LANSING – A newly-signed Massachusetts law requiring universal health insurance coverage for all residents has “changed the calculus” of the issue in Michigan, and officials here are going to watch with interest how the new system develops in the Bay State with an eye towards the future possibility of attempting a similar proposal in Michigan.
No one is yet willing to endorse a proposal similar to the Massachusetts plan here, but several people said the fact that a Democratic Legislature and Republican governor – and one with a Michigan connection – could reach agreement on the issue means a similar consensus could be reached in Michigan.
No matter who is governor a year from now, said Kevin Kelly of the Michigan State Medical Society, “universal coverage will be a topic.”
Gov. Jennifer Granholm’s administration already is working on a proposal that could provide insurance coverage to some 500,000 uninsured Michigan residents. A spokesperson for the Department of Community Health said a proposal for universal coverage may be the next logical step for the state to consider.
But again, officials are proceeding cautiously, wanting to see how the system in Massachusetts gets up and running.
Senate Majority Floor Leader Sen. Bev Hammerstrom (R-Temperance) was in Boston last week for another purpose and spoke a with a member of that state’s Senate about the universal coverage. “She was pretty excited about it, so I started paying more attention,” Ms. Hammerstrom said. “It’s an interesting concept.”
Rep. Ed Gaffney (R-Grosse Pointe Farms), chair of the House Health Policy Committee, said: “I’m kind of excited about it. I’m anxious to see it come through. Health care insurance shouldn’t only be for the rich.”
A spokesperson for the Democratic vice chair of the House committee, Rep. Stephen Adamini (D-Marquette), said he had requested a copy of the Massachusetts law and hopes to talk to administration officials about the proposal.
The law that Governor Mitt Romney, son of Michigan’s former Governor George Romney, signed on Wednesday, would create a lower-cost state health insurance system and require residents who are not covered by other means to either purchase a low-cost policy or pay a state tax penalty. Mr. Romney vetoed a portion of the bill that would have required companies with 11 workers or more to provide health insurance.
While there has been controversy over the bill, with a number of economists questioning the true cost of the measure, it has also generated significant praise. An economics column in the New York Times said the legislation deals deftly with two critical components of universal coverage: the cost and ensuring that people actually have the coverage by assessing a penalty to those that do not acquire the coverage.
That is a provision that does have a number of people in Massachusetts worried, however. A recent national radio talk show heard from a number of people in the commonwealth, some unemployed, who questioned how they would be expected to pay for the required policy.
Granholm identified dealing with the uninsured as a priority in her January State of the State address. Her Michigan First proposal, which would require a federal waiver to implement, is slated to provide insurance coverage for about 500,000 people, half the estimated 1 million that are without coverage now.
While administration officials had hoped they would apply for the waiver at the end of April, the actual application will occur later as state and federal officials are still in discussions on the proposal.
T.J. Bucholz, spokesperson for DCH, said the administration’s focus is now on the Michigan First proposal, but a universal coverage proposal could “be the next logical step.”
While the dispute over universal coverage has long festered in national politics, Mr. Bucholz said a number of states now recognize the linkage between insurance coverage and overall health care and state costs.
The medical community is also intrigued by the proposal. Kelly said universal coverage is one of four themes the organization has chosen as part of its future of medicine program. The society is also planning to create a workgroup on essential coverage, he said.
The Massachusetts act is important because it shows universal coverage can be accomplished on a bi-partisan basis, he said.
Finding a way to provide health insurance coverage is critical, Mr. Kelly said, because “when you have one million people without coverage it is tearing apart an already fragile system.”
Kevin Downey, a spokesperson for the Michigan Health and Hospital Association, said his organization is still reviewing the law and has no official stance yet.
“The concept is a good one,” Mr. Downey said. “It makes more sense to address health care costs up front through prevention, health screenings, regular sources of primary care rather than the uninsured waiting for their conditions to worsen before seeking treatment.”
Gaffney said Romney supporting the bill does add to its intrigue. “Mitt Romney is a reasonable guy, a conservative guy,” he said.
Hammerstrom said there are some factors in Michigan that would have to be addressed before such a proposal could be adopted here. For example, Blue Cross/Blue Shield of Michigan is the state’s insurer of last resort and has tax benefits for that. How the company would be affected would have to be studied, she said.
And Ms. Hammerstrom said she is interested in finding a way to expand the use of health savings accounts, but making sure that those accounts remain practicable by not requiring deductibles so large they essentially provide no help to lower income individuals
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