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Immigrant Children, Pregnant Women Wouldn’t Need To Wait For Medicaid Under Bill
The five-year waiting period for immigrant children and pregnant women to be able to use Medicaid services in Michigan would be waived under a bill taken up by a House committee early this month.
Rep. Alabas A. Farhat (D-Dearborn) told the House Insurance and Financial Services Committee that HB 4740 would help the lives of immigrants while addressing infant mortality and children’s health issues.
“It’s transformational for some lives and helps ensure that there are safe patches for that child,” Farhat said.
Sara Ismail of the Arab Community Center for Economic and Social Services (ACCESS) told a story about a family that had been living in the United States for nearly four years, but couldn’t get insurance. She said they had to rely on free clinics and limit their visits to the emergency room.
Michigan Council for Maternal and Child Health Executive Director Amy Zaagman told a similar story and said many of those populations didn’t get the health care they needed because of it.
“They increase utilization of higher intensity services, like emergency rooms. They struggle to find providers that will even accept them. They miss out on critical preventative services, like immunizations, prenatal care, well-child visits, and we know that those are effective in controlling illness and preventing complications,” Zaagman said.
She also said the bill would only apply to children and pregnant women. She said others would still need to wait the full five years.
Farhat said the five-year waiting period was a federal mandate, but there was an exemption for children and pregnant women, but a state would have to pass the legislation. He said the waiver was put in place on the boilerplate of the 2024 budget.
“This would just codify that and make it clear that we are accepting individuals ahead of that five-year waiting period, specifically in this case, children and people who are pregnant,” he said.
Panel Dialing Into Making Telemedicine Permanent
Insurance providers, Medicaid and Healthy Michigan must cover telemedicine services at the same rate as in-office visits, but they cannot mandate that their customers use the remote option, under legislation taken up in a House committee.
Four bills that continue into perpetuity the availability of telemedicine services after they were first allowed during the height of COVID-19 received their first House hearing today to generally favorable review.
House members and health professionals alike heralded remote health visits as using technology to get more people to see a medical professional.
“I have a telemedicine appointment tomorrow,” said Rep. Reggie Miller (D-Belleville), a member of the House Health Policy Committee. “I’ve had surgery. I can’t get in to have it checked. I have a job that I absolutely love, so having the ability to have this online is so important.”
No votes were taken on HB 4213, HB 4579, HB 4580, and HB 4131 during a Health Policy Committee this month, but nobody brought up any serious objections to them either.
Rep. Alabas A. Farhat (D-Dearborn) questioned whether physicians were saving money by being allowed to see patients online. Rep. Felicia Brabec (D-Ann Arbor), a bill sponsor and licensed psychologist, said the idea that there’s cost savings with telehealth, in the mental health arena anyway, is a “misconception.”
“I still have my space where I provide services. I still have my malpractice insurance . . . I still have my software that I use for billing. All of these things are still the same. They don’t change,” she said.
Committee member Rep. John Roth (R-Interlochen) said he wasn’t going to dispute Brabec’s testimony on mental health services, but what about physical health? Clicking someone into an appointment online would seem to be less costly than preparing a room for them to come in for an exam.
To that point, Rep. Natalie Price (D-Berkley) said she has “clear research” that shows that any cost savings to the providers are “negligible.”
“If you think about it, it requires the same level of expertise, the same level of paperwork, and the same malpractice insurance,” said Price, adding that providers cannot mandate telehealth services.
If a patient wants to be seen in person, an insurer can’t require a remote option.
Phillip Berquist, the chief executive officer of the Michigan Primary Care Association, said his members “dramatically scaled up” telehealth services in 2020. Those numbers have since stabilized to the point where about 10% of their services are provided remotely.
“While telehealth represents a small portion of what we do, it’s really important for the patients that engage with their care teams via telehealth,” he said.
Some patients don’t have reliable transportation. Some practitioners are a long way from the patients. People have busy schedules, etc.
“We need to create a health care system that supports the evolving needs of our patients, especially in this post-pandemic world,” said Dr. Kevin Bohnsack, Trinity Health’s executive medical director for population health management.
Key House Republican Puts Flag In The Ground Against Drug Board
“Whatever a hard no (vote) is, I’m that and times two.”
That’s the second-ranking Republican member of the House Health Policy Committee, Rep. Graham Filler (R-St. Johns), reacting to the Democratic proposal to create a board to establish the upper limits that drug companies can charge for their prescription medicine.
Bills creating the drug board passed the Senate this month without Republican support. Any thoughts that SB 483, SB 484, and SB 485 will get a better reception in the House Republican caucus were blown up by the DeWitt lawmaker.
He dismissed the whole concept as a “political stunt that has no legs.”
He favors allowing the marketplace to set prices and not a five-member government panel that would, in his mind, interfere with the market.
“I’m not going to get behind a sort of state takeover of the market and I don’t think you’re going to see it on the governor’s desk anytime soon either,” he predicted.
Gov. Gretchen Whitmer, in her “What’s Next?” fall agenda speech, came down four square behind the Prescription Drug Affordability Board, suggesting that no one should have to choose between paying for life-saving drugs and putting food on the table.
Filler said he thinks, at the end of the day, the governor’s support notwithstanding, “I can’t imagine that most of my Democratic friends believe in this either.”
Behind the scenes, it’s presumed the drug board becomes trade bait with the Senate Democratic leadership over whatever the Speaker’s top priorities may be, most likely the Land Value Tax reform.