Lansing Lines is presented in cooperation with MIRS, a Lansing-based news and information service.
Whitmer Signs Maternal Health Package, Pharmacist Birth Control Bills, Other Insurance Changes
Gov. Gretchen Whitmer signed 16 bills this month, many surrounding women’s reproductive health care, including two that let pharmacists prescribe birth control, a nine-bill package putting pregnancy on Medicaid, and two on birthing centers and doulas.
Whitmer was slated to sign HB 5435 and HB 5436 in Flint today, but the event was canceled because of the snow and freezing weather. Whitmer posted the signing on social media, where she thanked Reps. Stephanie Young (D-Detroit) and Kara Hope (D-Holt) for sponsoring the bills.
“Today, I’m signing commonsense bills to further protect everyone’s fundamental freedom to make their own decisions about their own body,” Whitmer said. “These bills will save women time and money so they can access the birth control they need and cut unnecessary red tape that stands between people and their health care.”
The bills would not only allow pharmacists to prescribe birth control, but would also require insurance to cover birth control, as well.
The bills passed along party lines and Republicans voiced their opposition to the bills, opening the guidelines to allow prescriptions regardless of age.
Planned Parenthood of Michigan applauded the passage of the two bills.
“As we brace for attacks on sexual and reproductive health care under a second Trump Administration, every step we can take to preserve and expand access to contraception is critical,” said Planned Parenthood of Michigan Chief Advocacy Officer Ashlea Phenicie.
Whitmer also signed nine bills that make up the Maternal Healthcare package, which open up many of the costs associated with pregnancy and birth to be paid for through Medicaid, including HB 5167, sponsored by Rep. Cynthia Neeley (D-Flint), and HB 5168, sponsored by Rep. Kimberly Edwards (D-Eastpointe), that cover blood pressure monitors; HB 5169, sponsored by Rep. Rachel Hood, HB 5170, sponsored by Rep. Brenda Carter (D-Pontiac), and HB 5171, sponsored by Rep. Kristian Grant (D-Grand Rapids), that expand mental health services and coverage for postpartum depression, which can be experienced after pregnancy; HB 5173, sponsored by Hope, requires hospitals to let new parents know about the insurance enrollment process for infants.
Other bills signed that were part of the package included HB 4728, sponsored by Rep. Julie Rogers (D-Kalamazoo), that removes the ongoing testing requirements for breast milk donors.
“I’m thrilled many of the policies signed into law today will have a positive impact by reducing preventable deaths and improving maternal and infant health outcomes for families,” Rogers said.
The Young-sponsored HB5166 directs organizations called Perinatal Quality Collaboratives, which is a collection of perinatal care and healthcare professionals, to work to lower the infant mortality rate across all economic levels.
The last of the package was HB 5172, sponsored by Rep. Carol Glanville (D-Grand Rapids), which creates a program to standardize the criteria for birthing facilities to help identify risk levels in infants and during birth.
The Michigan Council for Maternal and Child Health Executive Director Amy Zaagman put out a statement lauding the signing of the package.
“In Michigan, we have made many advancements in maternal and child health, but we will continue to identify needs and fight to address them and identify barriers and fight to eliminate them. Sustained efforts led by individuals and providers that know their communities and are tailored to address disparities are critical to ensuring the best outcomes for moms and babies,” Zaagman said.
Whitmer also signed HB 5636, sponsored by Rep. Laurie Pohutsky (D-Livonia), which sets up licensing for birth centers, midwifery care, and other pregnancy and reproductive services. The services are those not offered by hospitals and include services such as doulas.
Doulas also got a special shout out in HB5826, sponsored by Rep. Mai Xiong (D-Warren), which would set up a $3,000 one-time scholarship to cover the cost of anyone with financial need who wants to go through doula training in Michigan.
Rogers also saw the signing off HB 4224, which removes the work requirements for the people receiving the Medicaid-backed Healthy MI Plans.
Two changes would be made to health care providers and insurers under another Rogers-backed bill, HB 5825, and HB 5956, sponsored by Rep. Brenda Carter (D-Pontiac). The latter would prohibit discrimination against healthcare providers acting within their license. The Rogers bill would require health insurance to provide rebates if they don’t meet the spending requirements on patient care.
Anti-Cancer Lobby Takes A Pass On PDAB Debate
The American Cancer Society Cancer Action Network (ACS CAN) will not take a position on bills to create a prescription drug affordability board (PDAB) in Michigan, citing a lack of data concerning the proposal’s possible impact.
“We do not take a side on this legislation. There’s been a few introduced in states across the country,” said Molly Medenblik, the ACS CAN’s government relations director in Michigan. “Nobody has really fully implemented this legislation yet, so we’re not sure what impact it will have on patients, and that’s our number one concern, obviously, the cancer patients and how it will affect them.”
Earlier this month, Senate Majority Leader Winnie Brinks (D-Grand Rapids) made it clear that PDAB legislation was among her top priorities for the new year. Under the latest bills introduced – SB 3 , SB 4 and SB 5 – a PDAB would be a board of five governor appointees, as well as a stakeholder council including representatives for senior citizens, physicians and researchers.
After 18 months of becoming effective, the board must investigate drugs that are costing much more than they did, like a brand-name or biologic drug with a wholesale acquisition cost that has increased by $3,000 or more over a 12-month period.
According to the ACS CAN, more than 64,000 Michiganders were told they had cancer in 2024. For 2020, the state’s health department reported that 398.4 residents per 100,000 Michiganders received a new cancer diagnosis.
Also in 2020, the rate affected 5,613 residents younger than 50, more than 32,600 residents 50 to 74 years-old and 13,779 individuals 75 years old and over.
Medenblik said that, at the end of the day, an ongoing disease that a patient will have to fight for a long time is “going to be very expensive.”
When it comes to PDAB legislation, proponents claim the board will establish accountability and transparency around drug and treatment costs, especially due to the board being able to consider upper payment limits (UPLs) on drugs sold in the state.
On the other hand, opponents argue that the UPL could be a complicated price cap that will face federal lawsuits, limiting Michigan’s access to products and research and development (R&D) benefits.
“Since no state has really shown any, really pros or cons (of) the legislation, we just don’t take a stance on it yet,” Medenblik said.
Last year, Maine, Maryland, Minnesota, New Hampshire, Oregon and Washington state had an implemented PDAB. According to the Most Policy initiative, New York and Massachusetts have drug utilization review boards to negotiate state payments to drug manufacturers.
Instead of getting involved in the PDAB debate, the ACS CAN will be supporting so-called copay accumulator reform, which intends to ensure that drug cost assistance programs from manufacturers and nonprofits are transferred over to patients’ out-of-pocket costs and deductibles.
“Let’s not wait for 15 years to pass something like this, and so the reason that this is (such) a priority for ACS CAN and cancer patients is that access to care. (It) immediately will make your medication more affordable,” Medenblik said.
Making up numbers for an imaginary example, Medenblik said a cancer patient might face a deductible costing $5,000, but be informed by their doctor that assistance is available. After receiving a $2,000 assistance card, the patient might learn the assistance did not reduce the cost of their deductible, although it did go to their insurance plan.
“The insurance company has still received that $2,000 financial assistance, and then they will receive my full $5,000 deductible, so the insurance company is still made whole, and in some ways, (has) kind of double-dipped in this situation,” Medenblik said. “That’s just not what’s supposed to happen. The financial assistance is supposed to make it easier for the patient to afford their drugs.”
At the same time, some insurers claim that accumulator programs assist in managing their premium costs, keeping them affordable while also not allowing drugmaker coupons to artificially keep drug costs high and incentivize patients to purchase more expensive brand-name drugs.
As for PDABs, the reform will continue to be pushed by the national Committee to Protect Health Care, which is a group of patient advocates, doctors and other health care professionals.
“The rising cost of living, including health care, remains top of mind for Michigan residents. We hope that House Speaker Matt Hall (R-Richland Township) will listen to voters, patients, and doctors and work to implement a PDAB without delay so that Michiganders can access the drugs they need to live and thrive,” said Dr. Rob Davidson, committee’s executive director and a West Michigan emergency room physician.