Two Years Later: The Benefits of the Affordable Care Act for Michigan

Friday, March 23, 2012, is a day to celebrate. It marks the second anniversary of the Affordable Care Act, which gives hardworking families in Michigan and across the country the security they deserve. For too long, too many hardworking people were held helpless to policies that handed free rein to insurance companies and put barriers between patients and their doctors. The new health care law ensures that insurance companies are accountable to the people. Now, insurers are prohibited from dropping coverage due to sickness, imposing annual or lifetime limits that often result in bankruptcy or, soon, discriminating against anyone with a pre-existing condition.

Everyone will have the security of knowing that they don’t have to worry about losing coverage if they’re laid off or change jobs. And insurance companies now have to cover preventive care like mammograms and other cancer screenings. The new law also makes a significant investment in State and community-based efforts that promote public health and prevent disease, such as Health Centers.

The nationwide network of 1,200 Health Centers serving more than 20 million patients is the largest network of safety net providers. Today, 32 Michigan Health Centers provide quality, comprehensive, affordable primary and preventive health care for nearly 600,000 residents at over 190 sites across the state. Their doors are open to everyone in the community, regardless of insurance status, income level, race, education, age, or language spoken.

The capacity at Michigan Health Centers is expected to grow significantly under the Affordable Care Act. To prepare for this increase, Michigan Health Centers have received $46.2 million under the health reform law to create new Health Center sites in medically underserved areas, enable existing Health Centers to increase the number of patients served by expanding preventive and primary health care services, and support major construction and renovation projects.

The Affordable Care Act is also making a difference for the people of Michigan in many other ways:

Providing new coverage options for young adults
Health plans are now required to allow parents to keep their children under age 26 without job-based coverage on their family’s coverage, and, thanks to this provision, 2.5 million young people have gained coverage nationwide. As of June 2011, 57,527 young adults in Michigan gained insurance coverage as a result of the new health care law.

Making prescription drugs affordable for seniors
Thanks to the new health care law, 90,917 people with Medicare in Michigan received a $250 rebate to help cover the cost of their prescription drugs when they hit the donut hole in 2010. In 2011, 84,168 people with Medicare received a 50 percent discount on their covered brandname prescription drugs when they hit the donut hole. This discount resulted in an average savings of $582 per person, and a total savings of $48,999,065 in Michigan. By 2020, the law will close the donut hole.

Covering preventive services with no deductible or co-pay
In 2011, 1,123,354 people with Medicare in Michigan received free preventive services – such as mammograms and colonoscopies – or a free annual wellness visit with their doctor. And 54 million Americans with private health insurance gained preventive service coverage with no cost-sharing, including 1,849,000 in Michigan.

Providing better value for your premium dollar through the 80/20 Rule
Under the new health care law, insurance companies must provide consumers greater value by spending generally at least 80 percent of premium dollars on health care and quality improvements instead of overhead, executive salaries or marketing. If they don’t, they must provide consumers a rebate or reduce premiums. This means that 2,521,000 Michigan residents with private insurance coverage will receive greater value for their premium dollars.

Scrutinizing unreasonable premium increases
In every State and for the first time under Federal law, insurance companies are required to publicly justify their actions if they want to raise rates by 10 percent or more. Michigan has received $5 million under the new law to help fight unreasonable premium increases.

Removing lifetime limits on health benefits
The law bans insurance companies from imposing lifetime dollar limits on health benefits—freeing cancer patients and individuals suffering from other chronic diseases from having to worry about going without treatment because of their lifetime limits. Already, 3,547,000 residents, including 1,315,000 women and 977,000 children, are free from worrying about lifetime limits on coverage. The law also restricts the use of annual limits and bans them completely in 2014.

Creating new coverage options for individuals with pre-existing conditions
As of the end of 2011, 789 previously uninsured residents of Michigan who were locked out of the coverage system because of a pre-existing condition are now insured through a new Pre-Existing Condition Insurance Plan that was created under the new health reform law. To learn more about the plan available in Michigan, check here.

Supporting Michigan’s work on Affordable Insurance Exchanges
Michigan has received $10.8 million in grants for research, planning, information technology development, and implementation of Affordable Insurance Exchanges.

  • $1 million in Planning Grants:  This grant provides Michigan the resources needed to conduct the research and planning necessary to build a better health insurance marketplace and determine how its exchange will be operated and governed. Learn how the funds are being used in Michigan here.
  • $9.8 million in Exchange Establishment Grants:  These grants are helping States continue their work to implement key provisions of the Affordable Care Act. Learn how the funds are being used in Michigan here.

Preventing illness and promoting health
Since 2010, Michigan has received $22.8 million in grants from the Prevention and Public Health Fund created by the Affordable Care Act. This new fund was created to support effective policies in Michigan, its communities, and nationwide so that all Americans can lead longer, more productive lives.

Strengthening partnerships with Michigan
The law gives states support for their work to build the health care workforce, crack down on fraud, and support public health.  So far, Michigan has received more than $106 million from the Affordable Care Act. Examples of Affordable Care Act grants not outlined above to Michigan include:

On March 16, U.S. Health and Human Services Secretary Kathleen Sebelius unveiled MyCare, a collection of online personal video and blog stories of Americans helped by the Affordable Care Act. If you would like to share your own story of how the health care reform law has helped you, use the Twitter hashtag #MyCare or visit facebook.com/HealthCareGov.

Happy second anniversary Affordable Care Act!


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