Uncertainty over future of federal health care laws felt in Michigan

The uncertainty surrounding potential upheaval of the nation's health care policy has trickled down to Michigan, where some industry experts say the lack of clarity is impacting how both consumers and providers are preparing for the future.

The debate over whether to repeal and replace the Affordable Care Act, or Obamacare, is currently in the U.S. Senate, where Republican leadership has promised a floor vote next week. It's still unclear what exactly they'll be voting on, however.

National news outlets reported a general sense of confusion from Republican senators as they left Washington, D.C. Thursday evening -- several lawmakers told CNN they had no idea what the Senate health care plan would look like if a motion to proceed was granted.

The initial plans for a Senate vote on health care earlier this summer imploded Monday when Senate Majority Leader Mitch McConnell, R-Ky., announced he didn't have enough votes to pass the Better Care Reconciliation Act and would move forward with a repeal-only plan, delaying a decision on how to replace the legislation.

That, too, generated opposition from some Republican senators. On Wednesday, President Donald Trump spoke to the caucus over lunch and urged them to come to a consensus.

Michigan's two U.S. senators, Debbie Stabenow, D-Lansing, and Gary Peters, D-Bloomfield Twp., have both vehemently opposed any attempts to repeal Obamacare, along with the rest of the Senate Democrats.

At the state level, nearly all facets of the health care industry would be impacted in some way by the House plan, the Senate's initial plan or a full repeal without a replacement at the federal level. Federal funding for Healthy Michigan, the state's Medicaid expansion program, has been called into question, leaving the future of a plan that enrolls nearly 700,000 up in the air.

Timothy Michling, a research associate with the nonpartisan nonprofit Citizens Research Council of Michigan, said although the program has been running smoothly so far, it would be difficult for the state to make many tweaks or updates to status quo without knowing whether the federal Medicaid expansion will remain.

"It doesn't make a lot of sense to plan for the future until they have a better idea of their future," Michling said. "There's a sense of limbo, because everyone's waiting to find out what the future's going to be."

Not knowing what mandatory services offered in health insurance plans could carry over and questions over whether Congress will approve money to stabilize insurance markets also could have short term impacts, Michling said.

"Any time you have uncertainty in health insurance, uncertainty translates to risk," he said.

Laura Appel, senior vice president and chief innovation officer of the Michigan Health and Hospital Association, said the lack of clarity "hamstrings people trying to make smart decisions."

Although any potential impact on hospitals would likely be long-term, hospitals need to be on top of trends and expected health needs for the population they cover, Appel said. If large numbers of people lose insurance coverage, that would complicate any future plans and potentially require needs for cuts to current services or a lack of updates down the line.

Appel added that the twists and turns in the current Congressional debate over health care aren't helping clarify an already complicated industry for average consumers.

"Folks already find health care and insurance to be complex, and sometimes frustrating and difficult to manage," she said. "This creates more anxiety for many people."

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