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 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!

Legislative Update Week of March 18th

With the Educational Achievement Authority leaving those watching the legislature waiting until the end of the week the House signaled that they are not in favor of the Medicaid expansion by leaving money out for those programs with the first movement on the Department of Community Health Budget and the Senate signaling that they aren't interested in working on the money for the exchange, health care is becoming front and center; let’s review the week:

House:

Dr. Kay Watnick speaking to the press
about the tanning legislation.

The House this week took up House Bills 4274 and 4275 that would require interested parties work with the Insurance Commissioner or create a standardized two page prior authorization form for prescriptions. Now the legislation will move to the Senate for their consideration. This week Representative Jim Townsend introduced House Bill 4405 that would restrict the use of tanning beds by minors in Michigan, 16 and under. Kay Watnick, MD, a dermatologists and Immediate Past President of the Michigan Dermatological Society attended a press conference with Representative Townsend at MSMS to discuss the legislation. "Indoor tanning beds emit up to 15 times more ultraviolet rays than what is emit from the sun," said Dr. Watnick. The legislation is referred to the House standing committee on Regulatory Reform.

Senate:

The Senate Health Policy Committee convened this week to consider two items, Senate Bills 136 and 237, 238, and 239. Senate Bill 136 would allow for a conscientious objection to providing certain treatments based on a moral or religious objection by the physician. If there is an emergent situation the physician may not use the objection to not provide treatment. MSMS has worked with the sponsor of the legislation to find a compromise that we feel will be productive for everyone and continue to work with the sponsor. MSMS continues to oppose the legislation. The legislation was sent to the Senate floor for its consideration. Senate Bills 237, 238 and 239 would amend the public health code along with the school code to update the ages needed for vaccinations. The committee took testimony on the issue and is expected to vote out the legislation at its next hearing.

The full Senate considered their version of the prior authorization legislation by passing Senate Bills 178 and 179. These bills will head to the House Health Policy committee for testimony. It is uncertain at this point which legislation will be the final bills passed.

Budget:

The House Appropriations Subcommittee passed it first version of the Department of Community Health budget (House Bill 4213) this week with leaving the Medicaid expansion out of the budget. There were concerns that lawmakers had on the costs to consumers and sustainability of the program with some on the inside asking for reforms to the program before money will be appropriated for the expansion. This is just the first of what will be many more rounds to come. The Senate is expected to pass their version in the coming weeks.

The Health Insurance Exchange it a snag this week in the Senate will the Senate Majority Leader stating that the exchange was virtually dead for the moment. It will be interesting to see what the next moves of the Senate will be with the implementation of the exchange due at the end of this year.

For more information on what is happening in Lansing and beyond stay with MSMS at http://www.msms.org/advocacy. Your voice counts; make it heard by supporting MDPAC! Find more information at http://www.mdpac.org.