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Published: Thursday, 5/14/2009

Michigan health care proposals; roughly half of 1.2 million uninsured would be covered


LANSING, Mich. Roughly half of Michigan's 1.2 million uninsured residents could wind up with subsidized, relatively low-cost health coverage under a proposal rolled out Thursday by some key Senate Republicans.

The proposal will add to the long-simmering debate regarding what to do about rising health care costs and the growing number of uninsured in Michigan. Democrats in the state House have introduced a competing plan, and while there appears to be some common ground between the two approaches, major differences must be resolved before any new laws could be passed to guide the Michigan market.

The Senate proposal calls for an assessment on all claims paid by health insurance companies in the state to help subsidize the cost of basic coverage plans for relatively low-income residents who don't buy coverage because they can't afford it. The bill as introduced would allow an assessment of up to 1.8 percent, although it's possible a much lower rate could provide enough money to fund the program. A board established by the legislation would help determine the assessment rate.

"We're asking everyone to chip in," said Sen. Tom George, a Republican from Kalamazoo County's Texas Township and the chief architect of the Senate proposal. "We're stepping on everyone's toes a little bit in order to expand access to health care."

That's better than the current system, bill supporters say. People with insurance coverage pay significantly higher costs because they are helping offset the estimated $2 billion in annual uncompensated health care provided to the uninsured in Michigan. Supporters of the George plan say broadening insurance coverage could help lower costs overall.

House Democrats who sponsor a competing plan are wary of a broad assessment on health insurance claims, saying it could raise costs for automakers and businesses that can least afford it. But some provisions of the Senate and House plans appear to overlap and could lead to a compromise.

"We're both headed in the right direction, which is encouraging," said Rep. Marc Corriveau, a Democrat from Northville and a key sponsor of the House plan.

Both plans feature somewhat similar provisions to help cover people who have claims of $25,000 or more in a given year through assessments on companies competing in Michigan's individual health insurance market. Both would require more payments from nonprofit Blue Cross Blue Shield of Michigan in lieu of taxes. In exchange, Blue Cross could get some relief from some of the costs associated with its role as Michigan's insurer of last resort.

Both plans would increase consumer protections, including provisions aimed at preventing insurers from dropping people when they become sick.

Another piece of the Senate plan is aimed at getting more federal money tied to Medicaid to help expand coverage. It would include incentives for healthy behavior.

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