Healthcare (Medicare)

Michigan House Bill 6288 directs the state Department of Health and Human Services to seek federal approval for enrolling specific Medicaid-eligible individuals into managed care plans, while requiring these plans to spend at least 12% of their annual budget on primary care over an eight-year period. The bill mandates that hospitals accept Medicare rates as full payment from uninsured patients with incomes up to 250% of the federal poverty level and establishes a performance bonus system for health plans based on quality metrics such as fraud detection, substance use disorder treatment, and consumer satisfaction. Additionally, it requires contracted health plans to submit annual reports detailing their primary care spending levels and outlines provisions for telemedicine access, pharmaceutical cost controls, and the sharing of state data with qualified vendors to improve population health management.

This bill updates Michigan's Medicaid False Claims Act to clarify what counts as an illegal kickback or bribe in the medical services sector. It maintains the existing rule that offering or receiving payments to refer patients for services is a felony punishable by up to four years in prison or a fine of $30,000. The legislation adds a specific exemption stating that "model arrangements" and "model patient incentives" approved by the Centers for Medicare and Medicaid Services are not considered illegal kickbacks. This change aims to provide legal clarity for healthcare providers participating in federal-approved incentive programs while preserving penalties for other forms of improper referral payments.

This bill updates Michigan's no-fault insurance laws to set new maximum payment limits for medical treatment and rehabilitation services provided to injured individuals. It establishes specific reimbursement percentages based on Medicare rates, which vary by year and the type of provider, such as general physicians, hospitals with high indigent patient volumes, specialized trauma centers, and designated freestanding rehabilitation facilities. The legislation also includes provisions for providers lacking Medicare payment benchmarks by capping their charges at a percentage of their historical rates from 2019. These changes directly affect healthcare providers treating personal protection insurance claims and the insurers that reimburse them.

This Michigan House resolution urges the U.S. Senate to immediately pass an unconditional government funding bill (a "clean continuing resolution") to end the ongoing federal shutdown. It criticizes Senate Democrats for blocking votes on such a bill, which would restore critical services like Medicare, VA benefits, and food assistance for Michiganders affected by the 35-day shutdown. The resolution rejects the Senate's alternative proposal, calling it fiscally irresponsible due to projected $1.5 trillion in added debt. The Michigan House adopted the resolution with 54-46 support on November 6, 2025.

House Bill 4407, also known as the "MIcare act," proposes to establish a universal and unified health care system for all residents of Michigan. This bill aims to provide health care coverage through a simplified, publicly administered, and single claims payment system. It intends to integrate existing programs like Medicaid, Medicare, and MIChild, to the maximum extent permitted by federal law and waivers. The legislation creates a MIcare board and fund, and directs the Department of Health and Human Services to coordinate reform efforts and develop a strategic plan for its implementation.

This bill amends Michigan law to prevent health insurers from denying or conditioning Medicare supplement insurance coverage based on an applicant's health status, pre-existing conditions, or medical history. It directly affects individuals aged 65+ during their initial Medicare Part B enrollment window, non-age-eligible applicants with specific Medicare enrollment timing, and those switching insurers while maintaining the same policy. Key provisions require insurers to offer these policies without health-based exclusions or higher pricing (capping rates at those for 65-year-olds), and to reduce pre-existing condition waiting periods based on prior continuous health coverage. The law ensures equal access to Medicare supplement plans during defined enrollment periods while clarifying what counts as qualifying prior coverage.

This resolution urges Congress and the President to permanently extend the Affordable Care Act's Enhanced Premium Tax Credit, which helps low- and middle-income individuals and families afford health insurance premiums through the federal marketplace. It directly affects approximately 21.8 million Americans (including 484,000 Michigan residents) who currently benefit from the credit, which caps premium costs as a percentage of household income. The resolution emphasizes that without permanent extension, millions could face higher costs, risking coverage losses and reduced access to care - particularly for working families, seniors not yet on Medicare, and those with chronic conditions. As a procedural resolution (not a law), it does not change policy but formally requests federal action to maintain this existing affordability mechanism.