Obamacare in Michigan

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Obamacare-enrollment is a site where you can find detailed information on the Affordable Care Act

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Health Insurance Marketplace in Michigan

If you live in Michigan, you’ll use this website, HealthCare.gov, to apply for coverage, compare plans, and enroll. Spanish language speakers can contact cuidadodesalud.gov. Specific plans and prices will be available on October 1, 2013, when Marketplace open enrollment begins. Coverage can start as soon as January 1, 2014.

The Insurance Exchange/Marketplace

What has been done, not been done, or left up to the federal government to do.

Establishing the Exchange in Michigan

While Governor Rick Snyder (R) supports the creation of MI Health Marketplace, a nonprofit to oversee the state’s health insurance exchange, he acknowledged on November 16, 2012, that without authorizing legislation, he would plan for a state-federal partnership exchange.1 The state began moving in the direction of a partnership in August 2012 due to legislative opposition that left the state unable to meet the federal timetable for implementation.2,3 Michigan will perform plan management and consumer assistance functions and defer other exchange management functionality to the federal government.4

The Governor’s initial recommendation for a state-based exchange was largely informed by the work of the Exchange Steering Committee, which includes representatives from the Department of Community Health, the Office of Financial and Insurance Regulation, and the Department of Technology, Management, and Budget. The Department of Community Health, with the assistance of subcontractors, organized five stakeholder workgroups on Governance; Finance, Reporting, and Evaluation; Technology; Business Operations; and Regulatory and Policy Action, which met between February and April 2011 to plan various aspects of the exchange.5 The Department of Technology, Management and Budget, with the assistance of subcontractors, developed plans for new technology to establish a MI Health Marketplace portal which would allow for the integration of the exchange with new Medicaid eligibility requirements mandated in the Affordable Care Act (ACA).

Essential Health Benefits (EHB): The ACA requires that all individual and small-group plans sold in a state, including those offered through the Exchange, cover certain defined health benefits. States must decide whether to benchmark their EHB plan to one of ten plans operating in the state or default to the largest small-group plan in the state. Governor Snyder’s administration solicited public comment on the issue and in September 2012, the Governor received preliminary EHB recommendations from the Office of Financial and Insurance Regulation. Recommendations included using Priority Health HMO plan as the benchmark plan and supplementing with the state’s Children’s Health Insurance Program (CHIP) dental plan and the Federal Employees Dental and Vision Insurance Program (FEDVIP) for pediatric vision services.6

Consumer Operated and Oriented Plan Program

Consumer Operated and Oriented Plan (CO-OP) Program are qualified nonprofit health insurance issuers that offer competitive health plans in the individual and small group markets.  CO-OP’s in Michigan:

Michigan Consumer’s Healthcare CO-OP

 Exchange Funding

Michigan’s Department of Community Health was awarded a federal Exchange Planning grant of $1 million. In November 2011, Michigan’s Department of Licensing and Regulatory Affairs was awarded a $9.8 million federal Level One Establishment grant to conduct further insurance market analysis and technology planning; however, the Legislature has yet to approve spending the funds. In January 2013, Michigan received a second Level One grant of $30.7 million to support creation of a consumer assistance partnership program, establishment of an IT system that coordinates with federal partners, and the plan management functions that Michigan will carry out.7   

Michigan, along with nine other states, is receiving technical assistance from the Robert Wood Johnson Foundation through the State Health Reform Assistance Network; this assistance includes help with setting up health insurance exchanges, expanding Medicaid to newly eligible populations, streamlining eligibility and enrollment systems, instituting insurance market reforms and using data to drive decisions.8

Expansion of Medicaid

From 2014 to 2017, the federal government will pay for 100% of the difference between a state’s current Medicaid eligibility level and the ACA minimum. Federal contributions to the expansion will drop to 95% in 2017 and remain at 90% after 2020, according to the ACA.

As the ACA was originally written, states would lose all Medicaid funding if they refused to expand their program to the ACA minimum.

However, the Supreme Court in June 2012 ruled that the federal government could not withhold Medicaid funding for states that chose not to expand their programs. The decision effectively allowed state officials to opt out of the expansion, and some have said they will do just that.

Michigan is participating in Medicaid expansion.

Next Steps

On March 5, 2013, Michigan received conditional approval from the U.S. Department of Health and Human Services (HHS) to establish a partnership exchange. Final approval is contingent upon the state demonstrating its ability to perform all required Exchange activities on time; complying with future regulations; establishing a memorandum of understanding (MOU) between the Michigan Department of Licensing and Regulatory Affairs (LARA) and the state’s Medicaid agency that defines each agency’s role and responsibilities; and obtaining legal and spending authority for Exchange activities.9

1. Governor Snyder. “Michigan moves toward state-federal partnership health exchange, leaves door open for MI Health Marketplace.” November 16, 2012.
http://www.michigan.gov/snyder/0,4668,7-277-57577-290046–,00.html
2. Livengood, Chad. “Snyder gives up on plan for state-run health exchange.” August 23, 2012. Detroit News.http://www.detroitnews.com/article/20120823/POLITICS02/208230380/1409/metro/Snyder-gives-up-plan-state-run-health-exchange
3. A Special Message from Governor Rick Snyder: Health and Wellness. Office of the Governor. September 14, 2011. http://www.michigan.gov/snyder/0,4668,7-277–262254–,00.html
4. Letter from Governor Snyder to Secretary Sebelius. January 22, 2013. Available athttp://cciio.cms.gov/Archive/Technical-Implementation-Letters/mi-marketplace-letter.pdf
5. Michigan Department of Community Health. Health Insurance Exchange Planning Workgroup solicitation letter. January 25, 2011. http://www.mahu.org/images/Michigan_Health_Insurance_Exchange_Planning.doc
6. Michigan’s Essential Health Benefits Benchmark Plan: Executive Report. September 25, 2012. Office of Financial and Insurance Regulation. http://www.statereforum.org/sites/default/files/ehb_report_09_05_12-final_397063_7.pdf
7. Michigan Affordable Insurance Exchange Grants Awards List. http://cciio.cms.gov/archive/grants/states-exchanges/mi.html
8. Robert Wood Johnson Foundation. ‘RWJF Seeks Coverage of 95 Percent of All Americans by 2020.’ May 6, 2011. http://www.rwjf.org/coverage/product.jsp?id=72289
9. Letter from Secretary Sebelius to Governor Snyder. March 5, 2013. Available athttp://cciio.cms.gov/resources/files/mi-blueprint-letter-3-5-2013.pdf

Also of interest

Provided by the Henry J. Kaiser Family Foundation

Who can help you (the Navigators)

Get local help

Community Bridges Management Inc.

Community Bridges Management, Inc. provides expert IPA services including medical network management, claims processing oversight, provider relations, medical care service, patient relations and services. Funds will be used to provide both training and resources to make the process of enrolling in a health plan easier and more understandable through one-on-one contact. Community Bridges will also conduct widespread outreach and education activities.

Arab Community Center for Economic & Social Services

ACCESS is non-profit service agency that advocates for, empowers and enables individuals, families, and the Arab, Chaldean, and Bangladeshi American communities in metropolitan Detroit to achieve optimal health and wellness. Funds will be used to proactively reach out to
and engage under/uninsured community members through local, multicultural electronic and print media, public access television and radio, and monthly ACCESS and community partner events, like weekly health “Expos” at the three County Public Health Offices.

American Indian Health & Family Services of SE Michigan, Inc.

American Indian Health and Family Services is a non-profit health organization serving a large number of the uninsured or under insured. Funds will be used to host educational forums, publications, provide self-service kiosks and expert personnel able to assist consumers to enroll in health plans.

Michigan Consumers for Healthcare

The Michigan Consumers for Healthcare (MCH) network includes statewide organizations and local affiliates with deep experience in conducting Medicaid and CHIP outreach and enrollment and health insurance counseling for uninsured and vulnerable individuals and families. The project will provide services in 10 Michigan Regions and Tribal Health Centers. These organizations reach low-income, vulnerable populations in every region and county in the state, guaranteeing that the project will serve Michigan residents regardless of where they live.

Information for:

Individuals and Families

Small businesses

If you need more detailed analysis, identification of issues, solutions, and implementation of your health insurance plan please let us know at obamacare-enrollment.com and we’ll get right back to you.

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