This opinion piece was written by MAHP Executive Director Dominick Pallone and appeared in Bridge Michigan. Read more here.
Nearly a decade ago, the Michigan Legislature created the Healthy Michigan Plan (HMP) which expanded Medicaid eligibility to 138 percent of the federal poverty level. Since taking effect in March of 2014, HMP has proved to be a successful model for other states to follow, saving tax dollars and driving healthier outcomes for Michigan’s most vulnerable populations.
What makes HMP so successful is that it allows Medicaid enrollees to choose their health plan from a list of accredited managed care organizations contracted by the Michigan Department of Health and Human Services (MDHHS). Under HMP, managed care health plans provide health care insurance to enrollees through robust provider networks. Healthy behavior incentives and performance metrics for health plans have been established under HMP to help advance healthier outcomes for enrollees.
HMP coverage is available to Michiganders ages 19-64 who have an income at or below 138 percent of the federal poverty level – or $18,754 annually for a single person and $36,908 for a family of four. And enrollees must meet other eligibility requirements, such as not qualifying for other Medicaid programs.
The goals set by the Legislature when expanding Michigan’s Medicaid program were to lower the state’s uninsured rate, reduce uncompensated care, save taxpayer dollars and improve health outcomes. HMP helped provide health care insurance for an additional 600,000 Michiganders before the COVID-19 pandemic and it is estimated that the number of HMP enrollees increased to more than one million during the pandemic.
Since adopting HMP, Michigan’s uninsured and uncompensated care rates have dramatically improved. The rate of uninsured Michiganders has dropped from 11.6 percent in 2013 to 5.1 percent as of 2022, which is much lower than the national average of 6.6 percent. And uncompensated care was roughly 5 percent of all hospital expenditures in 2013; that number has been cut in half, standing at 2.5 percent as of 2020.
Research from the University of Michigan has shown that HMP has more than doubled primary care usage and reduced enrollees’ reliance on emergency room care by 58 percent.
But that’s not all HMP has done.
Since HMP was enacted, the state has saved hundreds of millions of dollars. The state Budget Office estimates Michigan saved more than $273 million in 2021 alone, and savings have been produced each year since the program has been in place.
It’s clear HMP has had a positive effect for Michigan’s residents and its health care system. While the performance of HMP has exceeded expectations, there is more that can be done to modernize and improve this health care system for years to come.
Michigan’s legislators need to proactively address coverage and access barriers to improve enrollee outcomes and health equity. Mandates on enrollee cost-sharing and health risk assessments must be reformed for effectiveness. Some program requirements on enrollees have proven costly to implement and enforce. Furthermore, greater flexibilities must be afforded to MDHHS to work with the federal government to make benefit design choices best suited for Michigan’s dual-eligible population.
We look forward to working with Michigan’s leaders to improving the Healthy Michigan Plan in the coming days and weeks. We have already seen the positive outcomes the HMP has on the health of Michigan’s residents, and by continuing to modernize we can ensure that HMP provides strong patient outcomes for years to come while saving significant taxpayer dollars.
This is why a diverse group of health care provider and insurance providers have come together to support the common sense, bi-partisan modernization efforts in House Bills 4495 and 4496.
A healthier Healthy Michigan Plan is good medicine for Michigan.back to blog