5 Things Michigan: MDHHS budget priorities, 15-point health proposal, Vaccine disparities

Next week, we hold our Convening Panel meeting ahead of our 2021 Michigan State of Reform Health Policy Conference. This is the group that kicks off our agenda setting process ahead of this year’s event. We’ll release the list of participants after our meeting to show you everyone contributing to this year’s virtual gathering.

If you’re interested in helping us build an agenda of the most important topics in Michigan health care ahead of our May 27th conference, drop me a note. I’d welcome your engagement and outreach.





With help from Emily Boerger

1. House unveils 15-point health proposal

Michigan legislators unveiled a bipartisan health care plan in the House last week focused on affordability, accessibility, and quality of care. In an effort to improve affordability, the 15-point plan looks to cap insulin co-pays, require transparency around drug price increases and hospital costs, and regulate pharmacy benefit managers.

The plan also proposes allowing out-of-state providers to provide telehealth services and would expand the scope of practice for Certified Registered Nurse Anesthetists. The proposal, which is being spearheaded Rep. Bronna Kahle and Rep. Julie Calley, will take the form of 15 separate bills during the legislative session.


2. MDHHS presents budget priorities

MDHHS Director Elizabeth Hertel presented the department’s budget priorities for FY 2022 at a recent House Appropriations Subcommittee on Health and Human Services meeting. Priorities include $37.5 million for a one-time supplemental increase in Medicaid payments to nursing facilities, $26.5 million for Certified Community Behavioral Health Clinics, $19.1 million for the MI Choice program, and $8.4 million to reduce racial and economic health disparities.

The Department is also asking for $121.4 million GF ($360 million total) to make permanent $2 per hour wage increases to direct care professionals. Hertel told the committee that “It became very apparent as we worked through and responded to the COVID-19 pandemic that we need to really commit to ensuring that those individuals who are direct care workers, who are going in and providing care for many of our most vulnerable citizens, are receiving a wage that is competitive and is something that ensures that they will stay in the position that they’re in.”


3. Behavioral health initiatives on the move

The COVID-19 pandemic has taken a toll on Americans’ mental and behavioral health, with symptoms of anxiety and depressions on the rise. Provisional data from the CDC shows overdose deaths in Michigan have increased 10.4% in the past 12 months compared to the previous year.

The Michigan Crisis and Access Line (MiCAL), a program that would create an access line for Michiganders undergoing a mental health crisis, is set to begin its rollout at the end of April. A bill working its way through the legislature would require info on hospital bed availability to be reported to MiCAL in order to create an up-to-date registry. MDHHS also put out a request for proposals last month to develop and expand mental health services for school aged children.


4. Racial data unknown for 40% of vaccine doses

Recent data from MDHHS indicates white individuals are about twice as likely as Black individuals to be vaccinated in Michigan, despite their case rate being 40% higher and death rate being three times higher compared to white individuals. MDHHS says racial data for nearly 40% of distributed doses in the state is unknown, however, making it difficult to assess the full impact of inequities in the rollout.

MDHHS Chief Medical Executive Dr. Joneigh Khaldun, who President Biden recently tapped to join the federal COVID-19 Health Equity Task Force, says the accurate collection of this data is critical to ensure an equitable rollout. Despite this incomplete data, MDHHS has introduced several initiatives in recent weeks aimed at ensuring an equitable vaccine rollout, including the targeted allocation of COVID-19 doses to FQHCs across the state.


5. Health reform in federal COVID bill

The $1.9 trillion COVID relief package passed the House over the weekend. It has not yet been transmitted to the Senate, but when it does, it will land in the Senate Finance Committee. The powerful Finance Committee is chaired by US Senator Ron Wyden — who incidentally will be a keynote speaker at our 2021 State of Reform Federal Health Policy Conference on April 7-8.

In his latest piece, State of Reform columnist Jim Capretta outlines the health measures in the bill that “will be significant for policy debates in the years ahead.” Among the list of changes is an increase in premium tax credits for households receiving insurance through the ACA exchanges. The bill would fully subsidize coverage for households below 150% FPL, it would increase subsidies for those up to 400% FPL, and it would remove the 400% FPL cap, allowing any household to get coverage through the ACA exchanges with a premium of no more than 8.5% of annual income.

A recent analysis estimates that for an enrollee in Michigan at 430% FPL, the expanded subsidies would decrease monthly premiums from $542 to $196 (lowest-cost bronze), $738 to $390 (benchmark silver), and $785 to $437 (lowest-cost gold). While the subsidy increase is set to expire after 2022, Capretta reasons that once in place, Congress will make the changes permanent.