Senate Approves BCBSM Legislation
A contentious Senate, split almost along party lines, has approved legislation designed to reform the individual health care insurance market. The actions, conducted over a four-hour period on May 1st, included the adoption of two new-and essentially unseen-substitutes by the members of the Senate Health Policy Committee, an unsuccessful effort to move the bills from committee, the discharge of the bills from committee, having one bill read aloud in its entirety and a call of the Senate. Passage of the two measures on identical votes of 23-13 ended more than six months of Senate deliberations and ensured the measures will be further revised by the conference committee process.

As passed, House Bill 5282(S-5) establishes a six-month waiting period for pre-existing conditions for all carriers, increases the medical rate loss ratio for commercial carriers and directs the Insurance Commissioner to conduct a study of the individual health care market and to make recommendations including whether or not the state should create a high-risk pool as initially proposed by BCBSM. The Senate version of House Bill 5283 (S-4) requires BCBSM to provide annual reports on how it has fulfilled its social and charitable mission, adds two new public members to the BCBSM Board with one appointed by the Senate Majority Leader and the other by the Speaker of the House, shortens the rate setting process and allows BCBSM to consider individual behavior-such as smoking-when setting premium rates.

Signatures Filed in Dillon Recall
The campaign seeking to recall House Speaker Andy Dillon (D-Redford Twp.) for his support of last year’s tax increases has filed 15,500 signatures in hopes of forcing an election. A total of 8,724 valid signatures from among the registered voters living in the 17th House District must be filed to force the election. State officials have until June 4th to complete the verification process, which will include a comparison between the submitted signatures and the Qualified Voter File for the district as well as legal challenges to individual signatures.

Dingell Sponsors Medicaid Rule Delay Legislation
In response to a Bush Administration proposal revising Medicaid rules to the detriment of the states, U.S. Representative John Dingell (D-Dearborn) has introduced and ably moved through the House HR 5613. The measure, entitled “Protecting the Medicaid Safety Net Act of 2008,” would suspend for one year the implementation of any proposed rule changes. The proposal is currently on the General Orders portion of the calendar in the U.S. Senate, with sources indicating final passage may require linking the content of HR 5613 to a spending authorization bill financing the war in Iraq. Without passage of HR 5613 or similar legislation, Michigan faces the loss of some $750 million annually in federal monies. In addition, the Graduate Medical Education Program would be cut which state officials stated would adversely impact the state’s health care efforts as the program provides financial support for physician residents working in hospitals.

Stabenow Offers the “Save Medicare Act of 2008”
U.S. Senator Debbie Stabenow (D-Lansing) is the sponsor of S 2785 the “Save Medicare Act of 2008.” Under the measure, current law would be extended to provide a 0.5 percent update in physician reimbursements while avoiding a 10.6 percent reduction in those payments. The proposal would also provide a 1.8 percent update to all physicians during 2009, thus avoiding expected reductions and extend the PQRI Program, the Medicare incentive payment program for physician scarcity areas and the floor on the Medicare work geographic adjustment until January 1, 2010. The proposal is currently before the Senate Finance Committee.

Push Begins for Chiropractic Scope of Practice Expansion
Efforts to expand the scope of practice for chiropractors beyond treatment of the spine are heating up. Measures have been introduced in both chambers with the members of the Senate Health Policy Committee—with the exception of Chair Tom George (R-Kalamazoo)—being open to the concept while House Health Policy Committee Chair Kathy Angerer (D-Dundee) has said she intends to place the measure on the Governor’s desk before year’s end. The MOA is opposed to the legislation on the grounds the proposed new scope of practice exceeds the education and training chiropractors have received and will continue in its efforts to drive that message home to legislators.

Senate Approves Smoking Ban
The Michigan Senate surprisingly discharged House Bill 4163—which had been languishing in the Senate Government Operations and Reform Committee since last December—from committee, adopted a substitute that strengthened the prohibitions on workplace smoking and passed the measure on a 25-12 vote. The sudden action followed an unexpected closed-door Senate Republican caucus on the topic the day before along with ever-increasing pressure for the Senate to act on the bill. As approved, House Bill 4163 (S-8) is more restrictive than the House-approved version by prohibiting all smoking in the workplace, including bars, restaurants and non-native-owned casinos. The only exemption granted by the Senate bill is to offices located in a private residence. The measure now goes back to the House for a concurrence vote.

If you have any questions abut these, or any other legislative matters, contact MOA Deputy Director, Fred Anderson at fanderson@mi-osteopathic.org.