Lansing Lines is presented in cooperation with MIRS, a Lansing-based news and information service.
Homeless Youth Could Receive Health Care Under Bill
Homeless youth would be able to access health care without parental consent under a bill sponsored by Rep. Amos Oneal (D-Saginaw) that is part of a bill package sponsored by Rep. Lori Stone (D-Warren) and Rep. John Roth (R-Interlochen).
Under HB 4085 , HB 4086 and HB 4087 , homeless or runaway youth between the ages of 16 and 21 would have to establish with the child care institutions’ staff that they do not have access to a safe living environment with their parent and have no other safe alternative living arrangement besides a homeless youth shelter in order to qualify for health care and supervision.
The bills would not apply to individuals involved in juvenile justice or foster care systems.
“Prior to becoming a homeless youth, I hadn’t been to the doctor in years. Within days of joining the transitional living program, I was seen by a doctor,” said Spencer Calhoun, board member at Comprehensive Youth Services and former homeless youth.
The bill would allow the youth to receive medical, dental or behavioral health examinations, care or treatment.
The bill would not provide access to abortion for homeless or runaway youth without parental consent.
Another bill in the package extends the window during which a homeless or runaway youth can receive care from a child caring institution to 72 hours rather than the current 24 hours while staff in the institution attempt to contact the parent or guardian of the youth to establish consent for the child to participate in the program.
“It’s a little concerning that someone who is 16 or 17 years old can have access to health care without their parents’ knowledge,” said Rep. Jamie Thompson (R-Brownstown).
The programs are intended to get the parents involved as quickly as possible, but urgent medical concerns can still be addressed while communication is being established, said Ben Moe, president of Michigan Network of Youth and Families.
Rep. Stephanie Young (D-Detroit) said she could see a situation where an asthmatic child leaves a dangerous home situation but still needs access to an inhaler to breathe, for which the bill would accommodate.
If the parent or guardian of the homeless or runaway youth was contacted and did not consent to the child receiving services or care from the child caring institution, the parent or guardian would still have the right to take the child home. If the institution detected a safety issue for the child, then Child Protective Services would be contacted.
Catholic Conference Polling Shows Support For Existing Abortion Restrictions
New polling shared by the Michigan Catholic Conference found at least a two-thirds majority of Michiganders support parental consent requirements for minors, 24-hour waiting periods and licensure practices.
The March 13-17 poll of 599 Michigan voters, conducted by Marketing Resource Group, had a +/- 4% margin of error.
When told Proposal 3 of 2022 “legalized abortions with virtually no restriction,” voters were asked to indicate their support or opposition of practices to regulate abortions, including:
“Requiring parents to consent to their minor-age child having an abortion?”
A total 67% of respondents said they supported parental consent requirements, including 54% strongly supporting and 14% somewhat supporting.
Another 26% were opposed, including 18% in strong opposition and 8% somewhat opposing. A total of 4% neither supported or opposed parental consent requirements, while an additional 4% said they did not know and the final 2% refused to answer.
Of those responding to the question in support, 60% said they voted yes on Proposal 3.
Voters were also asked if they supported, “a regulation that requires a 24-hour waiting period to allow for informed consent before a woman receives an abortion?”
Of respondents, 63% said they supported a waiting period, including 41% that strongly supported and 22% that somewhat supported.
Another 21% said they strongly opposed it, while 4% said they somewhat opposed and 5% said they neither supported nor opposed. Another 3% did not know either way, and the final 3% refused to answer.
Of those supportive, 65% were either pro-choice voters or Proposal 3 supporters.
The final question asked of respondents was if they would support “a regulation that requires that abortion facilities be licensed and inspected by the state for health and safety reasons?”
A total of 90% supported licensure for abortion care facilities, with 84% strongly supporting and 6% somewhat supporting.
Another 3% strongly opposed licensure, and 1% somewhat opposed licensure.
While 2% neither supported or opposed, 2% did not know and another 2% refused to answer.
Of those in support, 97% said they were also either pro-choice voters or Proposal 3 supporters.
In total, 277 of the survey respondents, or 46.2%, said they voted yes on Proposal 3 in November, while 218 voters, or 36.2%, said they voted no. Proposal 3 passed 56.7% to 43.3%.
Another 336 voters, or 56.1% of the 559 surveyed, said they would consider themselves “pro-choice,” while 222 voters (37.1%) said they were “pro-life.”
Three-quarters of the responses came from cell phones, and 49% of respondents were from metro Detroit, with another 22% from Grand Rapids, Kalamazoo and West Michigan.
Rebecca Mastee, a Michigan Catholic Conference policy advocate, said the support from even pro-choice voters made it clear that “legislative protections for parents, women and children should remain in place,” adding that lawmakers must decide if they stand with a majority of voters in support of reasonable guardrails for abortion care.
She said the polling is in response to renewed efforts by advocacy groups to remove parental consent requirements and waiting periods, which she said goes against past claims that abortion should be treated like other forms of health care.
“If abortion rights advocates want abortion to be treated like any other medical procedure, why would they want to get rid of informed consent and parental consent for minors, which are both standard and expected medical practices?” Mastee asked.
Steckloff Makes Powerful Personal Plea For Oral Chemotherapy Parity
Rep. Samantha Steckloff (D-Farmington Hills) rattled a House committee this afternoon with powerful testimony on how taking oral chemotherapy to fight back her cancer has allowed her to live life again.
In advocating for legislation mandating oral chemotherapy be covered by insurers at the same level as intravenous (IV) chemo, Steckloff was driven to tears retelling her story about how taking IV chemo was so debilitating she lost a job at Wayne State University she loved because she ran through her sick days.
This was on top of everything else the chemo treatment did to her.
“My breasts had been removed. My fertility was gone. My hair was gone. My eyebrows. My eyelashes. My toenails. Everything was gone,” she said, her voice cracking. “Everything was gone. It was everything that we still often hold dear to us as women was gone . . . ”
“IV chemo sucks,” she said. “It sucks.”
When Steckloff finished, House Health Policy Committee Chair Julie Rogers (D-Kalamazoo) thanked Steckloff for delivering her “powerful” testimony. The committee had run up against its time limit, which was likely for the best. The only thing anybody wanted to do after Steckloff got done was give her a hug. Several people lined up to do exactly that.
Three other cancer survivors hung around the committee room with Steckloff for a while after adjournment so they could decompress together.
For at least 14 years, health professionals and patients have pushed for insurance parity between IV and oral chemo, but concerns from the Michigan Chamber of Commerce about the sky-high prices for some of these treatments have kept the legislation stuck in neutral.
Steckloff said all but seven other states have figured it out, and the increase in premium costs are “pennies on the dollar.” The benefit to cancer survivors like herself is night and day.
“I get to make a change. I get to have friends. I get to see my friends. I get to see my family,” she said. “I get a paycheck. I don’t have to worry about missing votes. I don’t have to worry about missing work.”
Steckloff ended her testimony by sharing her “why,” an answer she grappled with for years after being diagnosed.
“At some point, you’re going to ask yourself, ‘why me? What did I do to deserve this?’” she said. “I asked myself that question for years.”
Steckloff said that it wasn’t until two years ago, when she testified on a similar bill to this one, that she found her why.
“I was in the elevator with two representatives from the other side of the aisle and they said to me, ‘Your testimony changed my vote,’” she said.
“This isn’t just ‘battling cancer.’ It’s about living with cancer, and the quality of life that comes along with it,” Steckloff said.
Steckloff was joined by several other cancer survivors to speak about HB 4071 . Steckloff said that prior to her diagnosis, she was single, working at Wayne State University, with a recently purchased condo, many friends and a life she was proud of.
“I felt like I was invincible,” she said.
Then, suddenly, she was forced to think about her fertility after a breast cancer diagnosis, having treatments to harvest her eggs and undergoing a double mastectomy, along with losing her hair due to IV chemotherapy.
She went through eight rounds of IV chemotherapy.
Steckloff said that in addition to struggling with the chemotherapy itself, she was forced to continue working to receive her healthcare benefits.
She balanced the days off required for her treatment with long hours working, even passing out in stairwells to fight the slowly dwindling sick days she was allotted.
But eventually they ran out, and Steckloff said she was let go.
“It’s impossible to work through IV chemo,” she said.
Now, Steckloff is on oral chemotherapy medication, which she told MIRS in February is only covered by her insurance because there isn’t an IV alternative available for that particular medication.
She said intravenous chemotherapy at a hospital or clinic is covered by insurance and is cheaper because it’s billed as a service. But oral chemotherapy is not covered unless it’s the only choice, and it often comes with a higher out-of-pocket cost because it’s billed as a drug.
Steckloff’s bill places a $150 cap on co-pay for a 30-day supply of orally administered anticancer drugs beginning Jan. 1, 2025, with language ensuring that increasing cost-sharing requirements or imposing stricter treatment limitations isn’t an option for health insurance providers.
During testimony on the bill, Steckloff was joined by Dr. Jerome E. Seid, a hematologist and medical oncologist with Ascension Medical Group, who said oral chemo agents now make up approximately 25% of treatment recommendations.
However, due to price and higher cost-sharing requirements, they are still “out of reach for many desperate patients,” he said.
But price controls only on the insurers included in the bill does not address the fundamental problem, which is the soaring cost of prescription drugs, said Christine Shearer, deputy director of legislation and advocacy with the Michigan Association of Health Plans.
She said the association opposes the bill package, in part because it doesn’t affect Medicare, Medicaid, TRICARE and other similar programs.
The bill would only help 0.06% of Michigan’s population, she said, while allowing drug manufacturers to hide behind insurance companies “and their profit margins will only drive up the cost of coverage and premiums.”
Seid disagreed, saying that the increased number of Michiganders who can’t afford treatment due to prohibitive costs will result in worse outcomes, higher rates of hospitalization and “conversely, higher costs to insurance, and that’s contrary to some of the arguments you may hear in opposition to this bill.”
The legislation has been brought to life nearly every session in some form since its first introduction in 2009 but has never made it across the finish line.
Seid said committee members now are in a position to give Michigan cancer patients the treatment they deserve after so many unsuccessful iterations of the bill.
End Of ‘Pandemic Status’ To Hit Medicaid Recipients Most
The federal emergency pandemic orders ended May 11, but unless you were one of the 3.1 million Michiganders on Medicaid you probably wouldn’t have even noticed, and even then you may not have realized it immediately.
Michigan Association of Local Public Health Norm Hess said any further public agency response to COVID-19 would look a lot like the seasonal flu, but would still require vigilance because of mutations, but if people wanted to get treatment or certain tests, they will need to start using insurance.
“The public health emergency declaration ending, I don’t think it’s going to seem like a big jolt to most people,” Hess said.
However, Michigan Department of Health and Human Services Chief Deputy Director for Health Farah Hanley said starting in June, every Medicaid recipient will need to return to a yearly redetermination schedule.
Hanley said in 2020, before the pandemic orders, there were about 2.2 million recipients on the books. She said people eligible for Medicaid after the emergency orders had grown by about 800,000 people and the Medicaid caseload had grown 100,000 since March.
“Some of the 2.2 million people who are on Medicaid might be deemed ineligible this summer, but some of the 800,000 people might be deemed that they should stay on Medicaid,” she said.
She said the redeterminations will take up to 12 months, with each month seeing the number of people who signed up in that month. Letters were sent to recipients three months prior to the time when the redetermination would take place.
She said there are about 100 various-sized Medicaid health plans that are also being looked over because of the emergency health orders ending.
Hanley said Medicaid health plans would reach out to those deemed ineligible or have a plan that is ending and they would be directed to the insurance marketplace.
“We are all really focused and dedicated and working really hard to make sure that we’ve got communications member outreach and any kind of data sharing that we could do with our providers and our external stakeholders,” she said.
Michigan Association of Health Plans Executive Director Dominick Pallone said eight of the association’s members hold contracts for Medicaid in the state and the plans are trying to assist the individuals through the redetermination process.
However, with the Medicaid population, Pallone said it is difficult to keep accurate contact information for those enrolled.
“I don’t think this is new just through the public health emergency,” he said.
Pallone said outside of Medicaid, people would need to pay attention because starting Thursday, getting any treatment, testing or vaccinations will be treated like any other treatment by insurance.
“The federal government is turning off the reimbursement for all of these things,” he said.
Hess said there would still be some free home testing programs available through MDHHS and the libraries, but the medical versions would be charged by the hospitals.
He added that the local health department response would be changed and the people who work in the field would see a big shift after the pandemic end date in the types of reporting they would need to do.
As of May 9, there were 2,718 cases over the past week, along with 62 deaths associated with COVID-19. There were also no areas in the state seeing high rates of spread.
From the start of the pandemic in 2020, there were more than 3.1 million cases and 42,873 deaths in Michigan.
“Folks will continue to monitor hospital case data, death rates, wastewater monitoring and they’ll just be vigilant about the trends,” Hess said.
Hess said there would be boosters that would be offered as mutations were seen and that he was amazed by the massive amount of work that was done in first rolling out the vaccine.
As of May 4, the COVID-19 Vaccine Dashboard indicated 69.9% of the Michigan population had received at least one dose of the vaccine.
“When you think about how quickly we went from no one being vaccinated to the majority of people who wanted the vaccine in just a couple of months, I think that was really incredible,” he said.
Michigan Gets A Lot From Tobacco Companies; Spending Little On Cigarette Prevention
Michigan and other states have “fallen down on the job” when it comes to steering Tobacco Master Settlement Agreement money into smoking cessation programs, a former director of the U.S. Food and Drug Administration’s Center for Tobacco Products said.
Michigan received $320.2 million in Fiscal Year (FY) 2022 from the 1998 settlement with major cigarette companies as part of an annual payment received from the $206 billion commitment to compensate states for the healthcare costs associated with treating unhealthy smokers on Medicaid.
When it came to putting money into helping smokers kick the habit, though, Michigan put in $1.8 million, among the lowest in the country. In 2020, the Mackinac Center reported the number was down to $0.
“Sadly, Michigan and many other states have simply fallen down on the job,” said Mitch Zeller, now an advisory board member for Qnovia, a smokeless nicotine replacement inhalant. “They take the money and everything, but they’re not making the investment that they need to be making to fund prevention and treatment programs and services.”
Zeller said Michigan has a smoking rate of 17%, 54% more than the national rate of 11%, so “there’s a compelling public health reason for your state to be making more of an investment in prevention and cessation.”
Felix Sharpe-Caballero, a former state official within what is considered the Department of Health and Human Services today, said the reality is that the windfall from the settlement was used to address other financial issues the state was confronting at the time.
“Government, quite frankly, needed the money. We weren’t operating with an excess budget the way we are today,” he said. “Think back to the years Jennifer Granholm was governor and we had no toilet paper in our restrooms in state government.”