Michigan's alternative approach to Medicaid expansion is showing early signs of success, a new audit reveals, with the vast majority of participants saying they've gained coverage and are now healthier.
Under the Healthy Michigan Plan, the state provides Medicaid coverage to all newly eligible adults with incomes up to 138% of the federal poverty level. More than 600,000 have enrolled since the program started in April 2014.
Healthy Michigan requires beneficiaries above 100% of the federal poverty level to make monthly premium contributions to health savings accounts equal to 2% of their income. Not paying won't result in loss of coverage as it would in other states with similar waivers. Instead, they incur a debt that can be garnished from tax refunds or lottery winnings.
Ninety percent of those surveyed agreed that the amount they pay for Healthy Michigan coverage is affordable, according to an analysis by the University of Michigan's Institute for Healthcare Policy and Innovation. The report was submitted to the CMS last week.
Those findings are a sharp contrast to results in Indiana, where half of Medicaid enrollees are sometimes, usually or always worried about being able to make savings account contributions.
Experts have calculated that cost-sharing would cause many beneficiaries to sit out coverage. While Indiana's survey showed that could be true, Michigan's does not. Prior to these two recent analyses, little real world data was available.
In a separate report not sent to the CMS, Michigan reveals that only 2,000 beneficiaries faced tax garnishment in 2015, with officials collecting just over $196,000.
In Michigan, beneficiaries can reduce their contributions to health savings accounts by following healthy behaviors, such as preventive screenings.
Nearly 60% of those surveyed said that they did not have coverage in the 12 months prior to joining Healthy Michigan. Since enrolling, 47.5% of respondents reported that their physical health has gotten better. And 60% reported that their ability to get primary care is better compared to before they got coverage under the program.
Nearly 70% are more likely to contact their doctor's office before going to the emergency room.
Finally, 86% say their ability to pay medical bills has gotten better since joining the program.
