Kathleen Sebelius: No Michigan coverage gap in Medicaid expansion

By Robin Erb

Detroit Free Press Staff Writer

http://www.freep.com/article/20140115/NEWS06/301150110/

Limbo

• Michiganders wanting Medicaid health coverage but caught in limbo — dangling between a federal website informing them they’re probably eligible for Medicaid and a state bureaucracy not yet ready to tell them for certain — need not worry, U.S. Department of Health and Human Services Secretary Kathleen Sebelius said in Detroit earlier today.

• Under health reform, Michigan is expanding its Medicaid program, raising the threshold of eligibility to extend coverage to an estimated 470,000 Michiganders.

Newly eligible• But applications aren’t ready yet for those who will be newly

eligible. Neither is the state software to handle the new program.• That has worried some consumers and advocates that Michigan’s

poor and uninsured won’t be covered April 1 — the anticipated opening date for new Medicaid.

• Additionally, some consumers also worry that a delay in the application process means that if they ultimately find out they must buy insurance policies because they’re not eligible for Medicaid after all, it will be too late to access financial help that for many Americans helps pay policy premiums for non-Medicaid products but that expire March 31. They additionally would face a tax penalty for being without coverage. Under the 2010 Affordable Care Act, most Americans will face a tax penalty of $95 or more if they are without coverage for three months of the year.

“Let the system work”, she says

• Sebelius, in town to work with new Detroit Mayor Mike Duggan to boost Detroit’s enrollment through www.healthcare.gov, said consumers can only do so much and then let the system work.

• The website is the virtual shopping site for coverage under health reform.

• “If they have taken steps to get themselves ready, they don’t have to worry about that at all,” she said, referring to tax penalties and credits that otherwise expire March 31.

Medicaid and Obamacare

• Obamacare has 2 major pieces:– Health exchanges for those who haven’t bought

care.– Medicaid expansion for those who need to buy

care.

• Medicare is a state level match program directed largely toward the poor.

• What is the public finance angle here?

How the Medicaid match works …

• Medicaid provides matching funds.

• BUT federal mandates of program they cannot simply substitute Federal $ for State $.

All else

Health for poor

A*

H*

A**

H** Hmandated

• In particular, Medicaid has provided universal health insurance for children under age 18, whether states wanted it or not.

• Probably a good thing.

A***