The Republican-controlled State Senate, the Democratic-controlled State House of Representatives, and the Governor are locked in a dispute over how to resolve Michigan's budget crisis. Revenues are down, the economy is poor, and the legislature has run out of quick fixes for funding Medicaid that pays for medical care for low-income people, including those with disabilities, the elderly, people with mental illness, and other vulnerable populations. It also pays for specialty services such as day programs, home help services, and long-term care.
The Michigan Department of Community Health, on orders from Governor Jennifer Granholm, will begin cutting fees for Medicaid services on June 1st, 2007, if the legislature and Governor can't agree on measures to avoid the cuts. The programs affected will include in-patient and out-patient hospital fees, Children's Special Health Care Services, Home-Help Services, Dental Services, and the Children's Waiver. The order generally calls for a 6% reduction in rates. For many of these programs this is on top of cuts made in previous years.
The hourly fee to pay people to provide Home Help Services, so that people can live in their own or their families' homes, will be cut 6% in addition to the reductions made in fiscal year 2003 and 2005 currently in place. Dental services for adults, which were eliminated for two years and then reinstated in 2006 with sharp reductions in fees will be cut again by 6%. After last year's reduction in fees for dental services, the number of dentists willing to treat people on Medicaid fell by 39%.
This is the kind of "cost-saving" measure that gives cover to policy makers. Technically, services are not being eliminated, but the effect of reducing fees will likely make services harder to find and poorer in quality. Many people with disabilities will not get the services they need and more families will give up in frustration, finding that the services that are available will not be worth the fight it will take to get them.
You can view the proposed changes here. To comment on them write:
MDCH/Medical Services Administration
Program Policy Division
PO Box 30479
Or email: MSADraftPolicy@michigan.gov