Proposed work requirements for Medicaid in Michigan: June 7, 2018

At the start of 2018, the U.S. Centers for Medicare and Medicaid Services (CMS) announced a major shift in federal policy that would allow states to request permission to establish, and test the impact of, work and community engagement requirements for able-bodied adults receiving Medicaid health insurance coverage. In the last five months, work requirement proposals have been approved in four states; formal applications have been submitted by seven more, and a number of others are preparing proposals.

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In April, the Michigan State Senate took the first step toward establishing work requirements by passing Senate Bill 897. The Michigan House of Representatives passed an updated version of the bill on June 6. And on the morning of June 7, the Michigan Senate approved the revisions and sent the bill to the Governor’s office for signature.

Setting the stage for the 2019 Health Insurance Marketplace


healthThe Centers for Medicare and Medicaid Services is rolling back regulations around rate increases, essential health benefits, health insurance navigators, and more, for insurers offering Qualified Health Plan coverage on the Health Insurance Marketplace in 2019.

In a new fact sheet, CHRT compares the current rules and regulations to the changes that go into effect in 2019—with a special focus on Michigan. Here are just a few highlights:

  • Rate increases under 15 percent will no longer require review;
  • Simple choice standardized plans will be eliminated; and
  • Consumer cost-sharing limits will increase by 7 percent.

These changes will impact Michigan consumers as soon as November 1, 2018, when the next Marketplace Open Enrollment Period begins.

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Issue Brief: Bipartisan Budget Act adds $3B for substance abuse, mental health, more

The Bipartisan Budget Act was signed into law on February 9, 2018. While the main purpose of the legislation is to temporarily fund the federal government through March 23, 2018, it also includes an agreement to raise the caps on domestic and military spending for the next two years.

The legislation includes many health care policies, as well. The major policies are described in Health Care Policies in the Bipartisan Budget Act (H.R. 1892).


Health Care Provisions in the Tax Cuts and Jobs Act (H.R. 1)

The Tax Cuts and Jobs Act passed the U.S. House of Representatives on November 16, 2017, and an amended version passed the U.S. Senate on December 2, 2017. Congress reconciled the differences between the two bills in a compromise conference report.

While the purpose of the legislation is to reduce tax rates for businesses and individuals, it includes several major health care policy changes. These provisions are described in the brief, Health Care Provisions in the Tax Cuts and Jobs Act.

Editor’s Note: CHRT updated this fact sheet Jan. 12, 2018 to include more recent Medicare beneficiary numbers, updated information on PAYGO, and reflect that the conference report is now law.

ACA Repeal and Replacement: Proposals and Action

Beginning last month, both U.S. President Donald Trump and the U.S. Congress began taking steps to repeal the Affordable Care Act (ACA). However, a single replacement strategy has not yet emerged.

In a new one-page fact sheet, CHRT summarizes the most developed ACA repeal and replacement proposals offered to date and outlines the tentative replacement process.

You can also review CHRT’s companion piece, Select Affordable Care Act Replacement Plans and Implications, for a detailed table summarizing the key features and implications of the most developed full ACA repeal and replacement plans offered to date.

Rate Analysis: Michigan’s 2017 Health Insurance Marketplace


While the results of the 2016 presidential election have sparked recent debates about options to repeal and replace the Affordable Care Act, the health insurance marketplaces created under the law continue to operate as usual. So although the future of the law remains unknown, consumers who enroll in Marketplace coverage can likely expect their coverage to remain uninterrupted for the 2017 plan year.

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The changing dynamics of the health insurance marketplace are important for 2017 enrollees to understand. Under current federal policy, enrollees who do not actively apply and enroll in 2017 coverage are auto-renewed into their 2016 plan, if it continues to be offered. Beginning with the 2017 open enrollment period, individuals who were enrolled in a plan offered by an issuer that is no longer participating in the marketplace will automatically be enrolled into a plan offered in their area by a different carrier if they do not actively choose another plan.

In addition, changes to benchmark plans directly affect premium tax credit amounts, so many enrollees will need to balance potentially higher costs for renewing their 2016 plan with other important considerations, such as the breadth of available provider networks.