Legislative Update Week of June 17th

The Legislature saw the light at the end of the tunnel with this being the final week before they leave on their summer recess. This week started with the Lieutenant Governor in the Upper Peninsula and the Governor in Israel working on creating economic development for Michigan but with the Medicaid expansions hanging in the balance, we saw trips being cut short with both the Lieutenant Governor and the Governor coming back to Lansing to try to get the Medicaid expansion across the finish line. Let’s review the week:

House:

The House started out this week with having a number of topics on the agenda including House bill 4736 that would allow Expedited Partner Therapy in Michigan. This was on the agenda for Wednesday for the House to take up but everything took a back seat to what was happening across the hall in the Senate.

Senate:

The Senate found itself in the limelight, where it wanted it or not, this week with the possible consideration of HB 4714 or the bill that addresses Medicaid expansion. Starting out the week the Senate Republicans were having troubles meeting their own imposed requirement where a majority of their caucus has to vote in favor of the legislation before they will consider an issue on the full Senate floor. Wednesday found the majority of those lobbying in the Capitol working on the Senate asking Senators to support the expansion. The Lieutenant Governor made his want back to Lansing to join those lobbying the Senate Republicans on supporting the exchange. At the end of the day, Wednesday saw no action on the expansion and left some wondering if it would ever get done.

Thursday and final day of session before the summer break, found those hoping for the Medicaid expansion to make its way to the Governor's desk, but with the Governor gone in Israel for the past week, it was hard for supports of the legislation to find any hope of moving the issue forward. Then word came that the Governor was on his way back to Lansing and would be at the Capitol before noon. With the Governor's arrival eminent, supports continued working with Senators to push them to support House Bill 4714. When the Governor arrived, he talked with his staff that had been working on the Senate, giving him a status report, and then started working members of the Senate. This went on for most of the afternoon where he also called representatives from the supporting groups to fill them in on his progress which was not promising at the time.



Kenneth Elmassian, DO, President of MSMS in the background at
the Governor's Medicaid Expansion Press Conference.
From the Detroit News
http://www.detroitnews.com/article/20130620/POLITICS02/306200084

Finally, after five hours of working the Senate, the Governor called a press conference with supports of the expansion asking the Senate to take a vote on the expansion rather than heading home for summer break. Kenneth Elmassian, DO, President of the Michigan State Medical Society was there for MSMS. "Every discussion about health care and health policy in Lansing should start and end with what is best for Michigan patients. The Healthy Michigan Plan puts patients first, helping more families receive the health care they so desperately need while being responsible with residents' tax dollars," said Elmassian in a statement. He went on to say, "Physicians across Michigan are grateful for Governor Snyder's steadfast leadership and look forward to working with lawmakers this summer and into the fall on reforms that put patients first."

Now the Senate will be back in August on the 27th to hopefully finish the work done on the Medicaid expansion, those supporting the package now have until August to continue working to garner support for the package. The blog will now take a break until the legislature comes back into session in August. Follow MSMS though through our twitter feed and Facebook page to get up to date information on what is happening over the summer at http://www.msms.org/advocacy.

Legislative Update Week of June 3rd.

With the summer recess looming on the horizon, both chambers are looking to finish up some of the larger issues that have been on the plate for the legislature. Lets review the activity of this week and whats still to come:

Senate:

The Senate concurred with the conference report for the General Government Omnibus budget, which covers the Department of Community Health budget as well. With the budget now agreed to by the both House and Senate, it will be heading to the Governor's desk for his signature.

House:

The House Michigan Competitiveness Committee convened again this week to consider the House Republican Medicaid Reform package. House Bill 4714 would require the state to ask for a waiver for their Medicaid program that would require full support of expansion by the Federal Government along with a 48 month limit for those able bodied individuals using Medicaid. There were rumors that the legislation was going to be voted out this week by the committee but it did not happen. Instead there was notification that a substitute piece of legislation would be introduced which would make the plan more attractive to the groups who are against this major change. We wait to see what the substitute legislation will look like, but signals from the chair of the committee along with the Speaker of the House is that the new legislation will have the 48 month limit included in it.

The House Judiciary committee came together with the House Health Policy committee to take testimony on House Bills 4694, 4695, 4696 and 4697, which is enabling legislation to create Mental Health courts statewide in Michigan, bring them under the authority of the State Court Administrator's Office (SCAO) and allow them to direct funding for the program. The General Government Omnibus budget included $2 Million for the courts in Michigan, now with this legislation it these court could become a reality. The joint committee heard testimony from those involved in the Mental Health court in Kalamazoo on Tuesday when the joint committee meet. The Judiciary committee continued taking testimony on this issue on Thursday  hearing from the judge in charge of the Mental Health court in Kalamazoo. This legislation is likely to be moved out of the committee at their next meeting as this was one of the issues that Republicans were interested in moving before the start of the break.

The House Health Policy Committee also meet this week to consider a host of issues including taking a vote on House Bill 4736, a bill that would bring EPT to Michigan. The legislation made it out of committee with no signs of fight back from the members of the committee with a vote of 13 yes votes 0 No votes and 2 passes. Now the legislation will be sent to the full House for their consideration and we are hopeful for a vote before the House members leave for break. The committee also took a vote on changing the grade requirement for immunizations. The push to to move the record from 6th to 7th grade since those who are in 6th grade may be younger than what traditionally someone in 6th grade would be. This legislation headed to the House as well.

The Coming Weeks:

The House has several large issues they are looking to tackle before heading home on their summer recess. Transportation and road funding is the major problem facing the legislators at the moment. Looking to increase the tax on gasoline while it is so high or tacking on an increase to your registration fees are just a couple of the ways the House is looking at to solve this road funding issue. Medicaid expansion will be in the limelight for the next couple weeks as well. The House is committed to get their Medicaid reform legislation to the Senate before break. Those are the two largest issues facing the legislature that are trying to be teed up to send to the other chamber.

For more information on what is happening in Lansing and beyond follow us at http://www.msms.org/advocacy. You can get all of the information there and from our Facebook and Twitter feeds. What to know what is happening politically? Check out MDPAC at http://www.mdpac.org to get all the information on who will be running for what in the coming months ahead.

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 November 19th

With elections finally over and the legislature facing its final weeks in Lansing, the chaos of lame duck is about to start. With the House Republicans losing five members, those leaving have agenda items that they would like to see get done in these short weeks. Those members find themselves fighting against the Governor who also has issues that he would like to see completed before the House and Senate head home for the holidays.

Let’s take a look at what we feel will be the top five projects the legislature will be working on in this coming lame duck session:

1.      Blue Cross/Blue Shield Mutualization: With the Senate pushing through their legislation before Election Day, we find that the House has a different story. Hearings have started in the House Insurance committee and have been marathon meetings starting last week and going through this week discussing issues surrounding Medigap and having the Attorney General Bill Schutte testifying that with this package we are pushing Michigan senior towards a cliff, possibly leaving them without the some of the coverage seniors need. MSMS has amendments it will be looking to introduce in the coming weeks to the package protecting some the privileges offered under PA 350.

2.      Personal Property Tax Reform: This is a request and an issue that is important to the Governor and the Lieutenant Governor. This has been an interest to this administration in the past. While LG Calley was a member of the House he was the minority chair for the House Tax Policy committee where eliminating the PPT was an interest to him at that time. A good thing for the LG is that Speaker Bolger is of the same opinion as him, I would imagine that the House will work to get the PPT off the books before they head home.

3.      Health Care Exchanges: With the Senate tackling this issue earlier this year, the House had a wait and see attitude when it came to the exchanges, first waiting for the United States Supreme Court to render its decision then waiting to see the outcome of the elections, the House now faces either federal implementation for work hard over the next few weeks to get a state exchange in place. We'll see what the legislature can accomplish when the majority feels that this isn't the program they wanted to deal with.

4.      Regional Transit Authority: With Detroit dealing with several financial problems, the thought of a regional transit authority would ease those concerns that surround the transit system. This issue has come up time after time and has never been able to make it out of the legislature, maybe this time it could.

5.      PA 4 Replacement: With Michiganders choosing to take the Emergency Financial Manager act off the books we find the state going back to the Emergency Manager act taking away some powers that some would argue were able to get some off the cities and school districts back on better footing. Now some feel there needs to be a replacement that would still provide the authority that the managers need to get these municipal units back on course.

Other items on the horizon could be mining taxes, educational achievement authorities, and the discussion that with the failure of proposition 2 and 4 if that is a signal to the legislature that Michigan is ready to be a Right to Work state.

MSMS will be making our final push for this legislative session on Tort Reform. We still continue to feel positive that we could get some movement on this during lame duck. We also will be working on getting our impaired drivers legislation moved from the House floor and to the Governor's desk and hopefully seeing movement on Expedited Partner Therapy by sine die.

Stay with MSMS throughout this lame duck session to get the latest information affecting you at http://www.msms.org/advocacy.

Legislative Update Week of September 24th

With the legislature winding down for the month of September, the last months of work for the legislators is starting to shape up. The Senate has started to focus on certificate of need reform and allowing for hospital to be built by McLaren in Clarkston. The Governor is focused on the transformation of Blue Cross / Blue Shield into a mutual insurer, and the House focusing on a variety of issues, let’s review the past couple weeks:

House:

Dr. Phillips and Mercantante
testifying in House Health
Policy Committee

The House Health Policy committee met this past week having two items on their agenda. The first was a presentation on the outbreak of the West Nile virus and the effects it’s having on the state. After the presentation they considered House Bill 5934 which would amend the Public Health code to allow for Expedited Partner Therapy in Michigan. Dr. James Phillips, a MD and health officer for Hillsdale, Branch and Hillsdale counties testified for the Medical Society in support of the package. Dr. Annette Mercantante, a MD as well and health officer of St. Clair county testified for the Michigan Association of Local Public Health (MALPH) and for Michigan Association of Public Health and Preventive Medicine Physicians (MAPPP). The Michigan Association of Justice came to the committee to oppose the bills since the legislation sets a gross negligence standard for physicians who utilize EPT and there is an adverse reaction to the antibiotics given for Gonorrhea and Chlamydia. The bill was sent to a work group where hopefully in October, when the House comes back for one day it will be considered by the committee for a vote.

The House Transportation committee continued the work of the Senate and considered Senate Bills 402 and 403. Testimony was taken on these bills similar to what was testified in the Senate and were reported out of committee on Thursday after the committee took a bunch of testimony on regional transit authority issues in Southeast Michigan. Hopefully these bills will be taken up by the House in the coming months and sent to the Governor for his signature. The House Insurance committee started taking testimony on the mutualization of Blue Cross/Blue Shield. This will be a highly contentious issue and one that will on the front burner until the end of the year.

Senate:

The Senate Insurance committee starting taking testimony on Senate Bills 1293 and 1294 that would allow for the mutualization of the Blues. The Attorney General Bill Schuette testified to both the House and Senate committee that he will trust but needs to verify that the conversion will not harm those who depend on the Blues for their insurance. The Senate will continue to take testimony on the legislation but it could be expected for the Senate to take a vote on the legislation in November to push it to the House. Currently the House does not seem interested in pushing this legislation forward so quickly which could push this issue into the New Year.

The Senate Economic Development committee for the past couple weeks has been considering Senate Bill 1269 which would amend the certificate of need statute but also allow McLaren to build a hospital in Clarkston. Testimony was given for and against the bill which lead to a substitute piece of legislation as was reported to the Senate floor on September 12 where the Senate approved the amendment and sent the legislation from second reading to the committee of the whole in the Senate. The timeline is unknown as of now but we could see the bill making its way to the House before Election Day.

Both the House and Senate will now take a break until October 17th when they will both be in for just that day.

If you are looking for more information on who MDPAC is supporting go to http://www.mdpac.org to get the latest election information.