Michigan health care experts concerned about impact of possible obamacare changes – crain’s detroit business

A group of state health care experts was unanimous in its concern Thursday at Crain’s 8th annual Health Care Leadership Summit that President-elect Donald Trump might gut large sections of the Affordable Care Act that nearly 1 million people in Michigan rely on for private and public health coverage.

The experts — who included a physician, a consumer advocate, an insurance executive and a hospital executive — said overhauling key sections of the act, also known as Obamacare, would also disrupt the business models of hospitals, doctors and related health care companies.

Despite losing the national popular vote by at least 1.2 million, Trump, elected this month in one of the greatest upsets in American political history, has promised to repeal and replace Obamacare.

He recently softened his position on full repeal and said he might want to retain two key popular sections of the bill: allowing children up to age 26 to stay on their family policies and keeping the ban on insurers from refusing to insure people with pre-existing conditions.

But nobody really knows what Trump will do. Youtube gas pedal dance He has proved himself to be not only unpredictable from a political standpoint, but also able to make policy shifts without acknowledging he has flip-flopped, a change of mind that historically dogs most candidates.

Conservative health policy experts who supported Trump don’t believe an Obamacare repeal is in the cards, at least for one or two years and without an immediate replacement. Wd gaster cosplay Many changes are in the offing, said health policy analyst Naomi Lopez Bauman of the Goldwater Institute, who spoke in an earlier summit panel on national politics.

Bauman predicted Trump and the Republican Congress will pursue many changes that will give states more local control, seek to reduce health care prices through increased competition and move to block granting to states’ federal Medicaid funds that can cover many lower-income people with subsidies.

However, health economist Jared Bernstein said he believes the Republican Congress will vote to repeal Obamacare within three months, but put a two-year sunset provision in the bill to give them time to come up with a replacement.

He said the Obamacare replacement will look a lot like Obamacare, but it will likely be so complicated — because it will be based on the free market — that he doesn’t envision it working.

Moderating the state panel at the Troy Marriott was Marianne Udow-Phillips, executive director of the Center for Healthcare Research and Transformation in Ann Arbor.

She quoted Detroit native Mark Bertolini, CEO of Aetna Inc., one of the nation’s largest health insurers, who said Aetna has no backup “plan B” for Trumpcare.

Gilda Jacobs, CEO of the Michigan League for Public Policy, said Healthy Michigan Medicaid expansion is a critically important safety-net program, has covered more than 630,000 people and is projected to save the state $1 billion over 10 years.

“(Gov. Electricity year 4 Rick) Snyder backed Healthy Michigan expansion,” Jacobs said. E85 gas stations in ohio “Many (Republicans) in the legislature don’t understand it, and the newly elected Republicans are more conservative. Gasco abu dhabi address If there was a vote now, Healthy Michigan would not pass.”

Ironically, Jacobs said, thousands of people in Michigan’s rural areas voted for Trump, receive care through Healthy Michigan and would be affected the most if it were de-funded or repealed.

David Krhovsky, M.D., president of the Michigan State Medical Society, said some doctors might support changes, especially in regulations that have sometimes increased overhead costs and made it difficult to practice medicine.

“I practiced medicine for 30 years and now I am a manager at Spectrum,” said Krhovsky, an anesthesiologist and vice president of medical affairs at Spectrum Health in Grand Rapids.

“The last five years we have gone down a path that we can’t go back from,” he said. Mp electricity bill payment online indore “Despite politics, there are many good things (about Obamacare). Gas oil ratio for weed eater The question is how do we pay for these things.”

Krhovsky said the state medical society and the American Medical Association support universal coverage — but not single payer — where everyone has a private policy or coverage by Medicaid or Medicare.

Rick Murdock, executive director of the Michigan Association of Health Plans, said he is interested to know how the CEOs and executives of his 14 Medicaid health plans feel about Trumpcare and possible changes.

Over the past two years since Healthy Michigan began enrolling people in April 2016, Medicaid managed care organizations have benefited greatly. Gas 0095 download Last year, Medicaid plans posted their highest profits in more than a decade and hired hundreds of workers to support the now 2.5 million Medicaid enrollees in the state.

Obamacare also has been good for the private insurance market, as taxes raised by the bill go to fund federal tax credits on the online exchange that reduces premium costs for eligible people. Gas efficient cars under 10000 More than 300,000 people purchase health insurance on Michigan’s exchange, with 85 percent of them receiving some subsidy.

“Enrollment on the (Obamacare private) exchange is skyrocketing” so far this year, possibly because Trump has promised to repeal it, said Murdock, who is retiring from the association at the end of the year.

So far, about 1.2 million people have signed up for private coverage on state and federal exchanges nationally, including 100,000 on Nov. Nyc electricity cost per kwh 9, the day after the election.

“It is possible there could be a spike in utilization next year,” said Murdock, noting that happened this year, which led to premium increases far above the previous three years in the individual market and several large health insurers pulling out of the exchanges.

Nancy Schlichting, CEO of Henry Ford Health System, said Obamacare has done a lot to help 22 million people gain health coverage, many of whom have suffered through economic rough times and income stagnation.

“(Obamacare) did a lot. Gas monkey cast We have the lowest increase in Medicare costs in history with providers thinking” about how to deliver care more efficiently and more effectively by coordinating care and increasing community outreach, said Schlichting, who is retiring at the end of the year.

“We need to pay attention to people — those we serve and our own (employees),” she said. Gas laws worksheet answers and work “We (Henry Ford) have a diverse population and they can be debilitated by comments made about them” during the campaign by Trump.

Udow-Phillips asked the panel about the expectation that a Trumpcare plan or a Republican solution modeled after House Speaker Paul Ryan’s “A Better Way” health care reform plan might lead to a shift of power to the states.

Examples would be greater flexibility on Medicaid waivers to experiment more on coverage and cost-sharing or a long-time Republican plan that would block grant federal Medicaid funding to states.

Jacobs said she opposes block granting Medicaid to states because history shows that funding increases never takes into account health care inflationary cost increases.

“You can’t anticipate higher costs with that,” said Jacobs, also implying that block granting federal dollars can lead to possible misuse. Electricity towers health risks “The writing is on the wall. Wikipedia electricity consumption No one will increase those funds.”

For example, the Temporary Assistance for Needy Families, or TANF, program, was designed to help needy families achieve self-sufficiency. Electricity use in the us Since 1996, states have received block grants that provided great flexibility to use the funds.

Jacobs said the Michigan Legislature has used TANF funds for a variety of purposes, including funding private colleges, leaving less funding for the base program.

Krhovsky said organized medicine is in favor of block grants as one option. E85 gas stations in houston He said he doesn’t know enough about the Trump plan to comment, but he said any plan should ensure enough funding is there to support patient care.

Murdock said block grants are an attractive solution because of budget predictability, but it all depends on how much funding is attached to it.

Murdock said he could favor block granting Medicaid because there are so many federal strings attached to Medicaid dollars today. Gas unlimited For example, Medicaid health plans must conduct health risk assessments with doctors of beneficiaries covered by the program.

“Clearly they are more conservative and probably more in tune with what’s going on in Washington,” Murdock said. Electricity generation capacity “We need to look to see who leads on health policy and appropriations committees. Electricity sources usa We have folks who have experience. La gasolina cancion The new speaker coming in (Rep. Gas up the jet Tom Leonard, R-DeWitt) has good appreciation of the insurance market. Hp gas online complaint He helped sponsor insurance reforms. Gas exchange in the lungs happens by the process of … Gas evolution reaction We need to wait and see.”

“They appreciate the education you can provide,” he said. La gasolina mp3 “They are not experts on every issue. J gastroenterol impact factor Within our sphere of influence, we can influence them and help them understand things that can be overly disruptive.”