With the new session still in its infancy, the Legislature has not been able
to get up to working at full speed yet. They awaited two crucial pieces of
information: one, how much money they would have to budget with, and secondly
the agenda and direction the Governor wanted to go in, Over the past week the
Legislature received that information, let’s review:
Consensus Revenue Estimating Conference
Before the start of the new legislative session the House and Senate Fiscal
Agencies along with the State Treasurer came together to discuss the estimated
revenue that the state would have in the coming fiscal year at the Consensus
Revenue Estimating Conference. This conference meets twice a year, in January
and in May. The conference heard from both of the fiscal agencies along with
the Department of Treasury. The University of Michigan was also invited to
provide an economic outlook for the state in the coming years ahead. Let’s
break down the numbers:
Unemployment:
The outlook for Michigan unemployment picture is slowly brightening up. With
a current rate for 2012 at 8.9%, economists forecast that the overall rate for
the coming year will drop a point to 8.8%; drop to 8.2% in 2014 and 7.6% in
2015.
Personal Income:
With the drop in unemployment forecasted and second positive is the forecast
of increasing personal income for those working. For 2013 it has been
forecasted to increase 2.6% with a 4.3% increase in 2014 from 2013 and 4.4%
increase in 2015. A direction the Governor has been advocating for since his
election two years ago.
State Budget:
What does that mean for Michigan? One could extrapolate that with the
increase in income over the coming year that revenues for the State will be
increasing. With FY 2013 though, that isn't the case. The General Fund General
Purpose monies, that fund programs like Medicaid, will actually see a decrease
from FY 2012 of $472.9 Million or a change of 5.1%. The School Aid fund is
expected to add an additional $249 Million than what was estimated May 2012. We
could see some cuts coming in programs in Michigan for FY 13 but expected an
increase in revenue of $472.2 Million for FY 14. Now the Governor will present
his budget proposal to the Legislature on February 7th, so we wait and see how
programs will be affected.
State of the State Address
The Governor's State of the State address was just like the other he has
delivered, using an outline to rather than providing an actual written speech
when he delivered it. The Governor started by providing a review of where the
State was with his dashboards that he has made famous over his term has
Governor. The dashboard can be view by clicking the link above. The Governor
reported that with the changes that Michigan has seen over the past two years,
the economy in Michigan was growing and Michigan was putting people back to
work.
The road ahead for the Governor looks to continue the same success that has
had over the past two years. There were three major messages that Governor
Snyder conveyed to the lawmakers this past Wednesday night: one an increase in
funding for roads is needed and needed now. The Governor is looking to raise
1.2 Billion each year for 10 years to cover the costs of repairing Michigan's
crumbling roads. This was met with hesitation by many from his own party since
the plan included a large fee increase to automobile registration. Time will
tell on whether this proposal will make it out of the legislature or not.
The second major proposal was educational and the increase efforts to pass
an Education Achievement Authority. Fifteen schools in the Detroit area are
already operating under the premise of an Authority that provides a different
look at education than what is considered typical in Michigan. Students are
taught to master skills without the fear of receiving failing grades and
worried about whether or not they will make it to the next grade. The Governor
would like to have the opportunity to bring this proposal state wide to all of
the schools that are struggling in Michigan.
Finally, the third biggest topic was insurance reform. The Governor vetoed
the last efforts by the legislature to reform Blue Cross Blue Shield due to the
abortion amendments that were tacked on by the House in the final days of the
last session. The Governor now asked the legislature to go back to the drawing
board and bring legislation forward that would move the Blues in a world that
had a health insurance marketplace. Auto no fault insurance was the other
insurance reform topic of his speech. He wants reforms done this year to
provide protection to the insurance companies on their liability and legacy
costs for those involved in an auto accident. It is inevitable that this will
be on the agenda of this legislature.
To get more details on the Governor's State of the State address click here.
Stay with MSMS to receive all of the up to date information at http://www.msms.org/advocacy.
Thursday, January 17, 2013
Thursday, December 27, 2012
Legislative Update (Special Edition)
With the Legislature finally closing its books on the 96th Legislature there
were many issues that made their way through the process that kept MSMS on its
toes. We provided several letters of support or opposition, provides hours of
testimony to the House and Senate, and made hundreds of office visits and phone
calls and e-mails. All of this truly helped shape the health policy that
Michigan gained over the past two years. Now that the session is over we want
to take a look at the issues that affected all of us:
Liability Reform:
The largest victory for MSMS this year was the passage of reforms that would
bring Michigan's tort climate back toward what was originally passed by the
legislature in 1993. Senate Bills 1115 and 1118 were passed by the legislature
in, what some would call, a legendary lame duck session of the Michigan
Legislature. These reforms did not come without the battles including five
committee hearings in the Senate on these bills which lead to huge crowds in
the committee rooms. Those who were for and those against the reforms packed
the room wanting to make their presence known to the committee and how they
felt.
After hours and hours of testimony the Senate committee moved the
legislation to the floor and from there the legislation had covered it first
real hurdle. Deliberations, discussions, amendments, and speeches against and
for the legislation lead us to the final day of working session for the
legislature where the House finally took up the legislation on the floor and
gave it its blessing to send it to the Governor for his signature. It has been
almost twenty years since there has been some significant tort reform for
medical malpractice in Michigan until the end of this session, these tort
reforms will be good for physicians but more importantly good for patients.
Earlier in the term MSMS worked on legislation that would allow those physicians
who are employed to volunteer in clinics and be provided protections that are
afforded to those who are retired and work in the clinics (House Bill 4350). There was contention
with this legislation since it provided what some classified as blanket
immunity has they had in the later tort reform debate. Working with the members
of the Senate, MSMS and other parties were able to come to an agreement that
would provide the protection to those who are not contractually compelled to
work in clinics to receive the liability protections of those who are retired
and volunteering. It was a great day for medicine by opening the door to those
physicians who wish to give of their time to help those who need the help the
most.
Medical Marihuana:
In this term Medical Marihuana left us with the question of what a
"bona-fide patient/physician relationship" was in the eyes of the
law. In medicine that question can lead to several answers. The face to face
relationship all the way to telemedicine can lead to the definition of a
patient/physician relationship. The Medical Marihuana statute stated that grey
area that required patients to have this relationship with their physician but
did not state what that relationship looked like and left law enforcement and
the medical community scratching their heads. Insert House Bill 4851 which for
the purposes of Medical Marihuana defined what that relationship looked like.
Now patients would have to have contact with their physicians regularly rather
that a one and done visit as some were seeing for those who were looking to
obtain a certification for Medical Marihuana.
Insurance:
Insurance was an issue that started right away in the session with the attempt by the House to change the Michigan Auto No Fault system. House Bill 4936 wanted to provide levels of coverage that a person can obtain that would provide a certain level of financial coverage for any personal injury that occurred in an auto accident. From the state this was an issue that MSMS was against. Legislators were looking to provide choice for those individuals who were looking to save on car insurance and also provide relief to the Michigan Catastrophic Claims Fund, the fund that covers those gravely injured in an auto accident. Proponents of the legislation stated that the changed needed to happen since in its current form it would bankrupt the system. Opponents of the legislation asked to see the numbers and in the end were never given the opportunity to see the hard data. The House Insurance committee did pass a series of reformed and sent it to the House floor for their consideration but were never able to obtain the votes. Expect this issue back again the new session.
It wouldn't be a complete legislative session if Blue Cross/Blue Shield wasn't involved in some way. This term they had the backing of the Governor and finally found a way to get out from under PA 350 or the Nonprofit Health Care Corporation Reform Act. This act provided the tax breaks that the Blues enjoyed but also provided some requirements that the Blues did not enjoy. With the impending implementation of the health insurance exchange in Michigan, the Governor thought it was time to bring a change to the Blues and give them the ability to compete in the insurance exchange among other reasons and push for legislation to reform the Blues. The Legislature responded and created a nonprofit mutual insurer in the state of Michigan and providing a path to those incorporated under PA 350 to convert into this mutual insurer. This legislation did not come without a cost, requiring that the Blues pay to the state $1.56 Billion from now until 2018. This money will be placed in a health fund used to cover health projects and subsides Medigap policies until 2021 at a cost of $120 Million a year. The Governor received his wish and Senate Bills 1293 and 1294 were sent to his desk where they await his eventual signature.
Helmets:
Before the Legislature left for the summer break this past year they decided to take up an issue that has been on the burners of the legislature for years. They finally made a decision on the age old question, should you be required to wear a helmet while operating a motorcycle? In their opinion you should not be required since it was your individual right to determine whether you ride with a helmet or not. Senate Bill 291 made its way through the legislature going through its ups and downs, being amended several time, and at one point being used in the same conversation the changes with Auto No Fault, but in the end it was finally time according to the legislature to act on this measure. MSMS was adamantly opposed to the legislation reasoning that the having helmet on in an accident will give you the greatest chance to walk away from that accident but the Governor and Legislature did not see it that way and now today we have those who cherish their individual freedoms riding without a helmet. Time will tell if this was a wise decision for Michigan.
Graduate Medical Education:
Every year at MSMS we always face small battles when it comes to the budget, whether it’s trying to get more money for Medicaid, trying to stop the cut to public health funding, or trying to keep J-1 visa waivers in the budget we always have some small battles. One that always continued to come up and we feel will continue to, is the funding for Graduate Medical Education. The Governor has presented his last two budgets to the legislature with significant cuts to the program citing that the priority should be funding Medicaid at a higher level so that physicians will service more patients on Medicaid rather than funding the training of new physicians, fresh out of medical school. We see and understand the investment on Graduate Medical Education and what care this provides to those who need to care the most. Through work and education of the legislators we have been able to stay away from the deep cuts proposed by the Governor and only work hard to absorb small cuts from the legislature. In the coming years we will have to continue this fight to keep GME at its current level rather than seeing another cut to the program.
Affordable Care Act:
This is the only federal issue that made out list this year. We all know about the sustainable growth rate (SGR) and how we face looming cuts into Medicare but somehow Congress always finds a way to kick the can down the road. This time we think it will be the same but with the fiscal cliff casting a shadow on other impending issues, it could take some serious lifting by Congress to get this done on time.
But now on to the Affordable Care Act and the decision from United States
Supreme Court that some say rocked and other say solidified the nation in the
future of its health care. The Supreme Court upheld the law saying that it was in
the taxing authority of Congress to mandate insurance for people and was not
within the commerce clause of the US Constitution. This left many states that
were waiting for a decision under the gun if they were going to start creating
their own health insurance exchanges. As for Michigan an attempt was tried with
legislation that was sent from the Senate to the House, Senate Bill 693, but
failed to gain the proper support from the committee. The state will now have a
state/federal partnership exchange in 2014.
Scope of Practice:
This year the Medical Society found itself involved in looking at the future of medicine and how the team approach to care can continue to grow in Michigan. At the start of the term, physician assistants and physicians came together to find ways to grow their partnership in Medicine and came out of those discussions with Senate Bill 384 which brought more clarification on the relationship between PA's and Physicians, strengthening it, providing greater avenues to provides the best care.
Physical Therapists made an attempt this year to provide direct access for patients, bypassing the physician in House Bill 4603. Nurses also were looking for some clarification on their profession and how they fit into the team approach of medicine with Senate Bill 481. Both of these pieces of legislation did not make through the entire legislative process but MSMS is looking forward to continuing discussions with these groups to better strengthen the medical team in Michigan.
Autism:
This legislative term saw the largest advancement in mental health parity in
Michigan in decades. MSMS has always had a long standing policy to support
mental health parity in the insurance coverage of treatment of mental health
conditions. Michigan took a step towards that this term by requiring the
coverage of services surrounding the treatment of Autism. This was a priority
of the Lieutenant Governor, Brian Calley; an issue that he worked hard for when
he was a member of the Michigan House. Senate Bills 414, 415, and 981 started in June of 2011 with 981 adding in March 2012
and by April 18, 2012 it was the law of the land that insurers had to start to
cover Autism services and treatment in Michigan. This is one small victory
towards the larger goal of mental health parity.
Claims Tax:
Starting in 2011 there were rumblings from the federal government that the use tax that was set up by Michigan to tax the insurers that held Medicaid plans in Michigan was going to be ruled illegal and could penalize the State by holding back funds for Michigan's Medicaid program. A dilemma was presented to the legislature on what to do to replace the revenue needed to obtain the funds needed for Medicaid. Thus the claims tax proposal was created. Senate Bills 347 and 348 eliminated the use tax and created a claims assessment or tax on each of the insurance claims filed at a 1% level in Michigan. This was supposed to solve the revenue shortfall that would come with the elimination of the Use Tax but that as time moved on it proved not to be the case and this year the Medicaid faces a $140 Million shortfall that has to be filled somehow. The Senate tried to move Senate Bill 1359 which would provide an adjustable rate to make the need for revenue but was rejected by the Senate Appropriations committee. The legislature continues to look for solutions for the shortfall.
Abortion:
Abortion was an issue that seemed to be on the forefront this term with the legislature as looked tightens up regulations surrounding this hot button issue. There were several bills introduced and has testimony taken but in the end, these bills were placed into one large bill House Bill 5711. This legislation took a look at four major issues the legislature felt needed to be addressed: the licensing of facilities that perform abortions, the disposal of remains, and the liability protections needed by a physician who performs abortions, and the use of telemedicine in an abortion. Those against this bill called this issue the War on Women and continued to push for its stall in the House and the Senate. Those efforts did fail and in the early morning hours of the last day of session, the House concurred with the Senate and sent the bill to be enrolled and presented to the Governor. It’s currently uncertain if the Governor will sign the legislation.
Abortion found its way into the blue cross mutualization changes mentioned above with amendments that were added by the House to require that coverage for elective abortions be an opt-in coverage rather than an opt-out situation when purchasing coverage. We will have to wait and see the impact it will have on Michiganders.
Impaired Drivers:
An issue that MSMS has been working on for several years was finally
accomplished this legislative term by providing liability protections for
physicians who report to the Michigan Secretary of State that a person may be
impaired to operate a motor vehicle. Senate Bills 402 and 403 started in the Senate Transportation committee and made
their way through the entire process landing on the Governor's desk at the end
of the second week of December. With the Governor's signature on this
legislation physicians can report those patients they feel should not be
operating a motor vehicle and let the Secretary of State decide whether that
individual should be driving.
Bullying:
A major issue for the MSMS Alliance with past term was the creation of regulations for schools on how to handle instances of bullying. House Bill 4163 was created to provide the school districts have plans in place to handle bullying and plans that are specific to their school district but meet certain requirements required in the act. In December of 2011 Michigan joined other states by have the Governor sign Matt's Safe School Law into law.
Concussions and High School Athletes:
Watching local high school sports over the past several years there continues to be a push to be faster, be stronger, hit harder and just become more physical overall. With this drive the amount of concussions happening in High School athletics was rising sharply leaving physicians, parents, coaches, and school personal concerned for the safety of the students playing athletics. This lead to the introduction of Senate Bill 1122 and House Bill 5697. Both of these pieces of legislation set into motion procedures that needed to be taken by school personal, what clearance was needed to be obtained by the athlete to compete again and what literature was needed to be provided to the athletes and parents on concussions and their treatment. We are hopeful that this will protect those athletes that want to compete at their highest levels.
With a busy legislative term over, MSMS is looking forward to what the next legislative term will bring. Some of the same issues mentioned today could very well make their way back into the legislative picture in the coming term. Stay with MSMS to get the latest information on issues going through the legislature that affect you and your practice at http://www.msms.org.advocacy. We will be taking a break now until the start of the new term, hope you all have a great new year!
Liability Reform:
 |
| Drs Elmassian and Chafty Testifying |
 |
| View at tort reform hearing. |
 |
| Wayne State Medical Students lobbying for Tort Reform. |
Medical Marihuana:
 |
| Dr. Newman testifying to the Senate Judiciary committee on Medical Marihuana |
Insurance:
Insurance was an issue that started right away in the session with the attempt by the House to change the Michigan Auto No Fault system. House Bill 4936 wanted to provide levels of coverage that a person can obtain that would provide a certain level of financial coverage for any personal injury that occurred in an auto accident. From the state this was an issue that MSMS was against. Legislators were looking to provide choice for those individuals who were looking to save on car insurance and also provide relief to the Michigan Catastrophic Claims Fund, the fund that covers those gravely injured in an auto accident. Proponents of the legislation stated that the changed needed to happen since in its current form it would bankrupt the system. Opponents of the legislation asked to see the numbers and in the end were never given the opportunity to see the hard data. The House Insurance committee did pass a series of reformed and sent it to the House floor for their consideration but were never able to obtain the votes. Expect this issue back again the new session.
It wouldn't be a complete legislative session if Blue Cross/Blue Shield wasn't involved in some way. This term they had the backing of the Governor and finally found a way to get out from under PA 350 or the Nonprofit Health Care Corporation Reform Act. This act provided the tax breaks that the Blues enjoyed but also provided some requirements that the Blues did not enjoy. With the impending implementation of the health insurance exchange in Michigan, the Governor thought it was time to bring a change to the Blues and give them the ability to compete in the insurance exchange among other reasons and push for legislation to reform the Blues. The Legislature responded and created a nonprofit mutual insurer in the state of Michigan and providing a path to those incorporated under PA 350 to convert into this mutual insurer. This legislation did not come without a cost, requiring that the Blues pay to the state $1.56 Billion from now until 2018. This money will be placed in a health fund used to cover health projects and subsides Medigap policies until 2021 at a cost of $120 Million a year. The Governor received his wish and Senate Bills 1293 and 1294 were sent to his desk where they await his eventual signature.
Helmets:
Before the Legislature left for the summer break this past year they decided to take up an issue that has been on the burners of the legislature for years. They finally made a decision on the age old question, should you be required to wear a helmet while operating a motorcycle? In their opinion you should not be required since it was your individual right to determine whether you ride with a helmet or not. Senate Bill 291 made its way through the legislature going through its ups and downs, being amended several time, and at one point being used in the same conversation the changes with Auto No Fault, but in the end it was finally time according to the legislature to act on this measure. MSMS was adamantly opposed to the legislation reasoning that the having helmet on in an accident will give you the greatest chance to walk away from that accident but the Governor and Legislature did not see it that way and now today we have those who cherish their individual freedoms riding without a helmet. Time will tell if this was a wise decision for Michigan.
Graduate Medical Education:
Every year at MSMS we always face small battles when it comes to the budget, whether it’s trying to get more money for Medicaid, trying to stop the cut to public health funding, or trying to keep J-1 visa waivers in the budget we always have some small battles. One that always continued to come up and we feel will continue to, is the funding for Graduate Medical Education. The Governor has presented his last two budgets to the legislature with significant cuts to the program citing that the priority should be funding Medicaid at a higher level so that physicians will service more patients on Medicaid rather than funding the training of new physicians, fresh out of medical school. We see and understand the investment on Graduate Medical Education and what care this provides to those who need to care the most. Through work and education of the legislators we have been able to stay away from the deep cuts proposed by the Governor and only work hard to absorb small cuts from the legislature. In the coming years we will have to continue this fight to keep GME at its current level rather than seeing another cut to the program.
Affordable Care Act:
This is the only federal issue that made out list this year. We all know about the sustainable growth rate (SGR) and how we face looming cuts into Medicare but somehow Congress always finds a way to kick the can down the road. This time we think it will be the same but with the fiscal cliff casting a shadow on other impending issues, it could take some serious lifting by Congress to get this done on time.
 |
| US Supreme Court rendering opinion in Affordable Care Hearings. |
Scope of Practice:
This year the Medical Society found itself involved in looking at the future of medicine and how the team approach to care can continue to grow in Michigan. At the start of the term, physician assistants and physicians came together to find ways to grow their partnership in Medicine and came out of those discussions with Senate Bill 384 which brought more clarification on the relationship between PA's and Physicians, strengthening it, providing greater avenues to provides the best care.
Physical Therapists made an attempt this year to provide direct access for patients, bypassing the physician in House Bill 4603. Nurses also were looking for some clarification on their profession and how they fit into the team approach of medicine with Senate Bill 481. Both of these pieces of legislation did not make through the entire legislative process but MSMS is looking forward to continuing discussions with these groups to better strengthen the medical team in Michigan.
Autism:
 |
| Dr. Phillip Wise with Lt. Governor Brian Calley at the signing of the Autism Legislation. |
Claims Tax:
Starting in 2011 there were rumblings from the federal government that the use tax that was set up by Michigan to tax the insurers that held Medicaid plans in Michigan was going to be ruled illegal and could penalize the State by holding back funds for Michigan's Medicaid program. A dilemma was presented to the legislature on what to do to replace the revenue needed to obtain the funds needed for Medicaid. Thus the claims tax proposal was created. Senate Bills 347 and 348 eliminated the use tax and created a claims assessment or tax on each of the insurance claims filed at a 1% level in Michigan. This was supposed to solve the revenue shortfall that would come with the elimination of the Use Tax but that as time moved on it proved not to be the case and this year the Medicaid faces a $140 Million shortfall that has to be filled somehow. The Senate tried to move Senate Bill 1359 which would provide an adjustable rate to make the need for revenue but was rejected by the Senate Appropriations committee. The legislature continues to look for solutions for the shortfall.
Abortion:
Abortion was an issue that seemed to be on the forefront this term with the legislature as looked tightens up regulations surrounding this hot button issue. There were several bills introduced and has testimony taken but in the end, these bills were placed into one large bill House Bill 5711. This legislation took a look at four major issues the legislature felt needed to be addressed: the licensing of facilities that perform abortions, the disposal of remains, and the liability protections needed by a physician who performs abortions, and the use of telemedicine in an abortion. Those against this bill called this issue the War on Women and continued to push for its stall in the House and the Senate. Those efforts did fail and in the early morning hours of the last day of session, the House concurred with the Senate and sent the bill to be enrolled and presented to the Governor. It’s currently uncertain if the Governor will sign the legislation.
Abortion found its way into the blue cross mutualization changes mentioned above with amendments that were added by the House to require that coverage for elective abortions be an opt-in coverage rather than an opt-out situation when purchasing coverage. We will have to wait and see the impact it will have on Michiganders.
Impaired Drivers:
 |
| Dr. Spanaki testifying with Senator Schuitmaker on Senate Bills 402 & 403 |
Bullying:
A major issue for the MSMS Alliance with past term was the creation of regulations for schools on how to handle instances of bullying. House Bill 4163 was created to provide the school districts have plans in place to handle bullying and plans that are specific to their school district but meet certain requirements required in the act. In December of 2011 Michigan joined other states by have the Governor sign Matt's Safe School Law into law.
Concussions and High School Athletes:
Watching local high school sports over the past several years there continues to be a push to be faster, be stronger, hit harder and just become more physical overall. With this drive the amount of concussions happening in High School athletics was rising sharply leaving physicians, parents, coaches, and school personal concerned for the safety of the students playing athletics. This lead to the introduction of Senate Bill 1122 and House Bill 5697. Both of these pieces of legislation set into motion procedures that needed to be taken by school personal, what clearance was needed to be obtained by the athlete to compete again and what literature was needed to be provided to the athletes and parents on concussions and their treatment. We are hopeful that this will protect those athletes that want to compete at their highest levels.
With a busy legislative term over, MSMS is looking forward to what the next legislative term will bring. Some of the same issues mentioned today could very well make their way back into the legislative picture in the coming term. Stay with MSMS to get the latest information on issues going through the legislature that affect you and your practice at http://www.msms.org.advocacy. We will be taking a break now until the start of the new term, hope you all have a great new year!
Friday, December 14, 2012
Legislative Update Week of December 10th
The final week of lame duck came to a close around 4:30am today, signalling the end of the work being done by the 96th legislature of Michigan. This final day did bring a flurry of issues though the House and Senate including money for a new arena for the Detroit Red Wings, replacement for the emergency manager law, repeal of the personal property tax, and the Detroit lighting authority just to name a few, lets take a look at the issues that will effect you:
Tort Reform:
The House Judiciary committee took up the tort reform bills that made their way from the Senate. Senate Bill 1115, 1117, and 1118 were considered in committee. The committee had a litany of legislation that it needed to consider on this past Wednesday. The committee finally was able to support 1115 and 1118 and sent them to the full House for their consideration. On the last day of session the House took up the remaining bills in the package and by 5:10pm, the House was sending to the Governor legislation that would be the most substantial tort reform that Michigan has seen for medical malpractice since the early nineties. Rumors have been floating around that the two other bills that did not make it through the process will be reintroduced in the coming term.
Abortion:
The House and Senate this week traded legislation, House Bill 5711, that addressed several issues surrounding abortion. One would make it illegal to perform an abortion on a woman who has been coerced into receiving one. Secondly there would be licensing requirement for those facilities that would perform abortions and would require reporting to the Department of Community Health. More information on the legislation can been seen at the link above.
Conscientious Objectors:
The House Insurance committee considered Senate Bill 975 which would provide the protection to physicians who chose not to perform a certain procedure due to a religious or moral objection. MSMS submitted a letter to the committee expressing some concerns we had with the legislation but more importantly praised the efforts of the sponsor of the legislation with his willingness to work with the medical community to address those concerns. The legislation did make it out of committee but did not make it out of the House. MSMS expects to work again with the sponsor in the coming term on the legislation.
With the legislative term coming to a close, we will be taking a break for a little bit. Check in next week as we will have a review of the legislative term discussing the issues that MSMS has worked on for the past two years. Comments are always welcome and we want to hear from you. We have a comment section with every article, please feel free to leave one. Keep up with all advocacy efforts at http://www.msms.org/advocacy.
Tort Reform:
The House Judiciary committee took up the tort reform bills that made their way from the Senate. Senate Bill 1115, 1117, and 1118 were considered in committee. The committee had a litany of legislation that it needed to consider on this past Wednesday. The committee finally was able to support 1115 and 1118 and sent them to the full House for their consideration. On the last day of session the House took up the remaining bills in the package and by 5:10pm, the House was sending to the Governor legislation that would be the most substantial tort reform that Michigan has seen for medical malpractice since the early nineties. Rumors have been floating around that the two other bills that did not make it through the process will be reintroduced in the coming term.
Abortion:
The House and Senate this week traded legislation, House Bill 5711, that addressed several issues surrounding abortion. One would make it illegal to perform an abortion on a woman who has been coerced into receiving one. Secondly there would be licensing requirement for those facilities that would perform abortions and would require reporting to the Department of Community Health. More information on the legislation can been seen at the link above.
Conscientious Objectors:
The House Insurance committee considered Senate Bill 975 which would provide the protection to physicians who chose not to perform a certain procedure due to a religious or moral objection. MSMS submitted a letter to the committee expressing some concerns we had with the legislation but more importantly praised the efforts of the sponsor of the legislation with his willingness to work with the medical community to address those concerns. The legislation did make it out of committee but did not make it out of the House. MSMS expects to work again with the sponsor in the coming term on the legislation.
With the legislative term coming to a close, we will be taking a break for a little bit. Check in next week as we will have a review of the legislative term discussing the issues that MSMS has worked on for the past two years. Comments are always welcome and we want to hear from you. We have a comment section with every article, please feel free to leave one. Keep up with all advocacy efforts at http://www.msms.org/advocacy.
Friday, December 7, 2012
Legislative Update Week of December 3rd
 |
| View of the wait into the House gallery. |
House:
The House Insurance committee finally meet after session on Wednesday to bring the agreement that the House, Senate, and Governor could agree to. The committee passed the legislation to the House Floor where it was amended again with final language that needed to be added. What was added? A fix for those who have medigap policies. The bill now requires the fund set up by the conversion to pay $120 Million yearly to subsidize the medigap policies until 2018. The House also added an elective abortion amendment that would require those who want to have coverage for an elective abortion to "opt in" for that coverage. The package will now head to the governor's desk for his signature.
The House Health Policy committee was scheduled to meet but with the Right to Work legislation being worked on that day, the committee was canceled.
Senate:
The Senate had a couple other items on their agenda that was health related this week, but as it was with the House, it was all about Right to Work. The Senate passed a series of three bills that made it illegal for those in the health insurance exchange to offer coverage for elective abortions unless the patient purchased an "opt in" coverage for the procedure. The package was sent to the House where it could be taken up since the House did consider some other controversial abortion regulations earlier in the year.
The Senate also considered and passed Senate Bill 975 despite some objections from the major medical groups. What this legislation would do, would provide protections for a physician who chooses not to treat a patient based on their religious beliefs. This raised several concerns to Senator , Kahn, a cardiologists, on the Senate floor saying that it goes against the oath that physician's take before entering into practice. The bill will now be sent to the House where with limited time in the legislative year probably will stay.
The House and Senate have one more week to consider items before they leave for the year. Tort Reform is expected to be taken up this week. Stay with MSMS at http://www.msms.org/advocacy to get the latest information on all of the action happening at the Capitol.
Friday, November 30, 2012
Legislative Update Week of November 26th
The first week of the legislative lame duck term was off and running right away this week. The House and Senate started working on several issues including some issues important to physicians around Michigan. Wayne State Medical School also made it up to the Capitol this week providing their insight to lawmakers on issues like tort reform and graduate medical education. Let's jump right into it.
House:
The House started their week of long goodbyes from members that will not be returning to Lansing at the end of the year. The House did consider and pass Senate Bills 402 and 403 that would provide protections to physicians to report patients to the Secretary of State, in their opinion, the patient should not be operating a motor vehicle. The package will now make its away to the Governor's desk where all indications are that the legislation will be signed.
The House Health Policy committee met on Thursday with an extensive agenda but ended up only considering Senate Bill 693, a bill that would create a health insurance exchange in Michigan. Testimony was impassioned by those who were against not just the exchange but the entire Affordable Care Act asking the members of the committee not to vote for the bill. The testimony continued and extended the comments that were made about the subject earlier on in the year to the end of committee, where Chairwoman Haines called for a vote on the bill. The bill failed to gain support out of committee with a count of 9 against, 5 in favor, and 2 passing. The Speaker put out the following statement:
The committee adjourned for the day after the vote where rumors were that it would be the last House Health Policy committee for the term. MSMS will continue to monitor the activity of the committee.
The House Insurance committee also came into session on Thursday this week and went to recess right away. The committee did not reconvene once the House session started due to what some say was a lack of a substitute bill for the Blue Cross/Blue Shield conversion. The committee will be scheduled to meet in the coming week.
Senate:
The Senate brought a dogfight to the floor between interest group by working on Senate Bills 1115, 1117, and 1118. These are three out of the four tort reform bills that MSMS has been supporting and working on. After hard work between the groups some compromises were made and placed in the bills. The Michigan Association of Justice was able to get some more amendments placed into the legislation that were not favored by MSMS. With the amendments being added the Senate voted all three bills to the House where the work will continue. MSMS will be working to take out some of the harmful amendments added during the Senate session.
The Senate Appropriations committee met to consider Senate Bill 1359, among others, which provided a fix for the Insurance Claims Tax that was added to replace the Medicaid Use Tax. The Senate Fiscal Agency along with the Michigan Department of Treasury projected that with the $400 Million that needed to be made up with the repeal of the use tax the state was going to be $144 Million short in funding for the current fiscal year. The committee heard testimony from General Motors being opposed to the legislation since it would be a cost for them since they self insure their employees. At the end of the committee there were pretty strong signs that getting a fix for the Claims tax was going to be difficult.
The Senate Health Policy committee also met this week to consider House Bill 5315 and Senate Bill 975. MSMS commented to the committee that it has concerns with SB 975 but that we were working with the sponsor to find a solution to our differences. Both pieces of legislation were passed to the full Senate on party lines.
Wayne State Lobby Day:
Wayne State brought some of their up and coming physicians to the
Capitol to have meetings with legislators and to lobby them on two issues that
they felt were important to them, Tort Reform and Graduate Medical Education.
With over 65 students invading the Capitol, several groups of students were
able to meet with members directly in their offices, while other groups caught
them in the lobby of the Senate and House as they made their way out of the
chambers.
Later in day Dr. Bizon and Dr. Elmassian joined the students to share
their thoughts on the future of medicine, why it was important to be lobbying
to the legislature, and how they can make a difference in their community. Both
were able to join the students later in the afternoon to work with them
and support their efforts to lobby the legislature. Dr. Elmassian commented on
how he was impressed with the turnout from the students and how we needed to
continue to have efforts like this moving forward. "All schools should be
thinking of doing this, it would be great for medicine and their future as
physicians."
Next week should bring more activity in the legislature, stay with MSMS to get the up to date information including when committee meetings are and what they are considering for the day on the House and Senate floors. Go to http://www.msms.org/advocacy to get all of the information you need.
House:
The House started their week of long goodbyes from members that will not be returning to Lansing at the end of the year. The House did consider and pass Senate Bills 402 and 403 that would provide protections to physicians to report patients to the Secretary of State, in their opinion, the patient should not be operating a motor vehicle. The package will now make its away to the Governor's desk where all indications are that the legislation will be signed.
The House Health Policy committee met on Thursday with an extensive agenda but ended up only considering Senate Bill 693, a bill that would create a health insurance exchange in Michigan. Testimony was impassioned by those who were against not just the exchange but the entire Affordable Care Act asking the members of the committee not to vote for the bill. The testimony continued and extended the comments that were made about the subject earlier on in the year to the end of committee, where Chairwoman Haines called for a vote on the bill. The bill failed to gain support out of committee with a count of 9 against, 5 in favor, and 2 passing. The Speaker put out the following statement:
“It was my hope the committee
would find that a state-run exchange afforded us more control over the
unacceptable over-reach by the federal government regarding the health care of
Michigan citizens,” Mr. Bolger said in a statement. “After due diligence, however,
it is clear that there were too many unanswered questions for the (Health
Policy) committee to feel comfortable with a state-run exchange and we will not
have one in Michigan.”
The committee adjourned for the day after the vote where rumors were that it would be the last House Health Policy committee for the term. MSMS will continue to monitor the activity of the committee.
The House Insurance committee also came into session on Thursday this week and went to recess right away. The committee did not reconvene once the House session started due to what some say was a lack of a substitute bill for the Blue Cross/Blue Shield conversion. The committee will be scheduled to meet in the coming week.
Senate:
The Senate brought a dogfight to the floor between interest group by working on Senate Bills 1115, 1117, and 1118. These are three out of the four tort reform bills that MSMS has been supporting and working on. After hard work between the groups some compromises were made and placed in the bills. The Michigan Association of Justice was able to get some more amendments placed into the legislation that were not favored by MSMS. With the amendments being added the Senate voted all three bills to the House where the work will continue. MSMS will be working to take out some of the harmful amendments added during the Senate session.
The Senate Appropriations committee met to consider Senate Bill 1359, among others, which provided a fix for the Insurance Claims Tax that was added to replace the Medicaid Use Tax. The Senate Fiscal Agency along with the Michigan Department of Treasury projected that with the $400 Million that needed to be made up with the repeal of the use tax the state was going to be $144 Million short in funding for the current fiscal year. The committee heard testimony from General Motors being opposed to the legislation since it would be a cost for them since they self insure their employees. At the end of the committee there were pretty strong signs that getting a fix for the Claims tax was going to be difficult.
The Senate Health Policy committee also met this week to consider House Bill 5315 and Senate Bill 975. MSMS commented to the committee that it has concerns with SB 975 but that we were working with the sponsor to find a solution to our differences. Both pieces of legislation were passed to the full Senate on party lines.
Wayne State Lobby Day:
|
| Wayne State students speak with Senator Smith. |
 |
| Drs Bizon and Elmassian addressing the Wayne Students. |
Next week should bring more activity in the legislature, stay with MSMS to get the up to date information including when committee meetings are and what they are considering for the day on the House and Senate floors. Go to http://www.msms.org/advocacy to get all of the information you need.
Tuesday, November 20, 2012
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.
Monday, November 19, 2012
Legislative Update Special Edition (Election Wrap-Up)
As the election results get finalized, we wanted to pass
along to you the unofficial results from the recent election. As you’re
well aware, President Barack Obama soundly defeated Governor Mitt Romney here
in Michigan, but here are other noteworthy elections in the state last night:
·
Senator Debbie Stabenow also scored a strong
victory over former Congressman Pete Hoekstra.
·
The state Supreme Court returned Justices
Markman and Zahra to the bench and Democratic nominee Bridget McCormack locked
up the third open seat on the court. The Republicans retained their 4-3
majority on the high court.
·
All six ballot proposals were
defeated.
The House Republicans retained their majority by a 59-51
advantage (down from 64-46). Here are some of the key races highlighted:
·
House District 76 - Representative Roy
Schmidt was defeated by Democrat Winnie Brinks. DEMOCRATIC PICK-UP.
·
House District 84 - Republican Dan
Grimshaw was defeated by former Representative Terry Brown. DEMOCRATIC
PICK-UP.
·
House District 101 - Representative Ray
Franz (Republican) defeated Democrat Allen O’Shea 51%-48%. REPUBLICAN
HOLD.
·
House District 91 - Representative Holly
Hughes (Republican) was defeated by Democrat Colleen LaMonte in a razor thin
contest by 333 votes. DEMOCRATIC PICK-UP.
·
House District 57 - Representative Nancy
Jenkins (Republican) faces former Democratic State Senator Jim Berryman.
Ms. Jenkins prevailed by over 2000 votes. REPUBLICAN HOLD.
·
House District 71 - Representative Deb
Shaughnessy (Republican) faced a rematch with her 2010 opponent, Democrat
Theresa Abed, whom she narrowly defeated. Representative Shaughnessy was
defeated by more than 3000 votes. DEMOCRATIC PICK-UP.
·
House District 63 – Republican Speaker of
the House Jase Bolger faced Democrat Bill Farmer on Tuesday. Speaker
Bolger survived a scare by 800 votes. REPUBLICAN HOLD.
·
House District 110 - Representative Matt
Huuki faced Democrat Scott Dianda. Mr. Dianda capitalized on the
increased turnout and defeated Representative Huuki by just over 1000
votes. DEMOCRATIC PICK-UP.
·
House District 52 - Representative Mark
Ouimet (Republican) faced Democrat Gretchen Driskell in this that covers parts
of Washtenaw County. Ms. Driscoll defeated Representative Ouimet by over
3000 votes. DEMOCRATIC PICK-UP.
·
House District 39 - Republican Klint
Kesto faced Democrat Pam Jackson in this open seat previously held by a
Democrat which includes West Bloomfield, Commerce and Wixom in Oakland
County. Mr. Kesto prevailed by almost 3000 votes. REPUBLICAN PICK-UP.
·
House District 25 - Republican Sean Clark
faced off against Democrat Henry Yanez in this seat consisting portions of
Sterling Heights and Warren. Mr. Yanez prevailed by just over 1000 votes.
DEMOCRATIC HOLD.
·
House District 67 - Republican Jeff
Oesterle faced Democrat Tom Cochren in this seat covering southern Ingham
County. Mr. Cochren defeated Mr. Oesterle by over 5000 votes. DEMOCRATIC
HOLD.
·
House District 103 - Representative Bruce
Rendon faced Democrat Lon Johnson in this seat that includes Kalkaska,
Crawford, Missaukee, Roscommon, and Ogemaw Counties. Representative Rendon
defeated Mr. Johnson by over 2500 votes. REPUBLICAN HOLD.
·
House District 108 - Representative Ed
McBroom faced Democrat Sharon Gray in this seat covering the Southwest Upper
Peninsula of Michigan. Representative McBroom defeated Ms. Gray by over 3500
votes. REPUBLICAN HOLD.
·
House District 70 - Representative Rick
Outman (Republican) faced a rematch versus former Representative Mike
Huckleberry (Democrat) in this seat that includes Montcalm and parts of Gratiot
Counties. Representative Outman defeated Mr. Huckleberry by just under
3000 votes. REPUBLICAN HOLD.
·
House District 23 - Representative Pat
Somerville (Republican) defeated Democrat Tom Boritzki . REPUBLICAN
HOLD.
·
House District 106 - Representative Peter
Pettalia (Republican) defeated Democrat Kenneth Hubbard in this seat covering
Iosco, Alcona, Alpena, Presque Isle, and Cheboygan Counties. REPUBLICAN
HOLD.
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