KALAMAZOO -- State Sen. Tom George is spearheading an ambitious, comprehensive overhaul of Michigan health care that would include creation of two new programs for the uninsured -- one that would expand Medicaid to the working poor and another for middle-class families.More government programs.
George, a Texas Township Republican who is running for governor, said Monday that the programs would be subsidized by an increase in the hospital-bed tax, an annual assessment paid by Blue Cross Blue Shield and a tax paid by insurers on all of their health claims.Higher taxes.
One of two physicians in the Michigan Legislature, George said the plan would be a step toward universal health-care coverage without going to a one-payer system and would incorporate strategies promoting healthier lifestyles that could reduce health-care costs.Government regulation of personal behavior.
"We're ripe for reform," George said, pointing out that more than 1.2 million Michigan residents lack health insurance. "If more people have access (to health insurance), it would lead to a healthier Michigan."Government monitoring of personal behavior.
George also is pushing for changes in regulations of individual policies purchased by Michigan residents, which is one of the most contentious areas of health insurance. Those policies can be difficult and expensive to obtain for the people who need them most.
George chaired a bipartisan Senate task force to consider ways to make health insurance more affordable and accessible. The task force's work led to four bills that were introduced in the Senate last week, with George as the lead sponsor.
One bill would create a program called MI Access that would cover households with incomes of up to 200 percent of the federal poverty guidelines, which is about $20,000 for a single adult and $40,000 for a family of four. It would dovetail with MI Child, which provides health insurance for children from low- and moderate-income families. George estimates that up to half of the uninsured adults in Michigan would be eligible for MI Access.
The premiums would be capped at 5 percent of income, and George said they would be lower for people who have healthy lifestyles, such as nonsmokers and those who are not overweight.
MI Access would qualify for federal Medicaid dollars, George said, "money that Michigan is now leaving on the table."More federal control.
The other program, MI Coverage, would cover uninsured families with incomes of up to 300 percent of the federal poverty guideline -- about $60,000 for a family of four.Higher taxes, higher taxes, higher taxes.
MI Coverage would offer a "stripped-down" policy for a monthly premium of $50 to $60, George said. It would provide some doctor visits, prescription coverage and hospitalization. As with MI Access, George said, the premiums costs would be lower for those with healthy lifestyles.
State funding for the program would come from an increase in the state hospital-bed tax; a tax of up to 1.8 percent on insurance claims, which would be paid by insurers; and an assessment paid by Blue Cross in exchange for allowing the insurer to keep its nonprofit status even as the state enacts reforms that lessen the company's burden as the insurer of last resort.
The other two bills are specifically designed to help level the playing field between Blue Cross and other insurers.More regulation, higher premiums for policyholders.
One bill would require insurance companies to renew polices of individual policyholders even if they get sick. It also would limit policy cancellations for technical reasons and shorten the period in which companies may exclude coverage.
Currently, companies other than Blue Cross can refuse to cover an individual for any conditions that existed within a year of buying a policy; that period would be shortened to six months, the same as Blue Cross.Higher taxes.
The other bill would create a reinsurance pool to reimburse insurance companies for individual claims of more than $25,000, which would lower the incentive for insurance companies to send their most expensive clients to Blue Cross. The pool would be financed by a fee on all individual policies.
Insurance is part of the problem with health care: Our Crazy Health-Insurance System