Legislative Update week of May 20th

The end of the yearly budget race is now in the sights of the lawmakers as the leadership teams of both houses were able to come to an agreement on where they wanted to budget to fall out, does that include the expansion of Medicaid, let's review the activities of the week.

House:

The House Health Policy committee this week took testimony on a host of legislation. House Bill 4736 which would bring Expedited Partner Therapy to Michigan, that could make it the 36th state to put this policy into place. Dr. Annette Mercatante, health officer of St. Clair County Health Department, testified on behalf of MSMS and the Michigan Association of Local Public Health. Dr. Mercatante was able to provide the experiences of those working in the public health field and those working in the local public health departments. Dr. Jody Jones testified on behalf of ACOG providing the aspects of pregnant mothers and their unborn children. The committee also considered Senate bills 237, 238, and 239 that would change immunization requirements by having children be immunized by the 7th grade rather than the 6th grade. It is expected that the House committee will take the legislation up for a vote on June 4th.



Senate:

The Senate Health Policy committee also met this week considering two items during their meeting. The the State deciding not the implement their own health insurance exchange, regulations have to now be put into place to deal with the impending changes. One of those changes came up in the committee in the form of Senate Bill 324 that would provide some regulations for navigators of the exchange. This bill rushed out of committee and on to the Senate floor where it has been posted to be considered in the House Health Policy committee on June 4th. Senate Bill 373 was also considered which would allow the Board of Pharmacy to allow for pilot projects for applications of prescriptions. This legislation will be heading to the House as well but not at the same speed at the navigators legislation.

Budget:

This week the final hurdle was crossed by the legislator allowing for the considerations of the different departmental budgets. Last week the May Revenue Estimating conference met letting the legislators know that there was just over $400 Million extra revenue coming into the State for the next fiscal year. major questions of road and education funding, a fix for the HICA tax that funnels into Medicaid, along with other ideas were thrown out on the table for consideration. After discussions between the leadership the decision was made to put the majority of that funding into road construction and maintenance and also putting $75 Million into the State's rainy day fund.

This left no discussion of a fix for the HICA tax shortfall and the Medicaid expansion with the news of the spending priorities with the new found money. This goes for the agreement discussions as well between the House and Senate leadership when looking at finalizing the numbers for the coming year's budget, leaving the Medicaid expansion off the table. Signs are not positive for those support the expansion with the feasibility of the expansion being including in this budget bill less likely by the day, leaving the legislator no choice than to do a separate bill if they choose to expand the program.  Conference committees will start meeting next week with the hope that a budget solution will be found by the end of next week.

Stay with MSMS to get the up to date information on what is happening in Lansing and beyond; go to http://www.msms.org/advocacy. Your support keeps physician issues on the forefront of the legislators, we need your continual support, go to http://www.mdpac.org to see how you can help today.

Legislative Update Week of May 13th

The Legislature received it's updated estimates on revenue for the coming fiscal year on Wednesday which sparked activity on the budgets in the House and Senate. The Senate finally sent its MDCH budget proposal to the full House without the Medicaid Expansion dollars realized in the budget, while House Republicans started taking testimony on their solution to the Medicaid question. Let's review the activities of the week:

House:

The House this week in the common procedural move "zeroed" out the budget proposals that the Senate sent to the House and sent them back which now sets up the budgets to go to conference committee. One lingering issue that the House will most certainly address next week is the MDCH budget that was finally sent to the House for their consideration without the Medicaid Expansion dollars allocated in the budget, leaving the question still on the table of the expansion will survive in Michigan.

The House Health Policy committee this week considered Senate Bill 165 and House Bill 4156 in its traditional second hearing fashion was looking to take a vote on the legislation. The committee provided a substitute to Senate Bill 165 and House Bill 4156 and sent them on their way to the House floor for consideration. The Senate bill will have to be sent back to the Senate for concurrence since the House amended the bill.

The main attraction this week was actually the House Michigan Competitiveness Committee which had House Bill 4714 which is the Republican answer to the Medicaid Expansion question. Committee meetings on this legislation started on Tuesday with hearing in the afternoon and then continued again on Thursday. Republicans are looking for major Medicaid reform and on Thursday had the opportunity to ask the Michigan Department of Community Health Director Jim Haveman and Medicaid Director Steve Finton if they felt that direction Republicans were taking was a good idea and to provide a general overview of the current system in Michigan. It is expected that the process will continue into the next week or two before any potential action from the committee.

The Senate

The Senate Health Policy committee reconvened this week where health insurance was on their radar. The committee considered Senate Bill 324 which would provide the licensure and governance of insurance "Navigators" in Michigan. With the pending implementation of the health insurance exchanges the use of navigators will be crucial to those looking to obtain health insurance. Currently under Michigan statute there is no mention of navigators leaving them to be unlicensed and unregulated on a state level. The committee just took testimony on the legislation and would expect to vote the legislation out before the summer break begins.

Expedited Partner Therapy Press Conference

On this past Thursday the National Coalition of STD Directors (NCSD) along with MSMS, the Michigan section of ACOG, MALPH, and the Michigan Pharmacists Association had a press conference and reception to education lawmakers on the policies of Expedited Partner Therapy. Representatives Gail Haines and George Darany were gracious hosts of the reception and press conference with Representative Darany being able to highlight his legislation House Bull 4736 that would bring EPT to Michigan.
     
"The treatment is critical to prevent reinfections and further transmission for untreated partners," Rep. Darany said in the press conference. Jeff Phillips, MD represented MSMS at the press conference providing his thoughts and expertise to the panel. "It's frustrating seeing these patients come back time and again with an infection that is easily treatable," said Phillips after the press conference. Stephanie Arnold Pang from NCSD provided the national outlook of the practice of EPT and what they are seeing from the different states that have implemented the policies. "If you don't treat a partner of a patient with an STD, the treatment of that index patient is not effective, they are just going to be reinfected and it will cause more costs and visits on our health care system," said Arnold Pang. The legislation is now scheduled for a hearing on May 21st with a possible voting out of the committee on June 4th.

Stay with MSMS to get the most up to date information on all of the items MSMS is following in the legislature and beyond at http://www.msms.org/advocacy.

Legislative Update Week of May 6th

This week Medicaid took the spotlight away from all of the other activities as the House Republicans produced their plan to reform Medicaid so that they could accept the expansion of the highly utilized program. Let's review that and the other activities of the week in the Michigan Legislature.

House:

The House saw little activity this week as the Tulip festival was underway on the west side of the state. This left little action by committees and the full House. The House Health Policy committee did schedule a hearing for the 14th where they will be likely voting on the Senate Bill 165 and House Bill 4156.

Senate:

The Senate this week considered Senate Bills 237, 238, and 239 which would change the grade requirements for immunizations in Michigan. The Senate Health Policy committee saw little to no objection of moving this legislation forward and neither did the full Senate Floor. The bills passed the floor without any objection and have now moved to the House where they have been referred to the House Health Policy committee.

Medicaid Reform:

Outline of Republican Medicaid Reform
Source: Michigan Republican Caucus

Over the past several months the Legislature has been grappling with expanding Michigan's Medicaid program to bring in those individuals who are at 133% of poverty or worse in to the program. Many in both chambers feel that they are setting up Michigan for legacy costs that could hamper the other essential services that the state provides, for example road funding and education. MSMS, the Michigan Hospital Association, along with other medical groups have come out with the Governor and supported the expansion.

Feelings in the legislature still where they were when the expansion was first announced found themselves asking for reforms in Medicaid, where it has the perception of being a huge money drain that is full of inefficiencies and waste. From the mindset both House and Senate members have been trying to find a way to reform Medicaid to allow for the expansion to happen while continuing to be fiscal responsible. House Republicans this past Thursday feel that they have the answer.

Their plan (House Bill 4714) looks like this:

• Requires that the expansion be 100% funding by the federal government.
• Would require those on Medicaid to pay a co-pay or deductible that falls within 5% of their income.
• Would set up Health Savings account for those on Medicaid.
• Preventative care would be a little or no cost to the patient.
• Providing incentives for those patients on long term care to get well and make themselves better.
• Options to those on Medicaid to choose private plans for insurance, similar to a insurance exchange except specific to Medicaid.
• Would only allow those who are single and able to be on Medicaid for 48 months which is seeking to rid them of an entitlement feeling.

It is uncertain when and if this proposal will receive a hearing but be assured it will be similar to the Auto No-Fault or Tort Reform hearings that have happened in the past. Stay with MSMS to get all of the up to date information on this and others at http://www.msms.org/advocacy.

 

Legislative Update Week of April 29th

Words of Auto No-Fault reform continued to stay in the air this week as the House Insurance committee while the topic of abortion found its way to the Senate Judiciary committee. Let's review the events of the past week:

House:

The House Health Policy committee met this week and considered two items which the committee took only testimony. The first bill was House Bill 4156 which would create liability protections for nurses who are practicing under a special volunteer license. This practice is common for other health professionals including physicians, dentists, and others. Little opposition was brought to the committee's attention and this bill should be voted on next week in the committee. The second bill the committee reviewed was Senate Bill 165 which would require hospitals to provide in writing information to the patient's parent or guardian, if the patient was a minor, on the use or non use of life sustaining treatment or non beneficial treatment. The committee is expected to vote this legislation out in the coming week as well.

The main event this week was again in the House Insurance committee where they continued taking testimony on House Bill 4612 that would reform Michigan's Auto No-Fault system. The committee started in the morning back in their normal committee location in the House Office Building. The committee room along with two other rooms were pack full of people concerned about the impending changes brought forth by the legislature. The committee went until Noon where it broke so that the members could go to Session to work on the items planned for the full House that day. After Session the members of the committee came back and continued until just after 5:00pm. Just before the committee broke, Chairman Lund asked for amendments to the bill and ran those, which would take away the $50,000 cap for retrofitting houses or cars and removing the 16 hours cap for in home care allowing for a full 24 hour in home care. After all the amendments were considered the committee took their vote seeing the legislation leave the House Insurance committee on a partisan vote, all Republicans voting for and the Democrats voting against. Now the legislation heads to the full House where some are saying that some members on the republican side don't want to vote on the issue.

Senate:

The Senate this week had the youth in mind this week. Starting with the Health Policy Committee, they considered Senate Bills 237, 238, 239 that would amend the Public Health Code, School Code, and the School Aid Act to move the grade requirement from 6th grade to 7th grade starting January 2014. Legislation was provided to move the grade requirement so that it would be able to fit all of the age requirements that health professionals were looking to obtain. These bills were sent to the Senate Floor after the committee voted out the legislation. It would expected for the Senate to consider the bills in the coming week.

The Senate Judiciary committee took another track this past meeting and had a discussion with the Department of Licensure and Regulatory Affairs about conflicts of interest on their licensure boards. This topic arose after a situation in Muskegon which involved the Michigan Board of Medicine. MSMS as been actively engaged with the issue of the committee and is working with the committee and the Board of Medicine to answer any and all questions.

Budget:

Budgets at this point are at a stand still. It is expected here in the next couple weeks that the House and Senate will whats called "zero out" the budgets sent by their colleagues in the other chamber returning the legislation back to their original chamber and finally sending them to Conference committee. All members of the Appropriations committee are awaiting the May Revenue Estimating Conference here in the coming weeks.

Stay with MSMS and MSMS Government Relations to get the up to date information either at http://www.msms.org/advocacy or on Twitter or Facebook!