Michigan

I've noted before that enrollment in Michigan's ACA Medicaid expansion program, "Healthy Michigan", has risen sharply over the past year since the COVID-19 pandemic hit; it's up by over 1/3 since last February.

However, it's also worth noting that non-ACA Medicaid enrollment has also jumped significantly since the pandemic arrived. I've dug into data from the Centers for Medicare & Medicaid, the Kaiser Family Foundation and Michigan's Health Dept. archives and put together the graph below, showing that non-ACA Medicaid enrollment has risen from around 1.66 million Michiganders in February 2020 to over 1.92 million today, a 16% increase.

Combined, total Medicaid enrollment is up by around 21% to over 2.82 million as of April 2021.

I should also note that in addition to this, 267,000 Michiganders enrolled in ACA exchange coverage during the 2021 Open Enrollment Period, of which a good 90% (240,000)paid their first monthly premium based on past ACA data. At the time I noted that around 83% were subsidized, or perhaps 200,000.

I last updated my Michigan Medicaid expansion tracking back in January.At the time, I noted that enrollment in this ACA programhas increased dramatically here in Michigan since the COVID-19 pandemic struck, increasing from 673,000 in February 2020 to 853,000 as of January 2021, or nearly 27% in less than one year.

As of April 5th, the Healthy Michigan program (that's the branding of Michigan's ACA Medicaid expansion) notes 897,261 enrollees. That's a net increase of 224,000 Michiganders enrolled in the program since last February, or over 33%.

With this as backdrop, consider the timing of the following events:

Back in November I noted that enrollment in Medicaid via ACA expansion has increased dramatically here in Michigan since the COVID-19 pandemic struck, increasing by 23% from 673,000 in February 2020 to 829,000 in November.

Today the Michigan Dept. of Insurance & Financial Services just issued the following press release:

More than 1 Million Michiganders Obtained 2021 Health Coverage from the Health Insurance Marketplace and the Healthy Michigan Plan

(LANSING, MICH) After an extensive joint outreach campaign by the Michigan Department of Insurance and Financial Services (DIFS) and the Michigan Department of Health and Human Services (MDHHS), more than 1 million Michiganders obtained health coverage for 2021 during the Health Insurance Marketplace open enrollment period or through the state’s expanded Medicaid program. 

Health Insurance Town Halls Offered to Michigan Consumers with Questions about Open Enrollment 

Thousands of Michiganders have lost health coverage during the COVID-19 pandemic, and the Michigan Department of Insurance and Financial Services (DIFS) is offering virtual town hall events to help answer questions about open enrollment on the Health Insurance Marketplace, which runs until Dec. 15.  

These live online town hall meetings are part of a series of events that will help consumers learn and ask questions about signing up for a health plan on the Health Insurance Marketplace. To attend a virtual town hall event, click the event link at its start time. Instructions for attendees are available and explain how to join an event and ask questions. 

Event Information: 

Over at Xpostfactoid, my colleague Andrew Sprung has been doing a great job of tracking ACA Medicaid expansion enrollment growth since the onset of the COVID-19 pandemic this past February/March at the macro (national) level, by looking at around a dozen states which have monthly reports available. He puts the overall enrollment growth rate at 23.6% from February thorugh October 2020.

Instead of replicating his work, I decided to take a closer look at individual states, starting with my own: Michigan. The graph below shows how many Michiganders have been actively enrolled in our Medicaid expansion program (Healthy Michigan) every month since it was launched in April 2014 (we had a 3-month delay in the program due to the state legislature refusing to implement the new law with immediate effect; I have no idea why):

October 12, 2020:

LANSING – Emergency orders Gov. Gretchen Whitmer has issued under the Emergency Powers of Governor Act are struck down, effective immediately, the Michigan Supreme Court said Monday in a 4-3 order that added an exclamation mark to an Oct. 2 ruling.

...Monday's Supreme Court ruling is in response to a lawsuit brought by the Michigan Legislature. The Oct. 2 ruling, which was a 4-3 decision striking down the Emergency Powers of Governor Act of 1945, was in response to questions sent to the court by a federal judge handling a lawsuit brought by medical service providers in western Michigan.

Monday's ruling means hundreds of thousands of Michiganders could lose their unemployment benefits "in a matter of days," Whitmer spokeswoman Tiffany Brown said. Among the orders struck down, and not replaced by a health department order, is one that extended Michigan unemployment benefits to 26 weeks, up from 20.

House Speaker Lee Chatfield, R-Levering, hailed the ruling.

Way back in July (a lifetime ago!), Michigan's Dept. of Financial Services posted the state's preliminary 2021 individual & small group rate filings. At the time, the average premium changes being asked for were around a 1.3% increase on the individual market and 1.4% on the small group market.

Last week, a few days ahead of the launch of the 2021 Open Enrollment Period, they posted the approved 2021 rates...and there's almost no changes at all. The only significant change was to Meridian's request, which was dropped from a 2.7% increase to a 5.6% decrease. Also, National Health Insurance dropped out of the Small Group market, but they don't appear to have anyone enrolled this year anyway:

RE-UPPED 1/31/22: It was announced this morning that John James, who lost not one but two statewide U.S. Senate races back to back in 2018 & 2020, is taking a third swing at elected office in 2022. This time he's setting his sights lower, going for Michigan's new open 10th Congressional district, which is still competitive but which definitely has more of a GOP-tilt to it. In light of that, I decided to dust off this post again.

A month ago, incumbent Democratic Senator Gary Peters of Michigan and his Republican challenger John James were both interviewed as part of a Detroit Regional Chamber series on several issues, including healthcare policy and the ACA.

As I noted at the time:

Nolan Finley is the conservative editorial page editor of The Detroit News.

On July 29th, he tweeted this out in response to criticism of the COVID-19 policy recommendations by himself and Michigan Republican legislative leadership:

Florida 20 million population, 6100 deaths. Michigan 10 million population, 6400 deaths. https://t.co/O1tNoyWwB0

— Nolan Finley (@NolanFinleyDN) July 29, 2020

That was late July.

Let's take a look at mid-October, shall we?

Here's a graph of official COVID-19 positive test cases and fatalities per capita for both Michigan and Florida. Cases are per 1,000 residents; deaths are per 10,000 in order to make the trendlines more visible:

 

This morning, U.S. Senator Gary Peters (D-MI) and his Republican opponent, John James, were interviewed online by Nolan Finley of the Detroit News and Stephen Henderson of DPTV & WDET. Here's the verbaitm transcripts of each of their healthcare/ACA Q&A sections, Peters first:

HENDERSON: "One of the things which has been made really manifest during the COVID-19 pandemic is the weakness of our healthcare system. We're now coming up on about a decade of life under the Affordable Care Act, which of course expanded access to insurance and made some other changes, but there are still obviously a lot of inefficincies...there are a lot of insufficiencies.

Give us an idea of what you would support in terms of changes to the healthcare system, changes to the Affordable Care Act, to get more people covered at lower costs and make the system work better."

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