Recent actions by Michigan policymakers are indeed troubling.
If the state is really concerned about controlling Medicaid costs, it would seem that repealing the requirement that motorcyclists wear crash helmets, requiring only that operators/riders carry a $20,000 insurance rider (reduced from the original $100,000) would not seem to be the best strategy. In the analysis of the helmet bill both the House and Senate Fiscal Agency analysts noted that Medicaid costs would likely increase as the result of more serious injuries. Yet, to date, no funding has been recommended to cover the potential increased costs of this law.
Indeed, senators on the Appropriations subcommittee on Community Health have made few decisions on the Medicaid budget, and the Community Health budget overall, declining to fund key policies and instead recommending $100 “placeholders” to keep programs and policies “under discussion.” The subcommittee document included 27 decision items, with 24 “decisions” being $100 placeholders.
While it is good that important programs and policies are still under discussion, we would hope that discussions and final decisions would be made openly with public input and participation.
An example of “placeholder” funding is autism coverage. On the same day that the bills mandating autism coverage in private insurance plans and Medicaid were passed by the Senate, the Community Health subcommittee declined to provide funding in the Medicaid budget, recommending a $100 placeholder (the governor recommended $34 million to fund this mandate). This is troubling.
Also on the same day, the subcommittee recommendation was reported out, a FY 12 supplemental appropriation for the Department of Community Health was approved by the Senate. Restorations included in the supplemental, such as Medicaid chiropractic services and graduate medical education, were not funded in the FY 13 subcommittee recommendation; rather, $100 placeholders were included. We are concerned that chiropractic services could be restored for six months then eliminated again, and graduate medical education could be dramatically reduced. This is troubling.
It is very difficult to understand what’s driving policymakers’ actions at this time.
Hopefully, they will step back and make sure they are acting in the best interest of those they represent by appropriating the funding for:
• the expansion of Healthy Kids Dental ($25 million),
• implementation of autism coverage in Medicaid ($34.1 million),
• retaining graduate medical education funding (reflecting the FY 12 supplemental and making the FY 12 one-time funding ongoing funding) at least at the FY 12 level of $162.4 million,
• expansion of home and community based waiver slots ($11 million),
• restoration of chiropractic and full vision benefits for adults,
• staff and funding to implement the Integrated Care for Dual Eligibles initiative as well as needed technology funding, to name a few.
— Jan Hudson