Lansing Lines is presented in cooperation with MIRS, a Lansing-based news and information service.
Thompson Wants House Hearings Held About Hawthorn, Walter Reuther Hospital
In a letter to House Behavioral Health Subcommittee Chair Felicia Brabec (D-Ann Arbor), Rep. Jamie Thompson (R-Brownstown) requested the subcommittee hold a hearing to look at instances where the state juvenile mental health system has failed greater Detroit families.
She specifically referenced the Walter Reuther Psychiatric Hospital in Wayne County, which is temporarily housing children within an adult facility, and the Hawthorn Center in Novi, which lawmakers have previously requested an audit of.
In addition to the 17 patient escapes Thompson said have been reported since 2020, the center was recently subjected to lawsuits after holding an unannounced shooter drill.
Though the suit was not successful, Thompson said she’s spoken with families who have loved ones in both facilities and who have expressed “concern and outrage” about communication barriers, restrictions on weekends, health concerns, erratic education services and limited recreation and outdoor time.
“Standing up for families and making sure children in our region and throughout the state are safe are my top priorities in the Legislature,” Thompson said. “There have been several reports and accounts about troubling issues at these two facilities. Even as months go by, there has been no accountability and very little commitment to remedying these situations so they don’t continue to happen in the future.”
She said in addition to parent stories, several children’s mental health advocacy organizations have reached out to her office to express concerns.
“I was recently told that Democrats in the Legislature would be looking into these matters,” she said, “But we need more urgency. Families have heard for months that these issues are going to be looked at, and they still are demanding answers.”
Thompson, who was joined in signing the letter by Reps. Kathy Schmaltz (R-Jackson) and Alicia St. Germaine (R-Harrison Township), said it’s imperative the House committee conduct a hearing and develop a plan to address concerns about the facilities.
Former Nurses Say Staffing Ratios Would Bring Them Back
“I wish everyone could have looked into the eyes of the people I watched die because of unsafe staffing. If legislators looked into the eyes of everyone I have watched die, even in just the last few years, I guarantee you they would also suffer from insomnia and PTSD (post-traumatic stress disorder).”
Those are the words of a critical care nurse named Brandy, in a statement that was read during House Health Policy Committee by registered nurse Jamie Brown, who testified on behalf of the Michigan Nurses Association.
“I have been forced into unimaginable life or death circumstances countless times because of this constant issue. It is not fair that people live or die because of short staffing,” the statement read. “It has done nothing but to continue to get worse. Last year, I coded someone in an ICU for 10 minutes all alone because there was no one to help me. I no longer can sleep because people did not have a fair chance at surviving.”
The committee took additional testimony on HB 4550 , HB 4551 and HB 4552 , also known as the “Safe Patient Care Act,” which together requires hospitals to maintain nurse-to-patient ratios and bans mandatory overtime.
Several former nurses who testified told members that eliminating mandatory overtime and requiring minimum staffing would encourage them to return to the profession.
But the bills (along with their Senate counterparts, SB 334 , SB 335 and SB 336 ) are opposed by the Michigan Health and Hospital Association, ANA-Michigan, the MNA/Covenant Healthcare, Trinity Health Oakland and the Michigan Organization for Nursing Leadership.
The opposition testifying today agreed that something needs to be done about nursing staffing shortages, but said mandatory ratios and eliminating overtime aren’t the way to do it.
Mandates could harm hospitals and reduce access to important patient services by sending nurses home during a staffing shortage, they said.
Rep. Graham Filler (R-St. Johns) also expressed concern that the bills rely on former nurses, who right now are “sitting on the sidelines” waiting for a better ratio, but who will “flood back into practice” when the legislation is passed.
“I guess my issue would be if it does turn into law and nurses don’t flock back, or simply the stats are wrong, we’re going to severely hamper health care in the state of Michigan,” he said. “I’m talking close the wards because you can’t meet the ratio, inability for a hospital to treat an emergent patient.
“It feels kind of…like a gamble we’re taking,” he said.
Brown said the ratios will save lives, but also hospital money, by lowering negative patient outcomes, which will be accomplished by increasing staffing ratios.
“We have a leaky bucket, no matter how many nurses we graduate or bring in, nothing will change unless we address hospital working conditions,” she said.
House Calls Up Telemedicine Parity
Health insurance companies, Medicaid and Healthy Michigan must cover telemedicine services at the same rate as an in-office visit, but no provider can mandate a remote option, under legislation the House passed overwhelmingly this month with Democratic support.
At a time of doctor shortages, particularly on the mental health front, telemedicine provides an option for care to those who may not seek it otherwise, according to bill sponsor Rep. Natalie Price (D-Berkley).
She argued on the House floor that an estimated 650,000 Michiganders with mental illness or 500,000 with substance abuse issues are not getting care. Meanwhile, the COVID-19 pandemic showed how effective seeing a doctor online can be, creating a “dramatic expansion” to access, she said.
State law temporarily allowed for telemedicine coverage to be paid for at the same rate as in-person visits. HB 4213 , HB 4579 , HB 4580 and HB 4131 make this permanent.
“Telemedicine helps bridge the gap,” Price said.
In committee, the bill received support from numerous medical associations, including the Michigan State Medical Society (MSMS) and the Michigan Health and Hospital Association. Blue Cross Blue Shield of Michigan opposed the bill.
The main two bills, HB 4579 and HB 4580 , passed 57-50 and 58-49, respectively, with Rep. Phil Green (R-Millington) and Rep. Jamie Thompson (R-Brownstown) joining Democrats in supporting the bills.
HB 4213 passed 75-32 with the chamber’s more conservative members voting no.
Among those was Rep. Curtis VanderWall (R-Ludington), the Senate Health Policy Committee chair last term, who has supported telemedicine in prior sessions.
He says he continues to be a supporter if it’s done in the right way.
“I felt this opened the door with very little oversight and was going to drive up costs,” VanderWall said.
Likewise, Rep. Graham Filler (R-St. Johns) said he is a supporter of telehealth and that his wife, a physician, appreciates it for some of her patients.
“That said, it was my opinion that these bills created a bit of a Wild Wild West in Michigan telehealth, which opens things up a little too much to fraud or misuse, instead of creating a narrow law,” he said.
Drug Immunity Repeal Heading To Governor
Pharmaceutical manufacturers in Michigan would again be subject to product liability cases even if their products were approved by the U.S. Food and Drug (FDA) Administration, under legislation that passed the House, 79-30.
The House passed Sen. Jeff Irwin (D-Ann Arbor)’s SB 410 without an amendment, meaning the Senate can send the legislation to the governor without needing to take a concurrence vote.
The bill passed with 23 Republican “yes” votes, a notable departure from 17 years ago, when Democrats used a similar bill to politically hammer a reluctant Republican majority for standing up for “Big Phrama.”
This go around, even conservative Rep. Gina JOHNSEN (R-Lake Odessa) spoke out in support of the bill in committee and Freedom Caucus member, Rep. Josh Schriver (R-Oxford) said he didn’t support the bill on the floor tonight because it didn’t go far enough.
“Big Pharma and the FDA both need to be held responsible for harming users of the products they push/allow,” Schriver said. “Neither should be granted immunity. There are little to no acts of recourse for Michigan residents when the FDA approves drugs that cause us to have severe issues.”
In the House, the measure was shepherded by House Judiciary Committee Chair Kelly Breen (D-Novi), who said the bill “fixes a disastrous mistake by former Gov. John Engler.”
The intent behind the bill was to create high hurdles to cover product liability shields as a way to bring more pharmaceutical companies to Michigan. That didn’t really come to pass, Breen said.
“This immunity did not make drugs safer or less expensive,” she said. “Under Democratic leadership and with bipartisan support, we are finally giving consumers the recourse they deserve when they suffer undue harm as a result of prescription medication.”
Only Republicans voted against the bill. One of them was Rep. Curtis VanderWall (R-Ludington), who last term was the chair of the Senate Health Policy Committee.
“I feel this opens the door for trial lawyers to pursue many lawsuits,” he said.
Michigan To Create A Marketplace For Healthcare
Michigan’s insurance department would be responsible for implementing a state marketplace for qualified health and dental coverage plans, as opposed to continuing to rely on a centralized federal exchange, under legislation taken up in committee this month.
As part of the 13-year-old Affordable Care Act (ACA) that became federal statute during President Barack Obama’s administration, states were instructed to set up health insurance marketplaces – or “exchanges” – where individuals and households could shop for private plans. This year, Michigan continues to be one of 30 states using the Federally Facilitated Exchange (FFE), directing citizens to plans that are compliant with ACA regulations.
“This legislation will have the practical effect of getting more lives in Michigan covered. The revenue generated by the exchange, instead of being returned to a federal department, can be used to do outreach in underinsured communities,” said Senate Health Policy Chair Kevin Hertel (D-St. Clair Shores) during a recent committee hearing.
Hertel’s committee took testimony on SB 633 , SB 634 , SB 635 , SB 636 and SB 637 .
Either before or starting on Jan. 1, 2025, insurance plans through the new SBE would become available online or through a toll-free hotline. In order to participate in the state-run marketplace, the DIFS director must certify the plan meets federal and state requirements. Additionally, the exchange itself and benefit plan carriers operating on it would be barred from charging users a fee if they opt to terminate their coverage.
Similar to the FFE, those offering a plan through the Michigan-based exchange would be charged up to 2.75% of combined monthly premiums for on-exchange policies. The bills that received testimony provide a new board – consisting of the DIFS director, the state’s health department director and 10 Governor appointees – the ability to increase the user fee on health plans through a 75% vote.
Hertel told his committee that a state-based exchange would enhance a “No Wrong Door” approach for residents seeking to gain coverage.
For example, he said if a person applies for Medicaid coverage through the exchange, although they earn too much money to qualify, state departments could coordinate and assist the individual in finding subsidies they’re eligible for and coverage plans most affordable for them.
“The reverse is also true for those seeking insurance on the exchange who would otherwise qualify for Medicaid – we will be able to direct them towards applying for those benefits,” Hertel said. “In summary, moving to a state-based exchange gives Michiganders the same choices, while allowing for flexibility, easier access and better state innovation.”
During the hearing, Legislative Liaison Manager Joseph Sullivan of DIFS said a SBE can be funded through user fee revenue and annual appropriations of General Fund revenue.
The legislation moreover instructs DIFS to apply for a “section 1332 waiver” from the U.S. Centers for Medicare and Medicaid Services (CMS) and the U.S. Department of Treasury, waiving or adjusting certain ACA provisions for Michigan if doing so can promote affordable and high-quality care coverage.
According to the CMS, a Section 1332 waiver allows a state to apply for a “State Innovation Waiver … to pursue innovative strategies for providing residents with access to high quality, affordable health insurance while retaining the basic protections of the ACA.”
Dr. Rob Davidson, an emergency room physician and executive director of the Committee to Protect Health Care, informed MIRS that a SBE could allow for a “more targeted approach to folks who don’t have exchange,” with a 1332 waiver capable of bringing more federal funds and lower premiums to Michigan.
He said with the federal exchange, “it’s less work for the states. … I mean, you don’t have to create the legislation, you don’t have to file for the waiver, but the downside is that you can’t target as much. … You can’t target the uninsured or the underinsured as closely as you can if you have a state-based exchange.”
He said even incremental increases in folks who have insurance coverage “is really critically important.”
Abortion Restriction Repealers Pass House; 24-Hour Waiting Period, Medicaid Funding Ban Stay In Place
Several abortion restrictions known in the industry as “Targeted Regulations of Abortion Providers” or TRAP laws would be repealed under legislation that passed the House late this evening on party line votes.
The nine bills repeal the need for health insurance policy holders to buy a separate rider for insurance coverage. It also allows students at public universities to access information on abortion and repeal hospital grade regulations on abortion clinics.
However, the Reproductive Health Act (RHA) bills do not eliminate the 24-hour waiting period for someone to receive an abortion nor do they allow Medicaid coverage of abortion, due to a lack of support by Rep. Karen Whitsett (D-Detroit) and presumably a handful of other Democratic caucus members.
The advocates for abortion access laid the failure to move those two provisions squarely at Whitsett’s feet. A joint letter credited to the ACLU of Michigan, Michigan Voices, Planned Parenthood Advocates of Michigan and numerous other groups issued tonight reads:
“Thanks to one Michigan House member’s foolhardy opposition to this critical legislation – this chamber just passed a watered-down version of the Reproductive Health Act . . .
“We condemn Representative Karen Whitsett, who pushed to remove these key provisions of the Reproductive Health Act. Her actions will perpetuate the harm being done to her constituents and communities across the state.”
At Planned Parenthood of Michigan, an average of 150 patients are forced to cancel their appointments each month due to the 24-hour waiting period. The “deliberately onerous restrictions forces patients to review biased information on a state website and print off materials in a very specific timeframe.”
The restrictions, they claim, mean some patients are severely delayed in care or may not be able to reschedule.
Before voting, members took the chance to speak to the package one last time – starting at 10:53 p.m.
Floor speeches from Reps. James Desana (R-Carleton), Gina Johnsen (R-Lake Odessa), Jamie Thompson (R-Brownstown) and Angela Rigas (R-Alto) said that the bills diminish the safety and sanitation of abortion clinics and eliminate guardrails that prevent a woman from being forced to have an abortion or from being fully informed before deciding to have one.
Rep. Joseph D. Fox (R-Fremont) said he had at least 2,000 people throughout the state praying that the bills would not pass.
“I cry out, it is time for you to act, oh Lord. Your law is being broken,” Fox said.
The bills passed, however, apparently without any divine intervention.
Rep. Natalie Price (D-Berkley) said her grandmother self-administered an abortion in 1941 and suffered complications that severely endangered her life.
“We will not go back to the 1940s. We resolve now, and we will continue to fight to ensure that people all across our state retain their fundamental, constitutional right to safe, affordable and accessible reproductive health care,” Price said.
After voting, Rigas said it’s not over.
“I will go back to my district tomorrow and I will be thanked for my efforts, trying to win the hearts and minds of these demonic people,” Rigas said. “I pray for them, because let me tell you what, hell is going to be awful hot for the people that voted for this crap tonight. I’m Angela Rigas, that’s all I have to say.”
Rigas said in her floor speech that in 2003 she was unwed and uninsured with an unplanned pregnancy, and that she was pro-choice and liberal in her views until she found out she was pregnant.
After enduring two miscarriages and suffering another, Rigas received the dilation and curettage (D&C) procedure to remove the fetus, which is also used for abortions. She fell ill with a life-threatening infection from the procedure.
“You have a radical Democrat legislature that is so obsessed with having the full ability to kill children at will, that they’re willing to risk mothers’ lives to achieve that. That is sick. The Democrats that serve in this legislature are sick individuals,” Rigas said.
During floor speeches, Rep. Josh Schriver (R-Oxford) was gaveled out for saying the package deserves to be called legalized murder and was not recognized to finish the speech.
Rep. Abraham Aiyash (D-Hamtramck) said anyone suggesting members of the chamber are committing murder is egregiously overstepping.
Rep. Laurie Pohutsky (D-Livonia) said that a choice was made tonight to get as much done through legislation as they could without litigation.
The House bills voted on today were Pohutsky’s HB 4949 , establishing the RHA, Rep. Kara Hope (D-Lansing)’s HB 4951 , removing abortion crimes from sentencing guidelines, Reps. Christine Morse (D-Kalamazoo), Felicia Brabec (D-Ann Arbor) and Price’s HB 4953 , HB 4954 , HB 4955 and HB 4956 which remove judicial references to abortion and modify the state school aid act and occupational code act and amends the law concerning expungement.
The Senate bills voted on were Sen. Sarah Anthony (D-Lansing)’s SB 474 that eliminates reporting requirements of abortion providers on the types of abortions they’re overseeing, Sen. Erika Geiss (D-Taylor) SB 476 that redefines abortion in the Born Alive Infant Protection Act and Sen. Megan Cavanagh’s SB 477 that eliminates the prohibition on student health services from referring abortion care to students.