Updates About Health Policy

The Michigan Department of Health and Human Services recently sent out a Michigan Medicaid Policy bulletin reminding Medicaid providers of the upcoming policy changes. In compliance with Section 71109 of H.R. 1, commonly referred to as “The One Big Beautiful Bill Act”, beginning October 1 only legal permanent residents, Cuban and Haitian entrants, and Compacts of Free Association (COFA) migrants will be able to receive full Medicaid coverage. Certain individuals will still need to meet the five-year waiting period for full coverage. Anyone who falls under a different immigration status will qualify for emergency services only (ESO).

Due to Michigan providing coverage under section 214 of the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIRPA), pregnant individuals and children under the age of 21 who are legal residents will not have their coverage affected by H.R. 1.

House Democrats recently introduced a bill package that aims to reform Michigan’s primary care. The eight-bill package is being led by Rep. Matt Longjohn (D-Portage). The series of bills aims to increase the share of state-contracted health plans spending dedicated to primary care from 6% to 12%.

Also included are bills creating a state commission and office focused on primary care access, workforce needs, and monitoring investments. The package would codify the MiDOCS recruitment program and create a MiNURSES program that would offer loan repayment and scholarships for nurses who work in underserved areas.

The package also comprises a proposal to create a program for state-backed loans to help students who are pursuing a career in primary care but have already reached the federal student loan cap. Lastly, a bill in the package is included to create tax credits for clinicians who train providers and grants for medical schools to introduce students to health careers.

The introduction of the package comes as primary care, and healthcare in general, see access shortages across the state.

The Michigan Senate has passed a package of bills that would create a state-based healthcare exchange in Michigan. Similar legislation was also passed by the Senate last session. If passed, Michigan would move away from the federal healthcare exchange to a newly created exchange run by the state by January 2028.

SB 973 would create the Michigan Health Insurance Exchange and outlines the creation of a 12-member governing board, which would create and oversee a non-profit corporation that provides the health plan marketplace. It also outlines governance, oversight, funding, reporting, and enrollment requirements for the exchange, while requiring the Department of Insurance and Financial Services (DIFS) to certify the qualified health plans according to State and Federal law and the provisions of the legislation.

SB 974updates insurance code definitions to align with the state-based health insurance exchange created under SB 973.

SB 975 requires DIFS to contract with the state-based exchange to certify qualified health and dental plans.

SB 976 would require insurers to provide enrollment information required by the state-based exchange.

SB 977 requires DIFS to apply for a federal waiver to create a state-based reinsurance program and report funding needs to the Legislature’s appropriations committees.

SB 978 repeals a law requiring certain health insurance plans to cover specific emergency and early prescription refills.

Each bill passed along party lines (20-16). The bills need to be passed by the Republican controlled House and signed into law by the Governor before the current session ends in December or would need to be reintroduced again next session.