For the last several decades, health care inside the United States has been a major topic of concern for all Americans. The debate over how to access health care and who ultimately pays for that access has impacted public policy decisions and political battles. At times, that debate has become so mired in the finer points of insurance coverage details that patient needs have been obscured by larger arguments about the free markets, deficits, and statutory interpretations. A recent study from the University of Michigan Institute for Healthcare Policy should help to remind many of those involved in these debates about the importance of refocusing on those patients. According to that study, Michigan’s 2014 expansion of the Medicaid program appears to have resulted in a significant increase in the number of residents who are now covered by health insurance. The research indicates that the state’s hospitals have reported significant declines in the number of patients without adequate health insurance. As more Michigan residents have qualified for Medicaid coverage, the number of uninsured has decreased across the state.
The Healthy Michigan Plan was signed by Governor Rick Snyder in September, 2013, and began providing coverage for Michigan residents in early 2014. The program was the result of Michigan’s Medicaid expansion – something that was made possible by the passage of the federal Affordable Care Act in 2010 and features of that law that allowed states an opportunity to expand access to Medicaid benefits for their residents.
Under the provisions of the Healthy Michigan Plan, residents who qualify for the program can receive benefits mandated by the federal government. These include hospitalization and emergency care, mental health services, maternity care, prescription drugs, wellness services, and more. The coverage is available for all residents between the ages of 19 and 64, provided that they meet income requirements and certain other eligibility provisions.
By the Numbers
According to an article published in the Lansing State Journal online, roughly one million residents in the state of Michigan were without health care insurance in 2013 – a number that represented 12% of residents below the age of 65. The Medicaid expansion through Healthy Michigan was designed to expand access to insurance coverage for lower-income residents, even as the Affordable Care Act’s subsidies provided and opportunity for those with greater financial means to purchase insurance in the private marketplace. As a result of the changes in the law, enrollment in the program jumped by more than 600,000 as of 2016. As a result, the researchers found that:
- The share of uninsured patients in Michigan’s 130 hospitals plummeted from 6% to 2%, as the percentage of patients with Medicaid coverage rose by 7%.
- More than nine out of every ten of those hospitals reported declines in the number of uninsured persons treated.
- Nearly nine in ten also reported increases in the number of Medicaid patients they treated.
All of that is great news for patients who might otherwise have had to go without treatment or be left with extremely high bills they could not hope to pay. One question that the study left unanswered, though, was whether any of this was having a positive or negative effect on the financial bottom line for those hospitals. Another study indicated that there was at least some decrease in the number of bills that simply went unpaid. There are also suggestions that the increase in the number of insured patients could help to offset the remaining unpaid bills, despite the reduced federal payments available to those hospitals accepting Medicaid.
A separate review of various other studies found that this Medicaid expansion – like those in other states – could enable the states to enjoy significant budget savings. One worrisome prospect involved access to providers. That issue has been a problem in some areas of the country, but the University of Michigan study seems to suggest that the state may have been able to dodge that pitfall. In fact, patients seem to be experiencing no appreciable increase in wait times for their primary care meetings with medical staff, largely due to the creative use of nurse practitioners and other non-doctors.
Great News, But…
Obviously, all of this is great news for the people of Michigan who now find themselves able to obtain the health insurance coverage they need without going bankrupt in the process. It is important to note, however, that this current solution is not one that can ensure your wellbeing throughout your life. Under the Healthy Michigan Plan, Medicaid coverage is extended to adult residents, but only those under the age of 65. As a result, retired seniors and those who are trying to plan for their golden years should be aware that sound estate planning is still necessary to ensure that you have access to the health care you need as you get older.
Obviously, older Michigan residents who rely on Medicaid will eventually become eligible for Medicare. However, Medicare is of little help in most instances in which a person suddenly needs long-term care of the type found in the typical nursing home. For many Michiganders, the most effective way to pay the high costs associated with nursing home care involves applying for Medicaid. To do that, you need to plan ahead to ensure that you are eligible when the time comes – and that requires sensible estate planning.
At Biddinger, Bitzer & Estelle, PLLC, our attorneys understand how complicated this planning can be for the average working American. At the same time, we recognize that ever-rising nursing home costs make such planning essential for many millions of people around our state and across the nation. The good news is that we have the experience and expertise Michigan residents need when they have to develop the comprehensive estate planning strategies required for ensuring Medicaid eligibility, preparing for potential incapacity, and leaving behind a legacy for their loved ones. To find out more about how our professional staff can help you with your Medicaid and estate planning needs, contact us online or call us today at (989) 872-5601,