State Unveils Plans For 2018 Healthy Michigan Marketplace Option

LANSING – With changes required to take place starting in April 2018 for some Healthy Michigan enrollees who will have to get coverage in a new marketplace arrangement that includes a health care savings vehicle, the Michigan Department of Health and Human Services is calling for comments on its plan.

Titled the Healthy Michigan Plan Second Waiver Operational Protocols, the plan will require current Healthy Michigan recipients who have been on the plan for at least four years and who do not meet healthy behavior requirements to seek coverage through a marketplace.

That marketplace will consist of insurance companies that will provide coverage to enrollees moving from Healthy Michigan and include a component called MI Health Account that will be “a unique health care savings vehicle through various cost-sharing requirements, which include co-pays and additional contributions for beneficiaries with higher incomes ….”

Officials familiar with the overall proposal said between 20,000 and 30,000 current enrollees of Healthy Michigan whose incomes are 100 percent of the federal poverty level and who have not elected and attested to engaging in a healthy behavior, such as stopping smoking, could be affected by the switch. Even if a person’s income is 100 percent of the poverty level, they could still be enrolled in Healthy Michigan so long as they were engaging in a healthy behavior.

The state is calling for public comments on the proposed plan by September 7.

The “second waiver” referred to in the title is the second waiver granted to the Healthy Michigan plan by the federal Centers for Medicare and Medicaid Services. The waiver requires that the entire state be covered by the marketplace created for those who would no longer be on Healthy Michigan.

Insurance companies wanting to provide that coverage had until this past Tuesday to file proposed rates with the Department of Insurance and Financial Services. Until DIFS determines that the rates filed meet requirements, the state will not know if adequate coverage will be available.

If the state finds itself without adequate coverage for the marketplace, it will need to meet with CMS officials to see what steps can be taken to maintain Healthy Michigan, DHHS spokesperson Angela Minicuci said.

The MI Health Account system will be managed by the firm Maximus, and will be funded through deductibles and co-pays paid by enrollees in the new marketplace.

Comments are to be sent to the state’s Medical Services Administration.

This story was published by Gongwer News Service.