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Healthy Michigan Plan Available Soon

March 20, 2014

Starting April 1, Michigan will begin accepting applications for the Healthy Michigan Plan online, by phone, or in in person at local Michigan Department of Human Services offices.

Since Governor Rick Snyder signed the Healthy Michigan Plan into law on Sept. 16, 2013, the Michigan Department of Community Health (MDCH) staff has worked closely with the federal government and Michigan partners to get the necessary information technology, federal approval, and program operations in place. Extensive testing and progress has been made to assure the necessary system requirements are ready for enrollment.

Throughout the stages of operationalizing the Healthy Michigan Plan, MDCH received approval from the Centers for Medicare & Medicaid Services on Dec. 30, 2013. This approval allowed MDCH to transition roughly 60,000 individuals from the Medicaid Adult Benefits Waiver (ABW) program into the new Healthy Michigan Plan, with coverage beginning April 1, 2014.

SBAM has been very vocal about our support for the expansion of the Medicaid program so the state can realize the financial savings and physical and mental health benefits of the Affordable Care Act. SBAM President and CEO Rob Fowler said Medicaid expansion will reduce the amount of uncompensated health care costs that ultimately get passed along to small business owners.
“I consider it a kind of organizational epiphany about a decade ago when we came to realize that the uninsured really matter to business,” said Fowler. “People go to our health care system and they get care, and if they can’t afford it, they still get care but it’s uncompensated care. Uncompensated care actually gets passed along to those who can pay. It’s called cost shifting and it’s been happening for a very long time. It’s found its way into the base rates of health insurance for small businesses all across the state. And I would say it’s a terrible business model, that we take a growing burden of people who come without compensation and we shift it to a shrinking group of people (small business owners) who struggle to pay for health insurance. We support (expansion of Medicaid) because we believe it ultimately can reduce the sort of piling on effect that’s been happening to paying customers for many years.”
Currently, Michigan hospitals end up providing more than $880 million a year in uncompensated care to patients that are unable to pay, costs that end up being shifted to people who have insurance, employers who pay for it for their workers, and taxpayers.

MDCH Director James Haveman says, “In making the Healthy Michigan Plan a reality, our primary concern has been ensuring our systems are fully prepared for Michigan residents as they apply and once they are enrolled. And as the Healthy Michigan Plan includes a strong personal responsibility focus, we are encouraged by the promising results we’ve seen so far with the ABW population and look forward to improving the health of all residents eligible for the Healthy Michigan Plan.”

For an individual to qualify for the Healthy Michigan Plan, they must meet the following requirements:

  • Be between 19 – 64 years of age
  • Not be enrolled in, or eligible for, Medicare
  • Not be eligible for our current Medicaid Program
  • Not be pregnant at the time of enrollment
  • Have an income below 138% of the federal poverty level (roughly $15,000/year)

It is expected that an additional 400,000 to 500,000 Michigan citizens will qualify for Medicaid under this program, bringing the total Medicaid population in Michigan to somewhere around 1.886 million – fully 25% of the Michigan population under the age of 65.

Healthy Michigan beneficiaries will enroll in one of the current Medicaid Health Plans and they will use the current prepaid Inpatient Health Plan system of care. Much like plans offered to individuals and small business, the Healthy Michigan Plan will cover the 10 Essential Health Care Services required by the Affordable care Act.
At the time of enrollment, the Healthy Michigan Plan requires a MI Health Account be established through which beneficiaries will contribute 2% of annual income (for individuals with income between 100% and 133% of the federal poverty level). Additionally, a health risk assessment (HRA) must be completed; if the beneficiary engages in healthy behaviors, a reduction in required cost sharing amounts occurs. The HRA will also provide the beneficiaries with information about health care costs incurred and utilization. The goal of the MI Health Account is to have beneficiaries more involved in their health care decisions and improve overall health outcomes.
If you have customers with employees who may qualify for the Healthy Michigan Plan, there are some new resources that you can direct them to for additional information and enrollment:
Michigan healthcare helpline: (855) 789-5610
Phone application assistance line: (855) 276-4627

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