As this year winds down, I wanted to take a moment to thank you for your commitment to our outstanding Association. As we take a moment to look back at the year, I hope you will all agree that we rose to meet the challenges in front of us and advanced new opportunities.
The ending of the calendar year also corresponds with the adjournment of the 101st Michigan Legislative session, and despite Lame Duck being lamer than ever, we were able to ensure our industry’s voice was heard louder than ever by policy makers. All totaled, MAHP evaluated around 300 pieces of Legislation over the two-year session cycle, and ultimately took positions on about a third of those bills. We were able to accumulate tremendous victories by continuing our commitments to be active participants in the Legislative process. I’m grateful to all our Health Plan members who continue to approach public policy issues with and open mind and the best of intentions for the health of the enrollees they serve. Our industry, and indeed our Association, has established a strong brand in Lansing as always being willing to put in the work on healthcare topics and be a resource for policy makers. We are one of the most trusted sources of healthcare knowledge in town. Below are just a few accomplishments I would like to share with each of you.
Agreement Reached on Prior Authorization:
This year we were able to successfully negotiate numerous of improvements to SB 247, which dramatically reformed the Prior Authorization process in Michigan. By staying at the negotiation table, we were able to work to find compromise with health care providers and create an improved and expedited Prior Authorization experience for patients.
HI-DATA Becomes Law:
With the assistance of Sen. Lauwers as bill sponsor, we were able to successfully enacts SB 447 (HI-DATA) this year. The Health Insurance Data Availability and Transparency Act passed with bi-partisan support and will undoubtedly lead to increased competition in the employer-sponsored large group market. This reform will help lower premiums for employers and create a more level playing field for all health plans.
Harmful PBM Changes Minimized:
Through our advocacy we helped to completely reshape legislation which created a licensure and regulatory structure for Pharmacy Benefit Managers. HB 4348 was eventually enacted in 2022, but MAHP tirelessly worked to educate policymakers on how realistic reforms could help provide greater transparency to pharmacy costs. Ultimately many of the bill’s original provisions which would have driven up the cost of providing access to care were removed because of your input and MAHP’s advocacy. While this effort is an example in the success of our industry to influence meaningful policy debates, it unfortunately also serves as an reminder that the ultimate purpose of the legislation has had no noticeable effect on controlling pharmaceutical drug pricing in Michigan.
Medicaid Rates Adjustments Realized:
This past year we’ve continued to sharpen our advocacy on Medicaid rates. The partnership our industry enjoys with the Michigan Department of Health and Human Services has allow us to help provide meaningful data during the annual rate setting cycle. Through our efforts at MAHP, we were once again able to secure actuarial soundness adjustments to the managed care capitation rates for the Medicaid comprehensive health care program. The work on this front continues, especially with pharmacy list prices on a per-unit basis continuing to increase, and the value Health Plans can provide against those cost increase pressures remains one of our industry’s greatest value to healthcare purchasers (including taxpayers).
Medicaid Adult Dental Redesign:
Despite an original proposal by the Governor to completely carve-out the adult dental benefit from the Medicaid Comprehensive Health Care Program, we were able to successfully educate policymakers and steer the administration towards supporting a fully integrated benefit design. With the finalized integrated adult dental redesign and additional Medicaid funding approved by Legislature in late November, we have begun the difficult work of focusing on the operational implementation of the integrated benefit with a target of April 1, 2023. We must now keep our eyes on the ultimate goal in 2023: to improve utilization of preventive dental services for a population that has historically lacked meaningful access.
Mental Health Discussion Exposes Broken Public System:
The success of integrating adult dental is interestingly juxtaposed with the failure of the Legislature in 2022 to integrate physical and behavioral health for the Medicaid population. In my opinion, this demonstrates the fundamental differences between dental providers that embraced reform as opposed to public behavioral health administrators who have long opposed financial and operational integration at any cost. Despite entrenched opposition that focused only on throwing more taxpayer resources into a broken administrative system, MAHP was able to help push the issue of integration further than ever with both the Legislature and the Administration. We also shined a light on the bifurcated broken public mental health system that exists today. The new year will bring additional opportunities to help improve access and outcomes for Medicaid beneficiaries, and MAHP will remain a willing participant in any conversations that seeks to improve whole-person health outcomes.
Next year will usher in a new legislative session, and single party control of the Executive, Legislative, and Judiciary branches of state government. I continue to ask my Magic 8 Ball what our industry can expect in the New Year, but unfortunately, I keep getting back “reply hazy, try again later.” Despite a lack of clarity as to what to expect next year, I want to reassure everyone that MAHP will continue to stay laser focused on providing leadership for the promotion and advocacy of high-quality, affordable, equitable, and accessible healthcare for the people of Michigan. It is this mission that will guide us each and every day.
I look forward to continuing to have MAHP at the center of all health policy conversations in Lansing. We have a unique and diverse membership that sets us apart that allows us to be objective, reliable and resourceful to policy makers on all thing healthcare. This effectively allows MAHP to be partners with state government in our collective missions to improve the health status of Michiganders. MAHP has done, and will continue to do, great things – and I’m honored to be a part of an association that is helping to shape the health of our great State.back to blog