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Universal Lead Testing Bills For Children Heading To Gov’s Desk
Young children must be tested for lead poisoning, with records of their testing placed on the same immunization certificate used to document childhood vaccines, under legislation currently on its way to the Governor’s desk.
“What this legislation does is it requires universal testing for minors for lead, and really what this is about is making sure that we are giving protection to kids from a variety of potential vectors of exposure to lead,” Sen. John Cherry (D-Flint) said to members of the media today, speaking about HB 4200 and his own SB 31 , which are tie-barred.
Cherry’s SB 31 deals specifically with the new testing instruction itself, mandating a physician to have a child tested for lead – or to order a test for them – once at 1-years-old, once at 2-years-old and once at 4-years-old if the minor resides in a geographic area flagged by the state’s health department for posing an elevated risk for childhood lead poisoning.
Additionally, if the child has not been tested earlier in life, they may be tested for lead poisoning at least once between 2- and 6-years-old.
HB 4200 by Rep. Helena Scott (D-Detroit) deals with the written certification of immunization a parent or guardian is presented with, archiving the immunizations their child has received, the number of doses administered and the date each one was administered.
Under the legislation, which was passed by the Senate today 27-10, the certificate must include a space documenting if the child’s been tested for lead poisoning. After receiving consent from the parent or guardian, the report record will be submitted to the Michigan Department of Health and Human Services.
“Part of the intent there is so we have a better picture of where children are getting exposed, so we can help inform any further policy actions that we need to take to make sure we’re protecting kids from exposure,” Cherry said. “We don’t just want to catch lead exposure once the child’s already been exposed.”
Youths covered by Medicaid need to be tested for lead poisoning at 1- and 2-years-old under federal law.
According to numbers from the DHHS, relayed by the Senate Fiscal Agency, 96,462 children in Michigan younger than 6-years-old underwent a blood lead test in 2021. Among those youths, 3.5% were found to have elevated blood levels at or above 3.5 micrograms per deciliter – at this level, the Centers for Disease Control and Prevention would advise action to be taken.
The Senate approved HB 4200 and gave SB 31 a final nod of support before sending it to the Governor’s desk. SB 31 was modified in the House to be tie-barred to HB 4200 , and the final version of the Cherry bill also passed 27-10.
Sens. Thomas Albert (R-Lowell), Joseph Bellino JR. (R-Monroe), Jon Bumstead (R-North Muskegon), Kevin Daley (R-Lum), Michele Hoitenga (R-Manton), Dan Lauwers (R-Brockway), Jonathan Lindsey (R-Brooklyn), Rick Outman (R-Six Lakes), Jim Runestad (R-White Lake) and Lana Theis (R-Brighton) opposed both pieces of legislation.
When asked about the price tag to screen blood for lead poisoning, Cherry explained the testing is covered by insurance and can cost $10 to $20 without coverage. Guardians and parents are permitted to opt their child out of being screened as well, under the legislation.
“I don’t think there’s an actual affordability barrier for folks, because if you’re a parent . . ., you can opt out of having it,” Cherry said.
Cherry’s district consists of Flint, where residents were exposed to eminently high lead levels following a 2014 switch in the city’s water supply from the Detroit Water and Sewerage Department to the Flint River.
He said parents in his district have offered a lot of support for the legislation, explaining how he thinks “Flint was kind of the canary in the coal mine on this.
“We want to make sure we’re taking those lessons or making changes to try to help everybody else before similar things happen in their community,” he said.
A December 2022 study available in the National Library of Medicine zoomed in on 429 children in Michigan residing across 345 homes, from 2017 to 2021, where lead was present in “blood, paint, dust, soil, water and other housing, demographic and behavioral metrics.” Among those youths, 53% were tested as having blood levels at or above five micrograms per deciliter.
Blue Cross Blue Shield Of Michigan CEO Announces Retirement
Blue Cross Blue Shield of Michigan CEO Daniel Loepp announced to his board of directors that he would be stepping down, even as union workers take to the picket lines.
Loepp said he would give the company a year to find a new CEO and would remain in the position until the end of 2024.
“It has been my life’s honor to serve in this role. I look forward to continuing to lead this great company throughout 2024,” he wrote on LinkedIn.
He said he would then be devoting time “to all the ‘something elses,’” that he had not attended to during his time leading the insurance company.
Loepp gave his gratitude to the company’s thousands of employees across the state, many of whom went on strike Wednesday morning after their contract expired Tuesday at midnight.
“Their dedication and commitment to our members, customers, provider partners and the people of Michigan is unparalleled,” he wrote.
The United Auto Workers union represents the technical, office and professional employees of the company.
According to a Crain’s Grand Rapids report, union workers were against compensation given to Loepp in 2022 that totaled $15.7 million.
The union has been negotiating since July for increased pay, increased health care benefits, and the return of some outsourced jobs.
Adding ACA Protections To State Law Gets 2nd Chamber Look
As the 13-year-old federal Affordable Care Act (ACA) continues to be scrutinized by legal challenges and higher courts, House-passed legislation aimed at codifying the act’s consumer protection measures was heard by a Senate committee.
The Senate Health Policy Committee took testimony on HB 4619 by Rep. Julie Rogers (D-Kalamazoo), HB 4620 by Rep. Kimberly Edwards (D-Eastpointe), HB 4621 by Rep. John Fitzgerald (D-Wyoming), HB 4622 by Rep. Reggie Miller (D-Belleville) and HB 4623 by Rep. Matt Koleszar (D-Plymouth).
Altogether, the package would ban insurance practices in Michigan based on gender, gender identity or expression and sexual orientation. It would also outlaw coverage exclusions linked to an individual’s pre-existing condition, as well as ensure coverage for a policyholder’s dependents will be available until they are 26.
The legislation would additionally codify that an insurer must cover preventative and wellness services and chronic disease management, which have been acknowledged by the state’s Department of Insurance and Financial Services.
An insurer must cover laboratory services, rehabilitative and “habilitative” services and devices, pregnancy and maternity care and emergency services as well, with the legislation not impacting an insurer’s ability to not cover the costs of out-of-network services.
During today’s committee hearing, Miller explained how her HB 4622 would prohibit insurance providers from placing a cap on annual and lifetime benefits for their recipients.
“For far too long, our most vulnerable populations have been forced to cover expensive medical treatments out of pocket because they have already reached their cap on benefits for a year, and sometimes a life,” Miller said. “If the ACA were to fall, insurance providers could deny further coverage to help treat their new diagnosis. As we learned in the past, cancer treatments alone can cost hundreds of thousands of dollars, which can lead to financial hardship and even maybe bankruptcy.”
According to the Michigan League for Public Policy, one of the bill package’s supporters, the rate of uninsured Michiganders moved from 11.1% in 2013, the final year before the ACA took effect, to 8.4% in 2014 and to 5.1% in 2021.
Moreover, the league published that from 2013 to 2021, the population of uninsured Michiganders under 18 dropped by 35,000 youths.
The San Francisco-based KFF – previously known as the Kaiser Family Foundation – reported that the federal ACA has been subjected to more than 2,000 legal challenges since its enactment. The latest case to be making headlines is Braidwood Manager Inc. Et Al. V. Xavier Becerra Et Al.
Briefings are ongoing pertaining to the case, where plaintiffs argue that the ACA’s preventive services mandate is unconstitutional due to violating the federal Appointments Clause, the Religious Freedom Restoration Act, and the nondelegation doctrine.
Self-insured Braidwood Management, a Christian-owned business providing management services, argued in the case that covering pre-exposure prophylaxis (PrEP) – a preventative medication for those at risk of being exposed to HIV – without cost-sharing violated its religious freedom.
As of June of this year, an appeal from the federal Fifth Circuit court has been pending.
On June 23, the Senate approved its own legislation to codify certain ACA measures if the federal act was ever revoked by Congress or the U.S. Supreme Court. The bills consisted of SB 356 , SB 357 and SB 358 , and prohibited health insurance companies in Michigan from rescinding coverage from a customer in cases not including proven fraud or misrepresentation.
Sens. Michael Webber (R-Rochester Hills), John Damoose (R-Harbor Springs) and Mark Huizenga (R-Walker) were the three Republicans to join the Democratic caucus in backing the Senate bills.
During testimony, Dr. Michael Redinger, who represents young physicians on the Michigan State Medical Society’s board of directors, said doctors recognize inadequate insurance coverage as one of the largest barriers to accessing health care.
“While we await a decision from the federal court, your support for this legislation now will help safeguard health care coverage for countless individuals and ensure greater access to care,” Redinger said.
Hospitals Push Back On Nursing Ratio Drive
Around 100 hospital and nursing leaders lobbied legislators this month against bills to create state-mandated nurse-patient ratios, saying that a “one-size-fits-all” requirement won’t help them find the 8,438 nurses they claim to be short.
Brian Peters, president of the Michigan Health and Hospital Association, claims ratios would make the situation worse.
According to a membership survey, the MHA reported that the staffing ratios proposed in SB 334 , SB 335 , SB 336 , HB 4550 , HB 4551 , and HB 4552 would bring the nursing staffing shortage to 12,954, causing hospitals to violate the law or turn patients away at the door.
In order to meet the staffing ratios, 5,074 hospital beds — the equivalent of every bed north of Grand Rapids and Flint — would need to be closed.
“These proposed bills may sound like a reasonable idea, but the truth is anything but,” Peters said.
Asked if there was some room to work out a better number, Peters said no.
“We believe very firmly that the concept is flawed,” he said. “This is not a question of adjusting the numbers and creating a slightly different ratio. There is no compromise.”
MHA claims that if the bills became law, 83% of Michigan voters would be concerned about their ability to receive care or the wait times in an emergency room.
The press conference comes the same day the Michigan Nurses Association launched an ad campaign on streaming platforms to support the ratio bills, called the Safe Patient Care Act. The ads are estimated to generate nearly 2 million impressions during the campaign.
The MNA’s argument is that hospitals are holding back on hiring additional nurses so they can maximize profit. The Safe Patient Care Act sets limits on the number of patients a nurse can see, curbs excessive overtime, and requires hospitals to disclose their staffing ratios.
“Too many people are dying unnecessarily because we’re being forced to take care of an unsafe number of patients by out-of-state healthcare executives who put profits first,” said James
Walker, RN, who also appears in the ads. “Our loved ones and our communities deserve better.”
MHA Board Chair Shannon Striebich, senior vice president of operations at Trinity Health Michigan, pushed back on the assertion that state hospitals are holding back on staffing in order to save money.
She said she would “hire any nurse” if there were nurses to be had. State-offered scholarships would be helpful in drawing more people to the profession. Ratios only limit local flexibility.
“Taking away resources from the bedside is not a solution,” Striebich said. “That’s not where we look to save money.”