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Michigan legislature passes pared-down retiree health care changes in late-night session

LANSING, MI — For the second year in a row, first responders in Michigan celebrated a victory as the state legislature moved to pare down legislation on retiree health care changes affecting police and firefighters.  

The legislature started considering changes after the Responsible Retirement Reform for Local Government Task Force found a collective $7.46 billion in unfunded pension liabilities and $10.13 billion in unfunded health care liabilities lurking in local governments’ finances in a July report. 

The House and Senate, after failing to gather enough votes on a plan with more teeth, took away the most controversial portions of the bill and reverted to the recommendations from Snyder’s Responsible Retirement Reform for Local Government Task Force, which met for months and issued recommendations in July.  

Those recommendations were a broad outline, and the legislation is, too. It would:  

  • Require local units of government to thoroughly report financial information including funding of pension and retiree health care plans.  
  • The Treasury department will then evaluate plans to determine which are underfunded. For retiree health care, a plan is considered underfunded if its obligations are less than 40 percent funded and if its annual contribution is more than 12 percent of the unit’s revenue. A pension plan is considered underfunded if it’s under 60 percent funded and if the unit’s annual contribution is more than 10 percent of its revenue. 
  • The treasurer will give waivers to communities with underfunded pensions if they have approved plans to rectify the situation.  
  • Creates a “Municipal Stability Board” comprised of three experts; one from local government, one from state  underfunded and haven’t self-implemented a plan to fix it. It will be comprised of three experts appointed by the governor; one from local government, one from state government and one representing employees and retirees, all with relevant financial experience. It will assist communities in coming up with and ultimately approve or disprove corrective action plans.  

The final package did away with a “Financial Management Team” included in the original legislation that proved controversial due to its emergency management powers, including going into a local government’s budget. That and other provisions in the original bill were opposed by police and firefighters.  

Police, Firefighters rally for retiree health care at capitol  

Senate Majority Leader Arlan Meekhof, R-West Olive, said the revised bills weren’t a total solution but a step in the right direction.  

“You didn’t get the touchdown but you got a couple first downs. Let’s keep going, move the ball,” Meekhof said.  

The changes swayed lawmakers like Sen. Rick Jones, R-Grand Ledge, a former Sheriff who was a hard “no” on the legislation as introduced. As amended, sticking to the task force’s report, he supported it.  

“It’s everybody working together, employees and employers, and I think it’s a good thing,” Jones said.  

Rep. Andy Schor, D-Lansing, served on the task force and supported the bills as passed. 

“We did put out the task force report. This is labor and business and CPAs and really everybody who was involved. I thought we came up with a great product, and today that product was put up for a vote,” Schor said. 

The bills passed unopposed in the Senate, but drew a scattering of opposition in the House – including from the House sponsors of the bills, Reps. James Lower, R-Cedar Lake, and Tom Albert, R-Lowell. There the main bill passed 105-5.  

Joe Adams, state president of Michigan Fraternal Order of Police, was among dozens of police and firefighters gathered in the Senate lobby as members entered the chamber at 10 a.m., the start of a session that would last more than 15 hours.  

“We were here a year ago today, we were here on the capitol steps rallying against it last year when something tried to get slammed through. And it worked last year,” said Adams, a police officer in Grosse Pointe.  

It was after a last-minute push and failure in December of 2016, the governor formed the task force. The Fraternal Order of Police were represented on that task force, and want the legislature to follow its recommendations.  

The bills passed today were mirror images in both chambers. They passed just after 2:30 a.m. To become law, one of the versions would have to pass the opposite chamber and be signed by Gov. Rick Snyder, who is supportive of changes to address retiree health care liabilities.  

Senate Passes Tax Cut Bill That Threatens Public Health and Clean Energy


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Mass. Senate Passes Sweeping Health Care Reform Bill – WBUR

A sweeping package of reforms supporters said aimed to fix broken elements of the state’s health care system while also saving consumers money passed the Senate on a 33-6 vote at midnight Thursday.

The bill sets a target for reducing hospital readmissions and imposes new oversight on the pharmaceutical industry. It aims to cut down on unexpected consumer costs like out-of-network charges and facility fees, and to increase access to telemedicine and mobile integrated health, which involves paramedics performing non-emergency services.

“The bill is really about the consumers and doing everything we can to make health care affordable to consumers,” Sen. James Welch, who led the working group that wrote the bill, told reporters after the vote.

While senators frequently tout their bipartisan work, Democrats were unable to attract any Republican votes for their bill, which passed on a party line vote with the chamber’s six Republicans dissenting and objecting to solutions they said rely on more bureaucracy.

Whether any provisions actually make their way into law depends on action in the House, where Rep. Peter Kocot, Welch’s co-chair on the Health Care Financing Committee, said Thursday he hopes to have a bill ready for debate early next year after he wraps up his own meetings and analysis. The Senate bill (S 2200) was developed by a group of senators, outside the traditional joint committee process.

Gov. Charlie Baker on Thursday said the bill “doesn’t save the state any money” and the Senate was “not trying to chase reforms that are going to make” MassHealth more affordable, one of the goals that punctuated the health care debate earlier this year.

“What they’re doing are chasing a variety of initiatives they believe will make the system better,” Baker told reporters.

Senate Ways and Means Chairwoman Karen Spilka, who has said the bill could yield $114 million in savings from MassHealth reforms and $475 million to $525 million from its commercial market reforms by 2020, said after the bill passed that she was “very surprised” and “dumbfounded” by Baker’s characterization.

“I understand the governor’s concerns,” Welch said. “He comes from the health care industry, comes from the insurance industry, and I’m sure obviously still has relationships in the health care industry that would make him concerned or that members of the health care industry might be concerned about. But I think the way we approached this bill is really to focus on the consumer.”

Debate began on Wednesday, and behind-the-scenes discussions both days involved negotiations around contentious measures proposing to automatically enroll MassHealth-eligible consumers participating in the home care program into Senior Care Options, a managed care program that covers services normally paid for through Medicare and MassHealth, with no copays. Senior advocacy groups opposed the plan.

Just before midnight, the Senate adopted an amendment that Spilka said preserved the passive enrollment while adding in extra protections and spelling out specifics of the opt-out process.

“We remain fundamentally of a different mind that older people are smart enough to pick their own plans, but the Senate, I give them credit for working hard to come up with language that would protect older people from any kind of dislocation of service and to make sure that the people who arrange their care are not financially at risk,” Mass. Home Care executive director Al Norman told the News Service.

Some of the most heated moments in the two days of debate came as Republicans tried unsuccessfully to beat back an element of the bill they dubbed the “name and shame” list — an annual public report identifying the 50 Massachusetts employers with the highest number of employees “who receive medical assistance, medical benefits or assistance through the Health Safety Net Trust Fund.”

Tarr said the amendment was an attempt to shame people into changing their behavior, while Sen. John Keenan of Quincy said it was a way to gather data to understand how many people with access to employer-sponsored insurance are enrolling in MassHealth, and which employers are not providing coverage that’s accessible to their workers.

In a back-and-forth with Keenan, Tarr said the bill tries to “somehow avoid directly the problem” of increased enrollment and subsequent higher costs at MassHealth. He called the bill “incredibly cumbersome” and repeatedly said it defaults to bureaucracy instead of direct action to try to control costs.

Before passing the bill, senators agreed to modify the way it attempts to shrink the gap between rates paid to the most expensive, larger hospitals and lower-paid community hospitals.

“We view that this is a market failure, and we’re asking the market to correct itself, and if it is unable to do so, then and only then would you turn to government regulation,” Senate President Stanley Rosenberg said.

The bill would raise rates for lower-paid hospitals to 90 percent of the statewide average for the previous year, and set a target rate of growth for total hospital spending.

While senators stopped short of imposing a rate cap at the upper level, they adopted a Sen. Jamie Eldridge amendment specifying that efforts to meet the target “do not directly contribute to increased consumer health care costs.”

The Senate overwhelmingly endorsed studying how the costs of a single-payer health care model would compare to the state’s current health care spending, which the Center for Health Information and Analysis tallied at $59 billion in 2016.

On a 35-3 vote, the Senate adopted an amendment calling for state officials to measure health spending against the estimated costs of providing health care to all residents through a single-payer system. If the single-payer projections prove to be less costly, the Health Policy Commission would need to submit “a proposed single payer health care implementation plan” to the Legislature for potential action.

Sen. Julian Cyr of Truro, the amendment’s sponsor, compared the current health care system to “one of those rubber band balls you get at Staples,” pointing to interconnected pieces that would be difficult to unwind without an extensive plan. He stressed the amendment would not commit the state to pursuing single-payer but said it would “keep all doors open.”

Tarr voiced concerns about the possible cost of a single-payer system, saying by some estimates it could double the state’s health expenditures, but ultimately voted for the amendment. Republican Sens. Vinny deMacedo, Ryan Fattman and Donald Humason voted against, and Sen. Richard Ross, a Wrentham Republican, voted present.

In 2012, a similar single-payer benchmark proposal failed 15-22 in the Senate.

Mass. Senate Passes Sweeping Health Care Reform Bill

A sweeping package of reforms supporters said aimed to fix broken elements of the state’s health care system while also saving consumers money passed the Senate on a 33-6 vote at midnight Thursday.

The bill sets a target for reducing hospital readmissions and imposes new oversight on the pharmaceutical industry. It aims to cut down on unexpected consumer costs like out-of-network charges and facility fees, and to increase access to telemedicine and mobile integrated health, which involves paramedics performing non-emergency services.

“The bill is really about the consumers and doing everything we can to make health care affordable to consumers,” Sen. James Welch, who led the working group that wrote the bill, told reporters after the vote.

While senators frequently tout their bipartisan work, Democrats were unable to attract any Republican votes for their bill, which passed on a party line vote with the chamber’s six Republicans dissenting and objecting to solutions they said rely on more bureaucracy.

Whether any provisions actually make their way into law depends on action in the House, where Rep. Peter Kocot, Welch’s co-chair on the Health Care Financing Committee, said Thursday he hopes to have a bill ready for debate early next year after he wraps up his own meetings and analysis. The Senate bill (S 2200) was developed by a group of senators, outside the traditional joint committee process.

Gov. Charlie Baker on Thursday said the bill “doesn’t save the state any money” and the Senate was “not trying to chase reforms that are going to make” MassHealth more affordable, one of the goals that punctuated the health care debate earlier this year.

“What they’re doing are chasing a variety of initiatives they believe will make the system better,” Baker told reporters.

Senate Ways and Means Chairwoman Karen Spilka, who has said the bill could yield $114 million in savings from MassHealth reforms and $475 million to $525 million from its commercial market reforms by 2020, said after the bill passed that she was “very surprised” and “dumbfounded” by Baker’s characterization.

“I understand the governor’s concerns,” Welch said. “He comes from the health care industry, comes from the insurance industry, and I’m sure obviously still has relationships in the health care industry that would make him concerned or that members of the health care industry might be concerned about. But I think the way we approached this bill is really to focus on the consumer.”

Debate began on Wednesday, and behind-the-scenes discussions both days involved negotiations around contentious measures proposing to automatically enroll MassHealth-eligible consumers participating in the home care program into Senior Care Options, a managed care program that covers services normally paid for through Medicare and MassHealth, with no copays. Senior advocacy groups opposed the plan.

Just before midnight, the Senate adopted an amendment that Spilka said preserved the passive enrollment while adding in extra protections and spelling out specifics of the opt-out process.

“We remain fundamentally of a different mind that older people are smart enough to pick their own plans, but the Senate, I give them credit for working hard to come up with language that would protect older people from any kind of dislocation of service and to make sure that the people who arrange their care are not financially at risk,” Mass. Home Care executive director Al Norman told the News Service.

Some of the most heated moments in the two days of debate came as Republicans tried unsuccessfully to beat back an element of the bill they dubbed the “name and shame” list — an annual public report identifying the 50 Massachusetts employers with the highest number of employees “who receive medical assistance, medical benefits or assistance through the Health Safety Net Trust Fund.”

Tarr said the amendment was an attempt to shame people into changing their behavior, while Sen. John Keenan of Quincy said it was a way to gather data to understand how many people with access to employer-sponsored insurance are enrolling in MassHealth, and which employers are not providing coverage that’s accessible to their workers.

In a back-and-forth with Keenan, Tarr said the bill tries to “somehow avoid directly the problem” of increased enrollment and subsequent higher costs at MassHealth. He called the bill “incredibly cumbersome” and repeatedly said it defaults to bureaucracy instead of direct action to try to control costs.

Before passing the bill, senators agreed to modify the way it attempts to shrink the gap between rates paid to the most expensive, larger hospitals and lower-paid community hospitals.

“We view that this is a market failure, and we’re asking the market to correct itself, and if it is unable to do so, then and only then would you turn to government regulation,” Senate President Stanley Rosenberg said.

The bill would raise rates for lower-paid hospitals to 90 percent of the statewide average for the previous year, and set a target rate of growth for total hospital spending.

While senators stopped short of imposing a rate cap at the upper level, they adopted a Sen. Jamie Eldridge amendment specifying that efforts to meet the target “do not directly contribute to increased consumer health care costs.”

The Senate overwhelmingly endorsed studying how the costs of a single-payer health care model would compare to the state’s current health care spending, which the Center for Health Information and Analysis tallied at $59 billion in 2016.

On a 35-3 vote, the Senate adopted an amendment calling for state officials to measure health spending against the estimated costs of providing health care to all residents through a single-payer system. If the single-payer projections prove to be less costly, the Health Policy Commission would need to submit “a proposed single payer health care implementation plan” to the Legislature for potential action.

Sen. Julian Cyr of Truro, the amendment’s sponsor, compared the current health care system to “one of those rubber band balls you get at Staples,” pointing to interconnected pieces that would be difficult to unwind without an extensive plan. He stressed the amendment would not commit the state to pursuing single-payer but said it would “keep all doors open.”

Tarr voiced concerns about the possible cost of a single-payer system, saying by some estimates it could double the state’s health expenditures, but ultimately voted for the amendment. Republican Sens. Vinny deMacedo, Ryan Fattman and Donald Humason voted against, and Sen. Richard Ross, a Wrentham Republican, voted present.

In 2012, a similar single-payer benchmark proposal failed 15-22 in the Senate.

iPhone X passes bend test with flying colors

Hardly an industry standard for testing, JerryRigEverything‘s torture routine has become a great source of insight on just how scratch and bend resistant you can expect your next phone to be. Well, in comes the X.

The Apple iPhone X is the latest to come out of Cupertino, and like the more pedestrian iPhone 8 and 8 Plus is a glass sandwich with a metal frame all around, only here the metal is steel and not aluminum, so it scratches with a different (still painful) sound. The display won’t get damaged by keys and coins, but beware of pocket sand and granite countertops.

There’s a plastic inlet between glass and frame, serving as buffer to help prevent cracking when you inevitably drop your X – a good thing since the back panel damage is a $550 replacement job.

Mohs picks scratch test, razor blade scratch test, burn test, you know Zack’s drill. It’s the bend test that comes last, and despite some flex, there’s no permanent damage. Check it for yourself in the video below.

Source

House Passes Children’s Health Bill, Sending Measure to Senate

The U.S. House of Representatives passed a bill to reauthorize a health insurance program for low-income children, sending the legislation to the Senate.

The bill would reauthorize the Children’s Health Insurance Program for five years, after which Congress will have to reconsider it. It passed the House by a vote of 242-174 on Friday.

CHIP covers children from low-income families under Medicaid even if their parents don’t qualify for the state-federal health insurance program themselves. It has enjoyed largely bipartisan support since it was enacted in 1997, and covers about 8 million U.S. children, according to the House Committee on Energy and Commerce.

The proposal will also extend funding for community health centers and several other health programs.

It’s funded by taking money from the Prevention and Public Health Fund, a program under the Affordable Care Act that finances public health efforts and tries to improve quality of care. It also limits federal subsidies to Medicare beneficiaries making more than $500,000.

Along with the reauthorization of the CHIP program, the bill would provide $1 billion for the Medicaid programs in Puerto Rico and the U.S. Virgin Islands, which have run short of funding. It also ends some cuts to payments to hospitals that treat a larger share of patients without health insurance or who have trouble paying their bills.

Assembly passes bill that would forbid state health insurance from paying for abortions for state workers

Members of Wisconsin Right to Life protest in front of Gundersen Lutheran Medical Center in La Crosse in this 2007 file photo.




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