Capitol insiders lay out important health conversations for the rest of the session
As the Michigan Legislature comes back from summer break this week, important pieces of health care legislation are ready to be discussed and worked through.
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According to capitol insiders from the Michigan Association of Health Plans (MAHP) and the Michigan League for Public Policy (MLPP), the most important pieces of legislation for the remainder of the session include two plans for mental and physical health integration and a 15-bill pharmaceutical transparency package.
The two mental and physical health integration plans in the legislature would “tackle a broken system” says Brian Mills, deputy director of MAHP. One plan — sponsored by Sen. Mike Shirkey — originated in the Senate under SB 597-598. The other plan — sponsored by Rep. Mary Whiteford — originated in the House under HB 4925-4929.
Mills says summer discussions around behavioral health reform have laid the groundwork for the “importance of [behavioral health integration] components in the future of health care.”
Shirkey’s plan aims to address gaps in Michigan’s mental health care system and would contract to provide a comprehensive Medicaid health care benefit package that includes the full integration of physical and behavioral health services. The state would force collaboration between the two silos and would adopt strict measurement standards to ensure performance. Shirkey says:
“Our system can and must be patient-centered and outcomes-based. The trauma suffered during the COVID-19 pandemic magnified and amplified the weakness in our current mental health system. The science shows when mental health and physical health care are addressed and evaluated together, it leads to better outcomes for both.”
Whiteford’s plan aims to modernize the behavioral health system and reduce extra administrative costs. It would replace the state’s 10 public Prepaid Inpatient Health Plans (PIHP) with a “single public or nonprofit administrative services organization.” This plan would allow the Michigan Department of Health and Human Services (MDHHS) to implement and oversee the plan. Whiteford says:
“Michigan will save an estimated $300 million in administrative costs by making this change. These savings will go directly to provide more services to our neighbors, family and friends in need of behavioral health care.”
Mills says MAHP believes either plan would be beneficial for Michiganders, but Shirkey’s plan is their preferred option. He says:
“We believe that [Skirkey’s plan] systematically gets at the root cause of the issue which is extreme collaboration that needs to take place on both the physical and mental health side. [It forces] the two different systems to communicate and collaborate better today. It forces that integration more overtly, rather than reforming the current system that’s there today, which Whiteford wants to do.”
Gilda Jacobs, executive director of MLPP, says these efforts to “totally remake the way mental health services are provided” is somewhat controversial among their advocate partners. Their partners think that these plans might reduce transparency and create barriers to accessing services. She says:
“So the reason it’s controversial is because the very people that are going to be affected by this, and their advocacy associations, don’t feel that this is going to be good for them. So if this is going to pass, they’re going to have to all come to the table in order to create something that the advocates are going to be able to be comfortable with.”
The other important piece of legislation is the 15-bill package around pharmaceutical transparency. The package — HB 4345 though 4359 — aims to create more transparency in the pharmaceutical industry around rebates and lower the costs of medications for consumers. Jacobs says the bipartisan package will make health care more affordable and more accessible for consumers while improving quality of care.
MLPP is supportive and excited for this package. Jacobs says that she thinks the package will go through the Senate and the Governor’s Office before the end of the year.
Mills says this issue will be “front and center” in the Legislature. The package is currently in the Senate Health Policy and Human Services Committee. Rep. Curtis VanderWall, chair of the committee, started deliberations on these bills before the break and throughout the summer to be ready to act as the session begins again.
More on the specific bills in the package can be found here.