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Former Gov. Rick Snyder helped sell a Republican Legislature on expanding Michigan's Medicaid program by claiming his plan would ultimately lead to a healthier state — and save the state money down the road.

The 2013 deal, which came with sizable federal subsidies under the Affordable Care Act, was dubbed Healthy Michigan and it currently covers about 660,000 individuals — many more than originally predicted.

Snyder said this state's program could be a model for the other states that adopted the expansion. New research supports this. 

Officials who implemented the expansion set up features to encourage enrollees to understand their own individual health risks and to seek preventive care — rather than rely on costly emergency room visits. The state expects enrollees to visit a primary care physician within the first three months of enrollment.

A recent pair of studies from the University of Michigan’s Institute for Healthcare Policy and Innovation shows that this has paid off.

Based on a survey of more than 4,000 individuals enrolled in the program, the studies show that implementation of Healthy Michigan led to an increase in the number of enrollees who completed health risk assessments, engaged in healthy behavior and sought preventive care.

Findings from the studies are largely positive:

►More than 20% of those surveyed reported that before they enrolled in the program they had not seen a primary care physician in more than five years. But 79.3% reported they visited a primary care provider after enrollment. 

►49.3% reported that they completed a health risk assessment after enrollment. Of those who completed health risk assessments, 89% said that it helped their doctors understand their health needs, and most committed to a healthy behavior, like exercise or dieting.

►85.2% of those with a primary care provider report visiting their doctor within the last year.

►33% reported that, prior to enrolling in the program, they had not received the medical care they needed. Of those who reported that they were getting regular care, 16.2% reported that they were getting it from the ER. After enrollment in the plan, however, 92.2% reported that they received the care they needed, and only 1.7% reported they relied on the ER.

“After enrolling in Michigan’s Medicaid expansion program, beneficiaries reported less forgone care and improved access to primary care and preventive services,” one study concludes.

While Obamacare promised that offering more people health coverage would reduce costs by avoiding reliance on expensive ER care, that’s not necessarily been the case in other states that rolled out the expansion (only 14 have not signed on at this point). In fact, one study out of Oregon showed an increase in ER visits among those with Medicaid.

Michigan’s rules for its Medicaid expansion seem to be a remedy. It makes sense that if people are getting taxpayer-funded health care, they should be mindful of their health. 

Starting in 2020, some Healthy Michigan recipients who earn more than 100% of the federal poverty limit will be required to complete a yearly health risk assessment to keep their coverage, in addition to some cost sharing.

There are many other reasons to be concerned with the costs of Michigan's Medicaid expansion, but these results are positive, and the state should continue encouraging healthy choices.

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