Affordable Care Act & Legislative Update April 19, 2016 Laura Appel, Senior Vice President, Strategic Initiatives Dave Finkbeiner, Senior Vice President, Advocacy 1
2010 But before a single Michigan resident has access to the federal exchange or Medicaid expansion 2014 Michigan hospitals forgo $525 million in Medicare funding
2014 MICHIGAN S FEDERALLY FACILITATED HEALTH INSURANCE EXCHANGE HEALTHY MICHIGAN PLAN 346,000+ Michigan residents currently benefitting from coverage options 600,000+ Michigan residents currently benefitting from Michigan s Medicaid expansion program Together these programs currently provide healthcare coverage for nearly 1 million Michigan residents
Reducing the Uninsured Reducing the Uninsured Center for Healthcare Research and Transformation coverage survey pictured MHA inpatient data nearly identical Number of patients admitted to hospitals without some type of coverage down 50%
Hospital Financial Health Post-ACA Margins at +8% for 2014 Hospitals still lost money on patient care Medicare/Medicaid rates don t cover cost of care 4.2 million MI residents use Medicare/Medicaid/ Healthy Michigan
Medicaid Expansion and Economic Impact Healthy Michigan Plan saves $235 mil in annual state spending (mental health/adult/prisoner care) Healthy Michigan Plan brings $3.4 bil federal dollars to MI annually Expansion states experiencing higher job growth compared to non-expansion* MI traditional Medicaid enrollment down 125,000 since Oct. 2013 *Robert Wood Johnson Foundation, State Health Reform Assistance Network Issue Brief, March 2016
Michigan Legislative Big Picture Flint water crisis: $68 million supplemental, $126 million pending, federal waiver Detroit Public Schools: $48.7 million supplemental appropriation approved Health Insurance Claims Assessment (HICA) sunset: extended until July 31, 2020 Election year for Michigan House Frequent reports of robust hospital margins 7
MHA FY 17 Medicaid Budget Priorities Protect existing funding Rates, GME, OB stabilization fund, small/rural pool Protect against excessive retention as state obligation for HMP increases HICA sunset extension until July 31, 2020 Renew Healthy Michigan Plan funding Including required match = $109m Fend off potential challenge to HMP waiver Universal positive feedback for avoiding budget fight 8
Auto Insurers Tax Credit Grab Office of Secretary of State 1973-2012 MI Auto Insurance Facility 2012 - Present AUTO INSURERS TAX CREDIT GRAB Expense passed through to policy holder Tax year 2012: insurers begin taking tax credit = $80 million Double-dipping: tax credit and pass-through to policy holders
2016 Elections - Nov. 8 U.S. President U.S. Congress 14 seats (9 R, 5 D) MI House of Representatives 110 seats (63 R, 46 D) MI Senate Special Election to replace V. Smith MI Supreme Court 2 seats (Justice Viviano, Justice Larsen) Election o Primary: Aug. 2, 2016 o General: Nov. 8, 2016 10
2016 Elections - President (Dems) Hillary Clinton Former U.S. Secretary of State Bernie Sanders U.S. Senator-VT Current Clinton 1,758 Sanders 1,069 *2,383 Delegates need Convention Date: July 25 (Philadelphia, PA) 11
2016 Elections - President (GOP) Donald Trump CEO of Trump Organization Ted Cruz U.S. Senator - TX John Kasich Governor of Ohio Current Trump 743 Cruz 545 Kasich 143 *1,237 Delegates need Convention Date: July, 18 (Cleveland, OH) 12
Scandals Crisis Shaping Michigan s Election Reps. Todd Courser & Cindy Gamrat Sen. Virgil Smith Flint Water Detroit Public Schools Elimination of straight ticket voting Anyone surprised Michigan didn t vote for the establishment? 13
Michigan Specific Data Michigan's primary turnout: 2.38 million breaking a previous high of 1.9 million in 1972 Sanders Won 73 of 83 counties Trump Won 71 of 83 counties Last Republican to win MI s Electoral Vote was Ronald Reagan in 1988 Donald Trump Bernie Sanders 14
Michigan Specific Data Michigan Republican Delegates* 59 Trump (25) Cruz (17) Kasich (17) Michigan Democratic Delegates 147 Sanders (67) Clinton (63) Unpledged (17) *15% Threshold 15
Trump unexpected front runner Won the somewhat conservative vote Picked up voters from all parts of the GOP electorate Simple, relatable answers Exudes confidence Popular among people who feel left behind in current economy Sick of establishment Stood out from the crowd Blunt 16
Health Care Stances of Two Front Runners Trump Repeal Affordable Care Act Advocates smaller number of vaccines for children Allow purchase of health care plans across state lines Advocates defunding Planned Parenthood Clinton Supports Affordable Care Act (repeal Cadillac Tax) Control pharmaceutical pricing Supports vaccination World is interconnected (Zika/Ebola) Women s access to contraception 17
Objective & Useful Information www.mivote.org Non-partisan guide to candidates and issues Secretary of State- michigan.gov/vote Elections in Michigan website www.michigantruthsquad.com Non-partisan website providing analyses of campaign ads and literature from candidates for Gov., state Legislature and Congress www.mha.org (click on election logo) MHA election web page containing candidate information and election information pertinent to hospital community 18
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Thank You! 20