Future unclear on legislation to alter health insurance rules

The future of House Bill 6058, which amends the Publicly Funded Health Insurance Act, is now mired in uncertainty, raising significant questions for local governments and the broader legislative process in Michigan. Passed during the 2024 lame-duck session, the bill has not yet been sent to the governor — a situation that could lead to the first legal challenge of the new legislative term.

HB 6058 aimed to address rising health care costs by adjusting the hard cap on employer contributions to employee health insurance. MAC supported an increase in the hard cap, recognizing that health care costs are climbing faster than current inflationary measures can account for. However, the bill’s proposed mechanism has critical flaws that make its implementation problematic:

• Flawed Inflationary Mechanism:

HB 6058 ties the hard cap increases to the medical care component of the Department of Financial and Insurance Services (DFIS)-approved rate increases.

This metric, however, is not reported separately by insurance companies, making it nearly impossible to calculate.

Previously, adjustments were tied to the medical care component of the Consumer Price Index (CPI), which excludes pharmaceutical costs, already a major driver of escalating health care expenses.

• Mandatory 80 percent floor:

The bill mandates that the 80 percent employer contribution becomes the minimum floor for health insurance cost-sharing, limiting flexibility for local governments to manage their budgets effectively.

Currently, local governments have three options under the Publicly Funded Health Insurance Act:

• Stay within the hard cap for how much the employer pays.
• Opt for an 80/20 split between employer and employee.
• Opt out of the act entirely through a resolution of the local governing board.

While MAC supported adjustments to the hard cap, the impracticality of the inflationary mechanism in HB 6058 complicates its utility.

In a surprising move, incoming House Speaker Matt Hall has decided not to send HB 6058 to the governor for signature, despite its passage in both chambers and being ordered enrolled. MAC is unaware of any precedent where an incoming speaker has withheld a bill from the governor after passage.

This decision raises several questions:

• Does the Speaker have the authority to block the presentation of an enrolled bill to the Governor?
• What precedent does this set for future legislative actions?

This could be the first legal battle of the new legislative term as stakeholders seek clarity on the speaker’s powers and the fate of HB 6058.

For more information on this issue, contact Deena Bosworth at bosworth@micounties.org

State allocates $10 million in opioid funds to work with local governments

As part of the state of Michigan’s share of the national opioid settlements, the Michigan Legislature has allocated $10 million in funding directly to the 10 Pre-Paid Inpatient Health Plans (PIHPs) through the Healing and Recovery Fund regional appropriations for fiscal year 2025.

This funding is to help with a variety of infrastructure needs for substance use service providers working along the continuum of prevention, harm reduction, treatment and recovery. These funds are also to be used to assist with collaboration with local governments to support community engagement with planning efforts related to settlement funding efforts.

To find out more about these funds or to coordinate with your local PIHP, please contact the Substance Use Disorder Director for your region found below.

MAC announces staff changes

Dolinky

The end of 2024 brought changes to the composition of county boards and the Michigan Legislature and to the staff of the Michigan Association of Counties. For 2025, Executive Director Stephan Currie announced the following staff moves:

The departure of Amy Dolinky as technical adviser, opioid settlement funds planning and capacity building. Dolinky spearheaded MAC’s highly successful and nationally recognized program starting in 2022. Since its inception, the program engaged 72 of 83 counties and fulfilled 339 requests for technical assistance in the deployment of legal funds to address substance abuse disorder.

Fata

Dolinky is moving on to a national opportunity, but not before leading a MAC webinar on Jan. 14 aimed at newly elected commissioners who are unfamiliar with the opioid settlement process.

Also moving on from MAC is Governmental Affairs Associate Madeline Fata. She joined MAC in 2022 from the Michigan Legislature and helped lead advocacy efforts on infrastructure and environmental issues. In her last weeks with MAC, Fata helped fend off potentially disastrous septic code legislation. Fata will continue her advocacy career with the firm of Karoub in Lansing.

Despins

Changing hats at MAC is Amanda Despins. She has been named MAC’s events coordinator, part of an expansion of services at MAC via its new Association Management Solutions (AMS) department.

Despins will work with Director of Member Events Tammi Connell on MAC events and assist clients of AMS.

Despins joined MAC in 2023 as Governmental Affairs Assistant. Prior to joining MAC, she served as a constituent relations liaison and legislative director in the Michigan House of Representatives.

 

Staff picks

• Governor signs bill expanding use of therapy dogs in court (WOOD-TV)
  
  
• Transparency in opioid settlement planning and spending (Bloomberg School of Public Health)
  
  
• How are states spending opioid settlement cash? (Kaiser Health News)
  
  
• Flooding Is a $400 billion problem that’s getting worse (Governing)

Lansing’s democratic trifecta came to an end this week after several weeks of lame duck session. From House Republicans leaving session in protest last week, to the Senate holding a marathon 26-hour session this week, lame duck has been nothing short of eventful. MAC’s legislative update is fluid at the moment, while senators approach Friday afternoon still in session. 

Friday, December 13th, 2024

House Republicans vacated session in protest amidst failed negotiations between House Republican Leader Matt Hall (R-Kalamazoo) and Speaker Joe Tate (D-Wayne) regarding fixes to minimum wage for tipped workers, Earned Sick Leave Act, and a potential road funding deal. After 13 hours of session, House Democrats adjourned late Friday night when a series of bills failed to pass, including legislation to increase tipping fees. Rep. Karen Whitsett (D-Wayne) left the House chamber around 10:00pm, forcing the House to adjourn with a quorum no longer present in her absence. 

Wednesday, December 18th, 2024

House Democrats’ ability to muster their majority, let alone a quorum, worsens with Rep. Karen Whitsett’s (D-Wayne) refusal to attend session unless her priority legislation is addressed. In the meantime, Sen. Sylvia Santana (D-Wayne) joins her House colleague in boycotting session, citing the legislature’s lack of movement on her desired criminal justice reforms and a dissatisfaction with ongoing “corporate welfare.” Both chambers adjourn without voting. Gov. Gretchen Whitmer chimes in, only to remind legislators of her disinterest in signing any legislation without receiving a road funding plan and her economic development package. 

Thursday, December 19th, 2024

After a tumultuous back and forth between Rep. Whitsett and House Democratic Leadership regarding her attendance on Thursday, a Call of the House was ordered in hopes of restoring a quorum and allowing democrats an opportunity to pass bills they otherwise could not take up. The Call of the House was issued for over an hour, and despite Rep. Whitsett being present within the Capitol, she did not return to the House floor, forcing Speaker Tate and House Democrats to adjourn until December 31st, 2024. At that time, a quorum is required to adopt the sine die resolution, officially ending the 102nd session. 

Sen. Santana, however, returned to the senate floor Thursday. As of 11:30am on Friday, December 20th, the Senate has been in session for nearly 26 consecutive hours. Senate Republicans have requested bills be read in their entirety prior to a vote. Lengthy debate and filibuster have filled more of the last 26 hours than votes have.

With the unexpected turn of events throughout the 2024 lame duck session, a flurry of bills did not see further action and “died” in the second chamber. Read below for issues MAC has tracked throughout the 2023-2024 term that came down to the wire this week:

MAC’s Policy Wins in the 2024 Lame Duck Session:

– SB 1167 and HB 4688, which would have made minimum staffing levels a subject of collective bargaining for sheriff’s deputies, died because it did not get voted on in the House. The bill would have also allowed such issues to be elevated to binding arbitration, a provision that raised significant concerns among county officials.

– SBs 605-611, dubbed “Polluter Pay” legislation, ultimately died in the House. The bills were inaccurately titled and would have actually held non-liable parties responsible for pollution caused by previous owners. 

– Although we came a long way with the bill sponsor on amendments to the statewide septic code, we consider the death of SB 299 a win for our membership. Initially sweeping in scope, the final version of the bill was significantly scaled back. The compromise included the elimination of the proposed periodic evaluation cycle and left county point-of-sale ordinance intact. The legislation passed the Senate along party lines but eventually died in the House. 

On the flip side, MAC is disappointed to see the following actions on bills:

– Despite intensive lobbying efforts, the Revenue Sharing Trust Fund bills, HB 4274 and HB 4275, failed to pass the Senate. These bills, championed by the Michigan Association of Counties (MAC), the Michigan Municipal League (MML) and the Michigan Townships Association (MTA) sought to secure consistent funding for local governments.

– Legislation amending the Public Employer Healthcare Contribution Act is headed to the governor’s desk, despite MAC’s attempt to offer amended language. HB 6058 increases the hard-cap limit on employer contributions to employee health insurance and adjusting cost-sharing provisions for employers and employees. Public employers opting for the 80/20 cost-sharing model are required to pay a minimum of 80% of healthcare costs, rather than the current cap of 85%. Counties will still have the option of opting out of the act altogether by a 2/3 vote of the board.

The Senate has not yet acted on the following bills:

– HB 5431, or Michigan’s Wrongful Imprisonment Compensation Act (WICA), is unlikely to receive a vote in the Senate Friday, due to MAC’s opposition and successful stalling of the bill. While MAC supports the goal of ensuring wrongly incarcerated individuals are made whole by the government, HB 5431 would have led to the dismantling of the 4 county- operated Conviction Integrity Units, increased court costs. As the largest funding source for trial courts, counties cannot be subject to increased costs. 

– HB 5695, requiring the Michigan Department of Health and Human Services (MDHHS) to participate in the federal Ground Emergency Medical Transportation (GEMT) reimbursement program. The GEMT initiative in Michigan will reimburse local agencies and emergency services providers for serving vulnerable populations. $500,000 was included in the FY25 state budget to assist MDHHS in starting up GEMT in Michigan. MAC supports this legislation and anticipates a vote on Friday. 

Please tune in to MAC’s Podcast 83 next week for further updates on the legislative action for the remainder of Friday, December 20th. 

Johnson retires in Otsego County, ending 44-year run in county office

Executive Director Stephan Currie was on hand in Otsego County on Dec. 17 to honor Commissioner Doug Johnson, who retired in December after 44 continuous years of service to his county and community. (Photo courtesy of Otsego County)

In a ceremony on Dec. 17, Otsego Commissioner Douglas Johnson was honored by his colleagues, legislators and the Michigan Association of Counties for his upcoming retirement, which will end a remarkable 44-year run as a county commissioner.

Johnson began his Otsego service in 1981, the first year of the Ronald Reagan presidency. “Starting Over” by John Lennon was no. 1 on the pop charts that January. And the Detroit Lions had just finished 9-7 behind rookie sensation Billy Sims.

“People’s attitudes change towards you once you get into office,” Johnson said in a Michigan Counties profile of him as the longest-serving commissioner in 2022. “They are not always going to agree with you. And it’s always a challenge to help them understand why you do what you’re doing, and you’re doing what you think is right for the majority of the people that you serve.”

In addition to serving many years as chair of the Otsego County Board, Johnson has long served as board president of the Michigan Counties Workers’ Compensation Fund.

For those interested in starting a public career, Johnson advised in 2022, “Stay focused on the work and be true to yourself, your beliefs and your values.

“It is important to be honest and dependable and follow through on your promises; also, accept the fact that not everybody is going to agree with you and to not beat yourself up over it.”

All at MAC wish a wonderful retirement for Johnson and his wife Sherry.

 

MAC announces office schedule for holiday season

MAC’s Lansing offices will be closed Dec. 24-27 and Dec. 30-Jan. 1 for the 2024 holiday season.

MAC will resume normal office operations on Thursday, Jan. 2, 2025.

This is the last Legislative Update email blast of 2024. The next blast will be on Friday, Jan. 3.

All of us at MAC wish you a safe and joyous holiday season.

 

Staff picks

• Whooping cough cases skyrocket in Michigan, as vaccinations decline (Bridge Michigan)

• Status of Renewable Energy, Distributed Generation and Legacy Net Metering in Michigan (Public Service Commission)

• Why later life can be a golden age for friendship (BBC)
  
  
• Natural Resources Trust Fund – 2024 Recommendations (Michigan Department of Natural Resources)
  
  

Health insurance bills pass the Senate

An attempt to reform state law on employer contributions to health insurance programs was passed out of the Senate in the early morning hours of Dec. 13. Senate Bills 1129–30, by Sen. Kevin Hertel (D-Macomb), would raise the hard cap on what employers could pay for publicly funded health insurance, but would also mandate that the employer pay a minimum of 80 percent of the premiums.

MAC supports the increase in the hard cap so long as it stays a cap and not a floor. MAC is opposed to the versions of the bills that mandate certain spending by creating a floor for what the employer must pay. 

House Bill 6058, by Rep. Mai Xiong (D-Macomb), is still in the House and is a much more expensive option for the Publicly Funded Health Insurance Contribution Act, commonly known as PA 152 of 2011. The House bill would increase the employer contribution to employee health insurance and significantly increase the number of items and groups that can bargain for additional contributions.

PA 152 was enacted to curb rising health care costs, while fostering shared responsibility between employees and employers. It offered counties three cost-sharing options:

• Hard cap: employers contribute up to a legislatively established maximum
• 80/20 model: Employers pay no more than 80 percent of health plan costs, with employees covering the remaining 20 percent
• Opt-out: Counties negotiate health contributions directly with bargaining units, often leading to disparities between employee groups

Most counties have adhered to the hard cap or 80/20 models to avoid costly and contentious negotiations. However, the act’s original inflationary mechanism, tied to the U.S. Consumer Price Index’s medical care component, failed to reflect the true rise in health care costs, especially in areas like prescription drugs. As a result, employees have been burdened with an increasing share of premiums.

HB 6058 introduces changes to address these shortcomings but does so in a way that complicates an already delicate balance between those employee groups represented by a bargaining unit, those groups who enjoy binding arbitration and those groups that do not belong to a bargaining unit. 

MAC, instead, advocates for a straightforward and effective fix to PA 152 that respects its original goals:

• Hard cap reset: Adjust the hard cap to higher levels reflective of today’s health care costs, easing the financial burden on employees.
• Inflationary adjustments: Replace the current inflationary measure with one based on the average health care rate increases approved annually by the Michigan Department of Insurance and Financial Services. This mechanism would reflect Michigan’s health care realities and ensure the cap keeps pace with rising costs.

This approach would allow employers to contribute more toward health care premiums, alleviating financial strain on employees and maintaining the original law’s intent to control costs and promote fiscal responsibility.

For more information on this issue, contact Deena Bosworth at bosworth@micounties.org.