Michigan Gov. Rick Snyder today said the state will move forward to create a key component of the Affordable Care Act —a health exchange where people can buy insurance at reasonable rates.
But he said the entire law “misses the point on the most important reforms needed in our health care system.” Without more cost controls, the nation’s and state’s economic recovery is in jeopardy, he said.
Snyder’s statement did not say whether Michigan may need to ask the federal government to help Michigan run the exchange, a largely Web-based program where consumers and small business owners can compare insurance prices and benefits and buy coverage.
Both Marianne Udow-Phillips, director of the Center for Healthcare Research & Transformation and one of Michigan’s leading health policy specialists, as well as Kirk Roy, who oversees implementation of the law for Blue Cross Blue Shield of Michigan, said Michigan risks having the federal government run an exchange for it if the state doesn’t move quickly to implement the law. If Michigan doesn’t act quickly, “we’ll have the federal government do it for us,” Udow-Phillips said.
States can create the exchanges on their own; default and let the federal government run one or states can use some private and public partnership to do it.
The exchanges are projected to serve an estimated 12 million Americans in 2014, when the individual mandate takes effect. The number is likely to grow to 28 million by 2019, according to White House estimates.
The law provides tax credits and discounts on co-pays to help people buy insurance if they earn less than 400% of the federal poverty level (those with monthly incomes under $373 a month or $7,683 for a family of four.)
Michigan has received $999,772 to start the program but the legislature last year decided not to accept nearly $10 million in federal funds awarded to the state to create an exchange. Legislators said they preferred to wait for the Supreme Court ruling.
Michigan is unlikely to meet a Friday deadline to apply for money for the exchanges but new grant opportunities will be announced soon, according to a spokesman for the U.S. Department of Health and Human Services.
The idea behind the exchanges is to make a complicated process as helpful and simple as possible. Small staffs would help take phone calls for those needing more help. The exchanges also would help determine quickly a person’s eligibility for Medicaid and point them to an application.
Here’s how an exchange works:
Policies sold through the exchanges would offer certain essential benefits determined by states or exchange boards. They would come in four different price ranges. The products would be easily identified with labels: from bronze, the most reasonable, and silver, gold and platinum, the costliest and most comprehensive.
Michigan’s Department of Financial and Regulatory Affairs currently is seeking public comment on what benefits must be offered in these plans. People can view a comparison of essential health benefits plans at the State of Michigan website.
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