's not that hard to figure this out either--there is a mathematical formula for it. 

Start with the cost of your premium.

We'll use the same premium: $100/month for a subsidized silver plan. 

Your deductible is $2000, but that turns out to be more important (in a worst case scenario) for the pace at which you pay bills, and less important for the actual Worst Case Scenario.

What is important is the line marked Maximum Out Of Pocket Costs. We'll say, in this case the Maximum Out of Pocket number is $4,000. Once you spend that maximum number, you pay nothing more. 

TOTAL COSTS FOR THE YEAR= Total premium cost + Maximum out of pocket amount

In this scenario, you would pay: ($100/month)*12 + $4000 = $1200 + $4000 =$5200

So with this plan, under the best case scenario you would pay $1200 and under the worst case scenario you would play $5200. Try out these formulas on any plan. 


Just one caveat: In some cases, the maximum out of pocket number applies only to in-network spending; or out-of-network spending may be subject to a higher maximum out of pocket number. Except for emergencies, try to stay in network. 

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