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Not that the item was questionable in any way but in order to gain understanding of why these payments had to be made following the inception late last year of the Affordable Care Act (ACA), which is supposed to provide insurance coverage for all citizens.
Linda Hamacher, President and CEO of the plan, came and addressed the boards’ concerns. She said Jones’ questions were reasonable and explained more about the mission of GHP as an agency which assists people in enrolling for, as well as providing coverage.
Hamacher said current county enrollment was at about 25,000 and her staff was working hard to get them enrolled in whatever coverage they were eligible for. She indicated more than 4,500 people would be moving to full coverage under the Healthy Michigan plan effective April 1.
Healthy Michigan funding was initially provided by the state at first and not through local taxes. “We’re going through them and getting them signed up,” Hamacher said. “We’re hoping when the smoke clears and everyone’s assessed, we hope to have enrollment down to 15,000. There will be some left who will be uninsured, and it will take time to get them into programs.”
One of the trends being seen by workers in the field is single women between the ages of 50 and 60 who will be exempt from the ACA but will be eligible for GHP.
Jones said, “I was told GHP was to provide medical coverage for low income or those who were in between Medicaid and their employer plan, so with the ACA, in my mind, I thought GHP would go away.”
It’s a common misconception the millage funds go to cover GHP administrative costs, Hamacher said, but the contract with county specifies millage monies can only be used for direct health care services.
“We wish the ACA would take care of the uninsured, unfortunately that’s not completely true,” Hamacher added. But in addition to moving people into other plans, they are facing a 35 percent decrease in tax revenue since the millage started.
“It’s very good news that we have the Healthy Michigan plan…and will have the Michigan marketplace, but there will always be people between or who don’t qualify for coverage and those who fall under affordability exemption,” Hamacher said.
“There are some who are not ready for Medicare but not young, either and the age categories that drive pricing make it such that those over 50 may find they qualify for exemption, because the marketplace is unaffordable for them,” she added.
“It’s very complex — a lot of moving pieces,” she explained. The GHP Millage was passed for seven years and Hamacher said hopefully by 2017 we will know if ACA will be repealed or not. Jones also asked: “Where are people obtaining health care without health insurance and Hamacher explained that many are going to free clinics or federal health centers, but some simply go without — causing their disease process to be further along and more expensive to treat when they do get into a plan.
“We get calls every day…about people absolutely desperate with no coverage,” Hamacher said. Another misconception is that all people qualify for Medicare when they become old enough, but she explained that a person has to have worked ten consecutive quarters (five years) to be eligible.
A lot of people that don’t meet that guideline are those who worked for churches or other non-profits. People who have been without insurance for some time and suffer a catastrophic health event requiring hospitalization still may not qualify for Medicaid or Medicare but have to apply for charity care through the hospital, according to Hamacher.
“People come to us having been uninsured and are really very seriously ill,” she said. ”Each hospital has a charity program, dependent on income, people do pay towards their medical care.”
“In the long term and as ACA gets more implemented those will probably change as people should be enrolled,” Hamacher added. GHP also enrolls people in Medicaid, Mi Child, Healthy Kids, Moms Program and other types of health care. Hamacher said in the past the Department of Human Services (DHS) did a lot of screening and enrollment but improvements in technology have enabled her office to provide a Medicaid kiosk in their office to help people enroll online.
Sometimes in the past she added, people would be referred to DHS or other agencies to enroll but never go, so they never got the care they needed. Although the ACA website is working better, Hamacher said now people are running into affordability issues more and more.
“We’re very dedicated to make sure we don’t pay for anything that can be paid for somewhere else,” Hamacher said, adding that they bring in almost $3 million in free prescription drugs per year. She didn’t believe they would lack for clients despite ACA, stating, “There’s always going to be a need… we’re very serious and thoughtful about how the plan is managed.”