MIFamily Plan to Expand Health Care Services

Michigan Department of Community Health Director, James K. Haveman, Jr., today announced public forums will be held on Monday, February 4, 2002 at the Lansing Center to discuss Governor Engler's proposed expansion of health care coverage. The 9:00-11:30 am, session is for beneficiaries, Native American Tribes and advocates. The 1:00-3:30 pm, session is for health care providers, health plans and health care organizations.

"The MIFamily plan is an innovative way for Michigan to provide comprehensive health care to persons in need," said Haveman. "As Governor Engler announced in the State of the State address, now that Washington has given states the flexibility to design programs that meet our needs, we can stretch the dollars and help more people."

The purpose of the forums is to discuss the proposed Health Insurance Flexibility and Accountability (HIFA) waiver to be submitted to the Department of Health and Human Services in order to implement the MIFamily plan. Once public comment has been reviewed and incorporated into the proposal, a waiver package will be developed and submitted to the federal government for approval for the MIFamily plan to begin coverage October 1, 2002.

MIFamily will not reduce or change health care benefits to senior citizens, pregnant women, persons eligible under a mandatory Medicaid category, children or persons with disabilities or persons with developmental disabilities. Mental health services will not change for any person currently receiving services and will be expanded to serve single adults and parents under the waiver. Under MIFamily, children covered by Healthy Kids will receive 12-month continuous health care coverage instead of the current month-to-month coverage.

Persons with disabilities will be able to earn more in the workplace without fearing they will lose their health insurance through Medicaid, as the MIFamily plan raises the income level to 350% of poverty for working disabled persons covered under Section 1619 (b). These persons received SSI cash assistance before earning more in the workplace, but retain Medicaid coverage until they reach an income level of $21,886. Currently, persons with disabilities on this coverage are limited to incomes of $21,886 and an asset limit of $2,000 for an individual and $3,000 for a couple. The MIFamily plan will make it possible for these persons with disabilities to earn up to $31,188 a year and to pay for retirement needs without losing their Medicaid benefits.

MIFamily will expand Medicaid benefits and improve health care access to 222,000 people.

-- Parents and persons acting as a parent living in families with incomes between 51% and 100% of poverty, or approximately $7,535 to $15,070 a year for a family of three. Current coverage in this category is only available for parents with incomes below 50% of poverty. The MIFamily plan is expected to provide coverage to an additional 80,000 parents of children currently covered by Medicaid. This coverage will provide a HMO-like benefit covering outpatient care, pharmaceutical coverage, mental health and substance abuse services and limited inpatient care. Some of these people are currently required to "spend down" their personal funds on health care expenses each month before they are eligible for coverage. Under MIFamily, they will receive continuous health care coverage, greatly improving their continuity of care.

-- Pregnant women living in families with incomes between 186% and 200% of poverty, or approximately $21,182 to $23,980 a year for a pregnant woman. Current coverage is available to pregnant women with incomes at or below 185% of poverty. The MIFamily plan is expected to provide Medicaid coverage to an additional 2,000 pregnant women.

-- Single adults with no children and income of up to 35% of poverty would receive health care coverage under the MIFamily plan. These individuals are currently not eligible for Medicaid and approximately 50,000 are expected to receive MIFamily plan health care coverage including outpatient services, pharmaceutical coverage, mental health and substance abuse services or coverage through a county health plan.

-- Under MIFamily, counties will be encouraged to partner with the state and federal governments to provide health benefits to an additional 90,000 county residents. Currently seven counties, Wayne, Ingham, Muskegon, Genesee, Kent, Kalamazoo and Midland, participate in a pilot of this program. Over the five year life of the waiver, it is expected that remaining counties will implement this program offering a specified outpatient benefit and cover eligible county residents to 100% of poverty. Individual counties have the ability to establish what income is counted in determining eligibility.

-- MIFamily beneficiaries may receive a voucher to purchase employer sponsored or private coverage in lieu of receiving benefits through the Medicaid program. The value of the voucher will be based on the cost of providing services through Medicaid and will not exceed the cost of the coverage purchased.

Approval of the HIFA waiver will allow the federal government to recognize the investment Michigan already makes in health care and allow the state to maximize unspent federal dollars from the MIChild program to expand health care coverage to more individuals. Michigan will also seek to increase federal funding as a match for state mental health funds, state medical funding and county health care program funding. Mental health funding will be increased $50 million by this method.