I am angry! I am disgusted! I am tired! Tired of the disappointing need to remind our “elected” officials to do what is best for the people they are sworn to represent. Or maybe we have it wrong; maybe they are representing their true constituents, their campaign contributors? There, I said it! I’ve tried not to, but it needs to be said.
What’s the old saying: follow the money? Well it’s about time we opened our eyes and follow the money, because it appears the Michigan legislators who received the greatest campaign contributions from the Michigan Association of Health Plans (MAHP) are selling us down the river. And if they are not doing it for the money, they should provide us with facts that support why they are literally trying to give our public mental health system to the MAHP.
What the House and Senate Appropriations Committees have proposed for the 2018 behavioral health funding completely defies logic, the evidence, the voice of Michigan citizens and 14 months of work by the 298 Facilitation Workgroup. It is reckless, ill-advised and frankly without rational, unless you follow the money. … amendments to SB 135 (s-2) that established the goal of HMO control by 2020, and the Cox amendment to HB 4323 (H-1) should be withdrawn. Since Feb. ’16 (when Gov. Snyder proposed transferring CMH Medicaid mental health money and clients to the HMOs), the state has conducted three major reviews of the issue. First was a Lt. Governor’s 120-member workgroup; then 45 affinity group sessions across the state last fall; then a DHHS workgroup that issued reports in Jan. and March of ’17. At each stage of review, the concept of Medicaid HMOs controlling all mental health-related services and supports in Michigan was thoroughly rejected.
Private health plans have had two opportunities to demonstrate their ability to manage the behavioral health and intellectual/developmental disability supports and services benefit. The first effort, running for nearly 20 years, is seen in the management, by the state’s private health plans, of the psychiatric and psychotherapy benefit for the state’s Medicaid enrollees. In communities across the state, Medicaid enrollees point to the inability to gain access to this benefit because the health plans have few, if any, psychiatrists and psychotherapists who will take new Medicaid patients. Long waiting times exist for Medicaid enrollees who are seeking psychotherapy or psychiatry. In some communities, there are no psychiatrists accepting Medicaid patients, for whom the private health plans are managing the psychotherapy and psychiatric benefit for these Medicaid enrollees.
Additionally, while the private health plans have managed, for these two decades, the physical healthcare for the state’s Medicaid enrollees with mental health and substance use disorder, the state’s data show that these persons have some of the highest physical healthcare costs and die earlier than the rest of the state’s residents, even while their physical healthcare is managed by the private health plans.
In the second opportunity for health plans to manage the care of the vulnerable, as part of a multi-year demonstration project, private health plans manage the physical healthcare benefit for Michigan residents in four regions in the state, who are enrolled in Medicare and Medicaid (dual enrollees). These dual enrollees have significant health issues and/or disabilities. Although program automatically assigns these persons to a private health plan for their physical healthcare, when given a choice to stop these health plans from managing their care, 65% of these dual enrollees choose to leave these health plans.
The Final Report of the 298 Facilitation Workgroup as submitted to the Michigan Legislature can be found: Here
The 298 Workgroup was crystal clear on over 70 thoughtful recommendations put forth as a sensible way forward. One unequivocal position that we maintain public oversight of public dollars, not abandon our constitutional obligation or relinquish our moral charge to assist in supporting the dreams and aspirations of the most vulnerable persons to the private/for-profit health plans/insurance companies. The essence of this recommendation was co-drafted and voted for by the Michigan Association of Health Plans.
The assertion the process was rigged, or there was too much weight given to the people served – their voice was too loud in the process is disingenuous, and demonstrates the complete lack of concern the health plans have for the people we serve. True integration of care begins at the consumer – provider level, not at the funding or administrative level. This is simply a money grab!
This is not about party affiliation, it’s simply about doing what is best for the people we serve. In the coming days information disclosing which legislators received campaign contributions from the health plans, and how they are voting will be presented via the press. If those contributions are not the driving factors behind their support of the health plans, they have every opportunity to provide further justification.
What will it take for Michigan legislators to see their failure to achieve savings through privatization? Privatizing Flint via the Emergency Manager literally KILLED an entire town; economically, loss of life and diminished quality of life for generations to come. The Emergency Management oversight of the Detroit Public School System led to significant increases in debt and lower outcomes for students. Privatizing the Grand Rapids VA home was a complete disaster that totally disrespected our veterans and cost millions to correct. And let’s not forget privatizing the prison food system was another huge failure. All chasing false promises of savings. PLEASE STOP!
Lives will be lost if our behavioral health system is turned over to the health plans. Savings can be achieved through our publicly managed behavioral health system. Below is the link to the contact information for the House and Senate Appropriations Committee members. I urge you all to contact them and demand they support the recommendations they requested from the 298 Workgroup, but are now ignoring. Click Here for 2017 Appropriations Committee Contact Information
I also ask that you all attend the Walk-a Mile Rally at the State Capitol May 10th from 1:30 – 3pm. No one is coming to help us but us. It is our responsibility to fight for ourselves. The health plans have the money and the lobbyist, but that doesn’t mean they have all the power! We must stop this money grab and honor the people we serve.
I try to be very careful with “Calls to Action,” but this one is very necessary. It’s time for all us advocates to ADVOCATE! Remember, we are BETTER TOGETHER!