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    Minyao: What is the current health care policy that the Michigan Department of Community Health working on?

    Tony: It is a large department. There are lots of different pieces and lots of areas it affects. There are number areas where there is a lot of time being spent. The Governor had noted in the State of State Address that he has what is called a dash board and you can go to our website and look at it and say if Michigan's improving is staying the same or is not improving. Two items he mentioned specifically for the department of community health is obesity and infant mortality. Those were two items that he wanted to see Michigan to do better on and just in terms how they impact across the states. So the Governor, Director Dazzo and the direct Department of Community Health are both focused on those items and bring people from all around the state to figure out what is being done, why aren't we moving in the right directions on these issues and we have seen what being done is helping and what being done is not working and trying to use the best practices to focus our resources.

    . Minyao: Can you tell us which area you are working on?

    Tony: I am the legislative liaison, so I get to work on pretty much any policy that affects. I help with the budget, we have folks who work specifically on the budget. The budget is a large part of what happening right now. The governor proposed the budget and the goal is to have it finished up through the House and Senate by the Governor by the end of May and so it is a pretty tight time frame. Usually the House starts with the budget and after they were done the Senate will take it and then they will try to put together any differences they would have along with the executive branch's budget. But, they were on the same time, so it is moving in a very fast pace and I think right now, that is the biggest focus now. Certainly, a lot of time is being spent on the health care reform. There is a very specific timeline on that as well as, and if you do not make decision, as a state there is an opportunity for the federal government to make a decision for you. So most of our folks are in agreement that they want to be able to do as much as we can to move forward because they want the decisions to be made with their state.


    Minyao: Will the 2010 Census data affect the federal level Medicaid and Medicare funds on the state of Michigan?

    Tony: It certainly is based on population and I think that certainly impacts cities. Their municipalities often times are based on their population sources. As a state, it impacts us just as right now we have a Medicaid caseload and we have to show where that caseload are coming by. I do not know that the Census number changing that dramatically. I think it has a larger impact probably on municipalities and funding based on their population size.

    Minyao: What is the state solution for this impact?

    Tony: In terms of the state, our funding is tied into specific programs. Now we lose one member of Congress based on the Census data, so you have one last opportunity. You have to redraw your lines based upon that, but you know most of our programs that I am aware of in run based on what our caseload is; based on the number of people we are working with that are serving and so I do not think that we are changing dramatically based on the Census numbers. It is not as Medicaid we are going to percentage based on help the state. It based on how many people are receiving assistant and those numbers will not be changed by the Census data.

    Minyao: Which are some of big changes in health care policy after Governor Snyder's budget plan released?

    Tony: Just like I said the two areas he is very focused on are obesity and infant mortality, so those two areas we are going to have spent a lot of time on focusing on. Also the budget there are cuts of, but he protect provider rates for primary care and the goal there is that we have these people proving primary care for recipients and Medicaid we want to make sure we keep as many as they doing and does not get to which happened that has lost more and more people who will actually provide the service. And so it is after number of years cut provider rates there is a priority item of the budget by not cutting those.

    Minyao: How these changes will affect Michigan residents' health care plan?

    Tony: The goal for these cuts, you want to keep as many as the primary health care providers providing services. I think the concern is that the rate has been cut past years and if you cut more you are going to lose more and more providers in those services. That makes difficult and what you do not want to do is get people where they do not have the primary care service and they wind up in the emergency room, which is the most expensive way to treat someone. It is so far down the road in terms of the treatment and the hope is to have the care in the front end.

    In his budget what he did, he set priority in terms saying we are not going to cut the primary provider and it happened and it become tough and it said we want to protect these rate and I think that it shows that there is a court in terms of having those individual out there.

    Minyao: In Governor Snyder's proposal, he did not cut a lot of budget in the health care part. However, he planed to increase some taxes, such the new 1 percent insurance claim tax for health care business. Please explain.

    Tony: It is a proposal and part of what the Governor talked about doing is putting Michigan on a solid ground and every year is not changing and trying to adjust to a crisis. Currently we have a six percent used tax through the HMO health maintenance organizations and that is used to leverage additional federal dollars. There is some question whether the federal government will continue to allow that used tax. In the Governor's proposed budget he takes away that used tax and replaces it with this one percent claims tax and that will go on all paid medical claims and so it will go across the spectrum. It will try to keep a rate low, but with this understanding with this provides the basis. We are able to for every dollar that we are able to provide on a state level were able to average two more dollars for federal government for Medicaid, so by generate 400 million dollars, we are actually generating 1.2 billion. By using those dollars we do not have to cut the provider rates and there are cuts in the budget but they are not as severe as they would have to be otherwise, and so that is the proposal to put that into place provide that foundation into the future.

    Minyao: Could you introduce what is the Medicare Medicaid Dual Eligible program and what are some changes in this program based on Governor's budget proposal?

    Tony: I think one of the things the department has been looking into is working in terms of serving the dual eligible's and there actually in a planning process on how we can best serve those. We can serve those individuals, and we can reduce cost and there can be efficiency in terms of serving those dual eligible Medicare Medicaid. There is a priority there for a lot of folks that have that have eligibility on both sides of that, so that is something that the department very focused on. I know that the directors, the folks in the Medicaid focus on taking a look at on how we looking now and within that population is there are way to do that. Making sure first that we provide service and secondly we are doing in cost effective manner.

    Minyao: So will the program save the money for the people who are eligible it?

    Tony: I think in terms the state providing the services there will be a state to do that in a more efficient manner, that is what we are looking that. We probably hear in lots of different manners and the department will take to do that and they are going to be spending sometimes next year. That is something what we are with the budget is, we think that we can do that differently and we can see savings.

    Minyao: How about the 3% health care contribution for retirees? Will those changes cause more burdens to specific group of people?

    Tony: Well I cannot speak for the Governor's office but that is something that was past and now is challenged in the courts and the courts will have that debate in terms where that will be resolved. The savings that based upon that are built into the budget. If that does not occur than they have to look at it like neither side of the saving or additional revenue to make that balance out. I think in both cases both with the teachers union and state employees those has been challenged. They are both in the court and will work their way through the court processes here.

    Minyao: Why Governor Snyder wants the 3% health care contribution?

    Tony: I know this have not been proceed by Governor Snyder and it puts there in terms of saving dollars. There is in terms saving dollars and realize the financial limits of the state. It has been a way to balance budget.

    Minyao: What is the MDCH legislative policy agenda in 2011?

    Tony: I think right now, our focuses have been on the issues we have been talked about. Honestly, the budget and proposal, the executive branch proposal and the other departments are working hard work with the legislature address question and works with those groups were represent the constituencies and by that budget which has a lot of different budget groups. Whether obviously through Medicaid; whether it is a department of public health and whether the department of behavior health and working with developmental disabled individuals and reaching out to them and working with them. The other items we mentioned obesity and infant mortality even expanding that and other areas we want to within a department measure ourselves in terms of how well we have been doing. It is something that the director is very focused on and the department of community health is very focused on. What type of measure do we want to use on a regular base to see how we are doing and where we need improvements.

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    About Us

    The Michigan Policy Network is a student-led public education and research program to report and organize news and information about the political process surrounding Michigan state policy issues. It is run out of the Department of Political Science at Michigan State University, with participation by students from the College of Social Science, the College of Communication, and James Madison College. 

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    Meet your Policy Fellow: Leah Brynaert

    Leah Brynaert is Health Care Fellow & Correspondent for the Michigan Policy Network. She is a first-year student in Lyman Briggs College at MSU.