Crain’s Forum – Election 2020: Nationalizing Michigan’s issues

With the General Election upon us and as we weather the COVID-19 pandemic, it’s time to frame the important policy considerations for the President and Congress in 2021. It should be no surprise that health care remains front and center with Michiganders continuing to worry about access, quality and cost of their care.   

No matter who is President or the makeup of the United States Congress in 2021, the private sector and the government must continue to work together to ensure that Michiganders and all Americans can maintain access to their health care coverage. We should build on and improve what’s working so that private coverage, Medicare and Medicaid can work together to expand access to coverage.  

The President and Congress should resist the urge by some to start over with a one-size-fits-all government health insurance system. Whether it’s called Medicare buy-in, Medicare for All, or the Public Option, these approaches will not expand access, improve quality or lower costs.  Studies by FTI Consulting and the Partnership for America’s Health Care Future have shown that a Public Option would threaten access to quality care by broadly cutting provider fees and putting hospitals and health care providers at greater risk of closure. 

Just as a one-sized-fits-all government health insurance system is not the answer, the President and Congress should avoid repeal of the Affordable Care Act (ACA), and instead focus their efforts on fixing the parts that are not working. Studies by the University of Michigan have continued to show that key provisions of the ACA are responsible for reducing the uncompensated care at hospital across Michigan by more than 50 percent.   

Thanks to the ACA and state action, 800,000 Michiganders, many working in low paying jobs, have access to health care through the Healthy Michigan Plan. The program continues to generate net financial savings to the State. Repealing the ACA will eliminate these advances in access, cost and quality. Congress can help control costs with carefully targeted legislation to address clear abuses of the system.  

Michigan just made health care headlines with a new law, passed with bi-partisan support, that will end the practice of surprise billing – the bill you get when one of your providers is not in network and you weren’t told until treatment. Our law will stop that, but assure providers get reimbursed for reasonable costs while saving dollars. Congress could move in that direction nationally, and add in air ambulance fees, which are controlled by the federal government. A recent study found 40 percent of helicopter air ambulance trips resulted in surprise bills averaging $20,000.  

Similarly, Congress could enhance access while lowering costs by ending the Originating Site Rule for Medicare. This would allow Medicaid providers to deliver telehealth service from the safety of their home rather than having to be in an office. 

The pandemic has created unimaginable stress on our health care systems. Enormous losses in employer sponsored Insurance coverage have been slowed by the temporary COBRA coverage as well as ACA-created alternatives in Medicaid and individual markets. The President and Congress should work towards ensuring that employers can financially maintain employer-sponsored coverage, even if that means considering federal subsidies to employers. Repealing the ACA, or embracing a one-sized fits-all government health insurance system would reduce access to care and leave many Michiganders worse off.  

We should stay the course with improving access to healthcare by supporting what is working. Our leaders in Washington D.C. should reject policy proposals in 2021 that would leave Michiganders paying more for lower quality care. We must work together to expand access, improve quality, lower costs and protect patient choice. 

– Dominick Pallone, Executive Director, Michigan Association of Health Plans