Both of Michigan’s legislative branches are under Democratic control for the first time in 40 years, and healthcare leaders gave an update on how new lawmakers are impacting industry initiatives during the 2023 Michigan State of Reform Health Policy Conference.
Michigan League for Public Policy President and CEO Monique Stanton noted that the Democratic majority (they hold a 56-54 majority in the House and a 20-18 advantage in the Senate) is very slim, however, which requires a strong bipartisan effort on their end.
“There really is a need to do bipartisan work and work across the aisle,” Stanton said. “In the first 100 days, we saw some pretty significant things pass. Hopefully by the third week of June, we’ll see a budget. We have a deadline of July 1st.”
Phil Yeiter, director of government affairs at Priority Health, noted that there was also more than a 50% turnover in lawmakers between the two chambers. But the new legislators have shown an interest in healthcare priorities, he said.
“There’s that many more new faces that we have to get in front of and educate about who we are as an organization,” Yeiter said. “It seems that there’s a deeper commitment to investing at the local level, looking at what the baseline issues affecting health outcomes are. When we talk about health equity or social determinants of health, it does seem that there’s an extra focus from this administration to focus on root-cause analysis to that end.”
Integrating new workers means there will be a learning curve in any job, however, and Michigan’s legislature is no different. Karla Ruest, lobbyist and association manager for The Frederick Group, noted that many new lawmakers will have added responsibilities as well.
“Educating these legislators on the difference between Medicaid and Medicare, or what Medicaid actually covers, has been a challenge,” Ruest said. “Many are on committees, some in the Senate are on over 10 committees. Trying to get a meeting with them has been extremely difficult. A lot of the legislators have never chaired a committee before, so the learning curve has been intense. The Democrats lean over more on social issues, so for most of our issues (healthcare, family services) it’s been good for us.”
The process has not been easy for Republicans either.
“The Republicans are having a little bit of a hard time understanding that they’re not in control anymore,” Ruest said.
Lawmakers are considering several impactful health initiatives, she noted. House Bill 4071 aims to require insurance companies to regulate prices of oral chemotherapy treatments.
“That would be capping the copayments of oral chemotherapy,” she said.
Private insurance companies would be limited to issuing copays on oral anticancer medication to $150 for 30-day supplies under HB 4071. The House approved the bill in May, and it is under consideration in the Senate.
The state is also considering efforts to lower insulin costs.
“The governor is looking at whether it might be beneficial for Michigan to produce insulin,” Ruest said. “California has done that. If we were able to do that here, we’d be able to give it to residents for basically the [drug’s] cost, which would reduce the copayments a lot. There’s also legislation out there that would cap the copays at $25 or $50. That sounds wonderful.”
However, she said lowering insulin costs is a complicated issue.
“The problem is if we don’t do anything about the cost of insulin, it’s just like a balloon,” she said. “You’ve got to squeeze it someplace, because the price of it is not going to go down. So we’re going to have to push the cost over to employers or do something with the copay; not take it down so much.
Insulin [costs] have been increasing, as you all know, and many of our residents are struggling to get their insulin every month. I think it would be wonderful if we could look at producing that here in Michigan. If we could, it could expand to other states too. And it could be a great signal for trying to keep the costs of prescription drugs a little more beneficial to all of us.”
Direct care professionals could also benefit from the legislative session. Gov. Gretchen Whitmer’s budget requests $210.1 million to provide a 10% boost in wages for direct care workers, which represents an average increase of $1.50 per hour.
“Many times these direct care workers are working in situations that we would not necessarily want to work in,” Ruest said. “Nursing homes and foster care agencies are some of those (situations). They could actually go across the street and work at McDonald’s for a lot more money. So any money to support direct care workers would be a huge benefit.”