Michigan Primary Care Association’s director of state policy, Doug Paterson, testified before the House Health Policy committee on January 19, 2012, on behalf of Michigan’s 32 Community Health Center organizations in support of the MiHealth Marketplace, Michigan’s proposed health insurance exchange. Michigan Community Health Centers, also called Federally Qualified Health Centers or FQHCs, operate over 190 community owned and operated delivery sites statewide, and provide comprehensive primary and preventive healthcare to nearly 600,000 Michigan residents. These organizations form an essential component of Michigan’s safety net and are on the front lines of the state’s healthcare delivery system, serving the most vulnerable populations in Michigan’s rural and urban communities. All of the Health Centers are located in medically underserved areas or serve medically underserved populations. In fact, three out of four Michigan residents that Health Centers serve are either uninsured or rely on Medicaid for their health insurance coverage.
The MiHealth Marketplace is of particular interest to Michigan’s Community Health Center network because so many of the people we treat are uninsured and will benefit from an insurance exchange in Michigan. A major portion of these patients have jobs, but their employers do not provide health insurance benefits or don’t offer benefits at a price they can afford. We believe implementation of the MiHealth Marketplace will allow market forces to work more effectively by creating competition among insurers and providers, spreading risk among the pool of people to be insured, and helping to mitigate against increasing premiums. We are before you today because we believe it is imperative to pass authorizing legislation immediately that will begin to create the structure in Michigan through which purchase of insurance for individuals and small businesses can be better organized.
We have four compelling reasons for our request:
A Health Insurance Exchange is a good idea even if the Affordable Care Act is found unconstitutional next June. Case in point is testimony written by the Heritage Foundation in 2006, two years before President Obama’s election, that concludes “State-level health insurance exchanges would increase health insurance coverage, significantly lower prices in the individual coverage market, give individuals and families access to more choice, allow coverage portability, and increase employer’s flexibility in offering health benefits.”
Unless Michigan is prepared to implement an exchange by June 30, 2012, our state will be ineligible for federal funding to design and operate an exchange. Without such funding, our state will likely abdicate responsibility for design and operation of the exchange to the federal government. This could mean that the federal government will likely be dictating eligibility and information systems requirements, which could have sizeable impact on Michigan processes and current IT systems. It also means jobs that would be created to operate the exchange in Michigan will likely be created elsewhere.
The federal government must certify by January 1, 2013 – just one year from now – that Michigan is capable and ready to operate a state exchange. The Information Technology requirements to implement the exchange will be massive. It just took the state’s Medicaid program four years to implement its new information management system (CHAMPS). To successfully implement a more expansive effort in just 12 months will be next to impossible if we don’t begin immediately. Important decisions need to be made now in Michigan to have the exchange be effective for our state.
The slower we go in getting the structure and decision making authority in place, the less time we will have to actually design the exchange. It is prudent to get the structure in place and identify the people who will be making important decisions to allow sufficient time for dialogue, research, and design to get it as right as possible. If Michigan delays, it will have to do the heavy lifting in a much shorter amount of time, which in our opinion is much more likely to lead to mistakes.
We believe legislation creating a Michigan exchange is needed now so that planning efforts can begin as soon as possible.