Michigan & The Affordable Care Act

What The Affordable Care Act Means For Michiganders
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For more information about the Affordable Care Act, visit CBSDetroit.com/ACA.

In 2007, 12 percent of Michigan residents reported they were unable to see a doctor when necessary due to cost. The cost of health insurance rose 39 percent for Michigan families between 2003 and 2009, bringing the average annual premium to $13,160. Premiums for single policyholders increased 34 percent over the same period. [1] Of Michigan residents who do have health insurance, 50 percent are covered through employment. Public programs such as Medicare and Medicaid insure 32 percent of the population, and five percent of residents purchase individual private policies. This leaves about 1,237,500 people, 13 percent of the population, uninsured. [2]

Who are the uninsured in Michigan?

Michigan’s children are uninsured at a rate of five percent. The uninsured rate among non-elderly adults–those younger than 65–is 18 percent. These figures rise for households with annual incomes less than 139 percent of the Federal Poverty Level, with nine percent of children and 38 percent of adults at this income level uninsured. Non-elderly Hispanics are uninsured at a rate of 21 percent in the state. Seventeen percent of Blacks and 13 percent of Whites lack health insurance. [3]

How does the Affordable Care Act affect Michigan residents?

The Affordable Care Act (ACA) requires states provide access to an online marketplace, also called an exchange, where individuals and small businesses may compare, select and purchase private health insurance policies that offer a minimum level of coverage. States have the option of establishing their own exchange, operating an exchange in cooperation with the federal government, or turning all administration of the health care marketplace over to the federal government.

Michigan Governor Rick Snyder supports a state-based health insurance exchange, but his proposal did not receive legislative backing. Therefore, Michigan will operate an exchange in partnership with the federal government. Governor Snyder plans to continue working with legislators so a Michigan-based exchange may be in the state’s future.

Under the ACA, all new policies, and in-force policies upon renewal, must cover a package of essential health benefits, including hospitalization, emergency services and mental health treatments. Annual wellness check-ups and other preventative screenings must be covered with no co-payments or deductibles. Residents may not be denied health insurance for pre-existing health conditions, and insurers may not place a lifetime cap on benefits. Households with incomes at or below 400 percent of the Federal Poverty Level may be eligible for tax credits to offset premium costs.

Michigan’s health insurance exchange

Healthcare.gov is the portal through which Michigan residents will access the health care marketplace. All plans offered there cover the essential health benefits based on Priority Health’s 100 Percent Hospital Services plan. As of May 2013, 14 insurance companies have submitted plans for inclusion. Under the Affordable Care Act, states may expand their Medicaid program to include households with incomes up to 133 percent of the Federal Poverty Level. With the support of Governor Rick Snyder, the Michigan House of Representatives passed legislation in June 2013 approving the expansion.

Small Business Health Options Program (SHOP)

Under the ACA, small business employers with fewer than 50 full-time workers, or full-time equivalent workers, will not be required to offer health insurance to their employees. (Check here for a definition and calculator to determine who qualifies as a full-time worker.) However, the ACA encourages many small business employers to provide health insurance by offering small business health care tax credits.

Many small businesses were already offering health insurance packages to their employees before the ACA was passed and signed into law. These plans are accepted, or grandfathered in, under the ACA.

For small business owners who wish to change their coverage plans, or for those who did not offer health insurance before the new law, the ACA establishes the Small Business Health Options Program or SHOP. SHOP allows employers to compare and shop for quality insurance plans side by side for their employees. To find out more about SHOP, visit the U.S. Small Business Administration.

Michigan health centers

Resources for Michigan residents

See the full list of external resources from CBS Detroit.

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[1] http://www.commonwealthfund.org/Publications/Issue-Briefs/2010/Dec/State-Trends-Premiums-and-Deductibles.aspx
[2] http://kff.org/other/state-indicator/total-population/?state=MI
[3] http://kff.org/state-category/health-coverage-uninsured/?state=MI

Gillian Burdett is a freelance writer covering all things home and living. Her work can be found on Examiner.com.

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