The bill entrenches an unaccountable bureaucracy that duplicates state regulatory power. Healthcare freedom requires limited government.

The bill entrenches an unaccountable bureaucracy that duplicates state regulatory power. Healthcare freedom requires limited government.

Only bureaucrats could insist that substantial dental services be offered remotely for public welfare recipients! The bill prohibits “lower rate than comparable services rendered in person, except when reimbursing a provider who exclusively provides telemedicine services.” It’s badly-written law, and designed to serve multiple special interests along the way, but it does force MDHHS to cover Medicaid patients connecting with clinicians.

Medicaid resources are limited. When the state expands Medicaid to include able-bodied adults, it reduces services to those for whom the program was intended. Work requirements help prevent this abuse of the system.

The bill would allow incorporating municipalities to determine the territory of emergency service jurisdiction. The whole point of public services is to serve entire taxing and voting jurisdictions. Who are supporters trying to cut out? Rural, or less-desirable urban? Transparency is lacking here.

This bill is a risk to life and a boon to the organ industry, already troubled by unethical practices.

As a method of price reduction, legislated controls are a failed experiment. They also increase government costs, power, and size – all a threat to individual freedoms.

The bill entrenches an unaccountable bureaucracy that duplicates state regulatory power. Healthcare freedom requires limited government.

The bill entrenches an unaccountable bureaucracy that duplicates state regulatory power. Healthcare freedom requires limited government.

A dual justice system, one option under MDHHS standards, isn't much of an argument for equal justice. Opening it to violent offenders is even worse.

A dual justice system, one option under MDHHS standards, isn't much of an argument for equal justice. Opening it to violent offenders is even worse.

Is a telehealth visit equal in value to an office visit? That is a highly individual question, and legislation cannot give a good answer - only clinicians and patients can do that. We should probably allow them to do so.

Extends temporary license from 120 days to 1 year. This merely rearranges the systemic problem of EMS shortages. Testimony indicates that the real bottleneck is the expensive national test for instructors. It has been proposed that MDHHS, as licensing body for EMS, should provide an alternative exam.

Current law requires testing for HIV every 3 months for donating breast milk. This bill removes the requirement to test quarterly, and retains initial testing. Reduced regulatory cost supports individual freedom.

The bill presents as justice for first responders, but costs include smaller jurisdictions being unable to afford to keep their part-timers. In the larger picture, why should public employees be given this presumption, but not private? This is undue interference with local government, as well as unequal rule of law. Opponents “suggest that a better source of funding would be the Christopher R. Slezak First Responder Presumed Coverage Fund," a duplicate program according to HFA.

Splits up SUDS licensing into prevention and treatment/ rehabilitation (exempts specialized clinicians, hospitals, etc, resulting in fewer duplicate licenses). LARA must provide comment section in licensing form. LARA claims will lose $70,000 per year. Reducing duplicate licensing will lower cost. Remaining questions: Will split services improve care? Or are they already naturally split, and this allows primary care to incorporate outpatient prevention with routine office work at no added cost?

Insurance mandates shift costs and reduce individual decision-making in care. HSA-type models are a better solution.

Insurance mandates shift costs and reduce individual decision-making about care. HSA-type models are a better solution.

Harms economic freedom. Insurance coverage mandates increase premium costs by an average of 4% each.

“All pregnant patients and those planning a pregnancy would have to be given access to expanded carrier screening that is intended for use in a global population that encompasses over 100 inheritable autosomal recessive and X-linked conditions with a carrier frequency of approximately greater than or equal to 1/200 in any ethnic group.... 2023 DHHS appropriations includes $6.0 million Gross ($900,700 GF/GP) to reinstate the Plan First! Medicaid-funded family planning service."

Medical Examiners (ME) are traditionally a local method of securing the right to life. This bill imposes central control. A web app run by MDHHS would limit local ME choices for recording manner, cause of death, and other details. In addition, it imposes training and access requirements, and allows fees or other barriers in the future.

Adds attending physician representatives like a partner. Still requires ME certification for “unexpected” deaths, but exempts if seen by a physician within a year, instead of 48 hr, if they can accurately state the cause of death. MI law already exempts identifiable deaths. With this extension, how many physicians will just guess instead of pinning down the facts? Reducing standards for identifying homicide, suicide, contagion, etc degrades the value we place on life, & our ability to defend it.

Renaissance zones are an admission that urban governance and state tax policy are not working, accompanied by state transfer of tax responsibility away from these areas to the rest of the state. They especially favor urban hospitals, but act as a bandaid. In the end they further complicate healthcare funding and service (not paternalism) to local patients.

Expands MI Strategic Fund leverage in the private sector. A windfall for narrow special interests (friends of whoever happens to be governor).

This bill attempts to use corporate handouts to leverage corporate behavior. This is aimed at Spectrum (now Corewell) and other hospital systems that transferred billing and call centers to India. However, that horse left the barn years ago. This sort of market manipulation is meant to impress voters, but in reality it fixes nothing.

This bill seems to assume that the state has a magic caregiver machine that will pop out more quality clinicians if legislators just pour more money into it. On the contrary, this wholesale promulgation of new rules, regulations, and spending leaves taxpayers and real-life caregivers with fewer resources and lower morale to get healthcare done.

Medicaid already covers BP cuffs for hypertensive disorders in pregnancy, childbirth, or the puerperium period. Expanding coverage beyond those diagnosed could cost up to $3.1M, and would be of dubious benefit if even used. Note: Medicaid pricing ($62.30) is 30-60% higher than products offered on the open market.

Mandates clinicians to do maternal mental health screenings and referrals if they think necessary. (As they already do, with less documentation time.) Directs MDHHS to create a screening tool. The net effect here is bigger, more expensive healthcare administration.

Amends Chapter 34 (Disability Insurance Policies) of the Insurance Code to require a health insurer in Michigan to provide coverage for mental health screenings during the postpartum period as proposed in House Bill 5169 (H-1). Such insurance coverage mandates further escalate the cost of premiums by an average of 4% each.

Amends the Social Welfare Act to specify that Medicaid eligible individuals could receive postpartum mental health screenings as proposed in HB 5169. HB 5170 and HB 5171 are tie-barred to HB 5169. Significantly, HFA notes that according to testimony, 40% of mothers do not attend their postpartum checkup, which can result in mental health issues going undetected and unscreened. In effect, this bill attempts to bypass patient choices deemed to be bad, by adding burdens to other clinicians.

Empowers MDHHS to create, register, and subsidize levels of hospital maternity care units. If big government could create quality care, we’d already be there.

This is an additional mandate on healthcare time, which is already stretched. (An unfunded mandate, to boot.) And it’s a waste of legislation for hospitals that already do this, realizing it’s in their best interests to have enrollment complete before future visits. Perhaps the biggest impact is getting DIFS and MDHHS together on a promotional insurance project.

This bill is a boon to the organ industry, already troubled by unethical practices. In addition, the bill would increase state (and perhaps local education) costs according to HFA. MDE: although a curriculum has already been developed by Gift of Life, meeting the requirements under the bill would require 1.0 FTE and $200,000 for a presentation on organ donation and transplantation; guidance to districts; and ensuring compliance.

According to House Fiscal agency, the bill amends the Public Health Code to specify that the term drug paraphernalia does not include testing products (such as fentanyl testing strips) that are used to determine whether a controlled substance contains chemicals, toxic substances, or hazardous compounds in amounts that can cause death or physical harm.

Adds the National Insurance Crime Bureau to allowed fraud report sharing list, shields reports from liability, and felonizes all but the lowest levels of fraud. List already includes NAIC, another industry org. Per DIFS, scams against government and private healthcare insurers form by far the largest type of insurance fraud. Healthcare fraud likely steals tens of billions of dollars a year. Q: Does federalizing this fraud serve freedom? Is MI passing the buck or leveraging federal funds?

Addresses health insurance fraud. In 2016-18, MI SC limited no-fault “innocent 3rd party” coverage in case of fraudulent applications according to DIFS. “Staged-crash rings fleece auto insurers out of billions of dollars a year by billing for unneeded treatment of phantom injuries. Usually these are bogus soft-tissue injuries such as sore backs or whiplash, which are difficult to medically identify and dispute.”

This package creates bureaucracy, not care. Veterans already have plenty of the former; give them the funds so they can seek out the latter locally.

This package creates bureaucracy, not care. Veterans already have plenty of the former; give them the funds so they can seek out the latter locally. Directs MDHHS to “ enter into an interagency agreement in cooperation with the MVAA to conduct statewide outreach on mental health and substance abuse support resources”

This package creates bureaucracy, not care. Veterans already have plenty of the former; give them the funds so they can seek out the latter locally. Creates a "buddy-to-buddy program.”

This package creates bureaucracy, not care. Veterans already have plenty of the former; give them the funds so they can seek out care locally. Requires DMVA “to develop a program called the Transition Bridge Program to help service members and veterans focus on mental health, wellbeing, and suicide prevention. "

Are we safer when the state and Big Health know our health data, in real time – or not? Privacy is essential to healthcare freedom. It’s horrifying to imagine MI Medicaid exchanging “disparate clinical and other health data for treatment, care coordination, quality improvement, population health, public health emergencies, and other public health and community health purposes” and a governing board of experts doesn't help (public health /MDHHS, HIT Commission, a hospital, a health plan, etc).

There is no right way to do a wrong thing. (See previous bill comments.) Directs millions of MDHHS revenue obtained from insurance provider taxes to a new Health Information Exchange.

Currently per HFA, requesting a new birth certificate to designate a sex other than the one assigned at birth must have an affidavit from a doctor certifying sex-reassignment surgery was performed. The bill eliminates this and directs a form approved by the director for the person to indicate male, female, or “X.” If accompanied by a court order changing the person’s name, the new certificate would also have to reflect the new name. Allows state registrar to seal the original birth certificate.

HBs 4532, 5368, and 5369 empower MDHHS to define elevated blood levels (EBL) of lead & report the number of children <5 to the legislature, & require referral to LEAP programming. Redefines EBL from 10mcg to 3.5 mcg; abatement to mean temporary instead of permanent reduction; expands paint investigation to risk assessment; certifies renovators & techs, with recert & penalty fees, loosens lead-work registry mandate, raises penalties to $5-$25K, extends statute of limitations from .5 to 3 years.

Lays groundwork for even larger bureaucracy by defining emergency renovation operations and “firm” for this Act. Evidence for dose-specific lead harm was noticeably lacking in hearings; the catch-phrase became “no level is safe.” However, in context of environmental harms, lead is not alone or even dominant.

Entrenches CMS mental health clinics in Michigan, via MDHHS certification.

Entrenches CMS mental health clinics in Michigan, via MDHHS certification.

Boosts organ donation, already troubled by systemic failure to protect life.

The bills facilitate cosmetology school chains within a grossly-excessive regulatory scheme. Put another way: this makes it easier for existing schools to expand, than for start-ups to begin.

Centralizes Michigan’s county CASA program under MDHHS. Analysis claims no increased state costs but “An additional $1.5 million is allocated on a one-time basis in the FY 2023-24 DHHS budget.”

Mandates on health insurance coverage serve manufacturer interests, and raise costs for everyone else.

Expands LARA’s rulemaking over pharmacists. From here it’s a short step to mandating such prescriptions. A better alternative is to re-designate them as over the counter, requiring no prescription. “According to testimony, Michigan is experiencing a shortage of obstetricians and gynecologists (OB/GYNs), with 1/3 of Michigan’s 83 counties having no OB/GYNs at all.” - HFA

Empowering MDHHS to define safe gun storage is an abuse of state health policy power.

Empowering MDHHS to define safe gun storage is an abuse of state health policy power.

Weaponizes department funding to pressure local governments: “(2) From the funds appropriated in part 1, local governments shall report any action or policy that attempts to restrict or interfere with the duties of a local health officer.”

Funds a massive childcare study with LARA and MDHHS to find the top 10 most common rule violations, # of licenses revoked/ suspended, violations for incomplete health & safety training and safe sleep training. Actions to strengthen health & safety of care, including # of licensing consultants, avg caseload, on-site visits by provider type and region, etc. $3M to collaborate with DHHS to continue the network of infant and early childhood mental health consultation to child care providers.

Sec. 351. The legislature finds and declares that appropriations for the critical industry program and the Michigan strategic site readiness program are for a public purpose and serve the health, safety, and general welfare of the residents of this state.” (Except none of the provisions are about healthcare.) Oversees independent living grant-making “(vi) Other wraparound services that may include, but are not limited to, health services, behavioral services, and licensed child care."

Includes $151.5M for school mental health funding. The bill blurs lines between education and family, healthcare, and law enforcement. Institutional integrity and local decision-making are essential to healthcare freedom.

The bill inserts state influence into local community colleges, leveraged by tax funds. College independence from direct enrollment and local funding can foster academic arrogance and drive political agendas. This undermines the local nature of healthcare, a strong source of trust between patients and clinicians.

Higher ed is the immediate pipeline for healthcare professionals. Michigan Competitive Scholarship provisions: Redirects MDHHS Title IV TANF funds back to temporary assistance and substitutes TIP (Tuition Incentive Program) funds from the General Fund to phase in the Michigan Achievement Scholarship program. MDHHS determines Medicaid/TIP qualifications. Weaponizes department funding to pressure local government any action or policy that attempts to restrict or interfere with health officer.

Local reporting requirement for restricting/interfering with health officer Blurs institutional lines, for example Sec. 601. From the funds appropriated in part 1 for adolescent and school health, the department shall use the funds to replace federal funding reductions from the CDC for homeless youth and children. Shifts infant and early childhood mental health to MI LEAP.

“Health” is used 194 times in this 470-page school aid bill, and related expenditures total >$545M. Among other projects, assigns $2,425,000.00 for 2024-2025 for the purpose of employing school nurses, classroom aides, school social workers, and community health workers; for the provision of behavioral or mental health supports.

Michigan's total number of offenders increased by 13,251, or 17.7%, since the previous year. Recidivism data lacking. Provides Mental health and substance use disorder treatment services staff 462 FTEs and $66,998,500. Requires local governments report action/ policy to restrict or interfere w local health officer, more staff training in mental health, detailed Health Care Utilization Reports, nurse attraction/ retention, MAT clinics, more long acting injectables. Cuts prisoner fees & co-pays.

Public Impact: high hourly rates ($34.65 - $45.82) may skew the local RN job market towards state employment. Weaponizes local governments to report any action or policy that attempts to restrict or interfere with the duties of a local health officer. Provides $16.4 million to reflect Veteran Homes' operating cost increases for contracted nursing services, state healthcare employee wages, medical supplies and services, utilities, and DTMB accounting services fees.

Weaponizes bill to require local govts to report action or policy to restrict/interfere with local health officer duties. Requires free training to local LEOs: Cultural awareness & competency; Tolerance, diversity, & implicit bias; Conflict management & de-escalation,; Use of force on vulnerable individuals, incl children, individuals with disabilities, unmet mental health needs, or under the influence, and pregnant individuals; and Mental health & wellness for law enforcement officers.

Weaponizes bill to require local govts to report action or policy to restrict/interfere with local health officer duties. Markets Bridge Card food program, drives participation, and directs a count of participants by county.

Weaponizes department funding to pressure local governments: “(2) From the funds appropriated in part 1, local governments shall report any action or policy that attempts to restrict or interfere with the duties of a local health officer.”

Weaponizes this spending bill to require local govts to report action or policy to restrict/interfere with local health officer duties. Spending increase of $3,623,500 (4.9 %). New PBM and health insurance rate regulation. Funding sources: $76,317,900 industry fees (read: consumers), $753.5K interdepartmental grants, $700K federal. 401 FTE (increase of 7). Deletes dept dashboard and reporting severance pay.

This is LARA incrementing costs by $8,526,300 (1.4%), and healthcare paying for it. From: Nurse aide and medication aide registration fund 1,657,800; Nurse professional fund 1,967,200; Health professions regulatory fund 27,323,300+; Health systems fees 4,139,500+; HHS-Medicaid, certification of health care providers & suppliers 9,118,700+; HHS-Medicare, certification of health care providers and suppliers 14,647,000+. Pays $250K for an Implicit Bias Study.

Increases spending to $14,288,200, up 4.0% Diversion court programs create two-tier justice based on health, and cost a LOT. Less than prison? More effective than alternatives? It’s hard to tell. Pays for Drug Treatment Courts, Mental Health Courts, a Behavioral Health Administrator, a MAT program, and expands Prescription Compliance through Oral Fluid Testing including the Veteran Courts.

Decreases spending by $214,083,600) (4.0%) but increases FTEs by 59.9 / 0.8% Funding sources: 10+ are health-related, mostly interdepartmental grants. Weaponizes bill to require local govts to report action or policy to restrict/interfere with local health officer duties. Deletes dashboard, severance pay reporting, and grant funding transparency. Pays $1.365M for free feminine hygiene products pilot program.

Increases spending to $234,739,300 (3.5%) Weaponizes funding to require local govts to report action or policy to restrict/interfere with local health officer duties. Coordination of transportation dollars among state departments that provide transit-related services, including the department of health and human services. Deletes key metrics dashboard and severance pay reporting.

Replaces the Michigan Economic and Social Opportunity Act with the new, less accountable, and more powerful “Bureau of Community Action and Economic Opportunity Act.” Gives MDHHS rule-making authority. Removes its mandate to develop interagency agreements and provide the house and senate committees that oversee labor matters an effectiveness report.

This 205-page bill increases MDHHS budget by $2,034,945,400 ($2 Bn, or 5.7%) for a total of $37.8 Billion. Requires local govts to report local health officer restrictions. Brings Healthy MI co-pays down to standard Medicaid rates. Establishes pharmacy dispensing fees based on the medication standing on the DHHS preferred drug list. Increases Autism behavioral tech rates to $62.00+ per hour. Deletes requirement for unwed Medicaid mother or the baby's father to pay part of the birth expenses.

In mandating what is common sense, this bill engages in obvious healthcare micromanagement. More importantly, it fails to answer the root cause question: why are eye surgeons not doing this already?

Restricts professional practice, innovative care, and patient access. LARA estimates that staffing costs of $75,000 and one-time IT costs of $360,000 would be required. All such expenses eventually get billed to patients.

This 3-bill package shifts $60M to the Michigan Innovation Fund to support various venture funds. Venture capital is a red flag for state influence in the healthcare market, which has led in this space for several years. It’s not the state’s job to invest in startups. Worse, they’re no good at it. The private sector does better, given inherent safeguards and accountability for results. For the same reason, people spend their own money better than government does.

This 3-bill package shifts $60M to the Michigan Innovation Fund to support various venture funds. Venture capital is a red flag for state influence in the healthcare market, which has led in this space for several years. It’s not the state’s job to invest in startups. Worse, they’re no good at it. The private sector does better, given inherent safeguards and accountability for results. For the same reason, people spend their own money better than government does.

This 3-bill package shifts $60M to the Michigan Innovation Fund to support various venture funds. Venture capital is a red flag for state influence in the healthcare market, which has led in this space for several years. It’s not the state’s job to invest in startups. Worse, they’re no good at it. The private sector does better, given inherent safeguards and accountability for results. For the same reason, people spend their own money better than government does.

DTMB oversaw ~550 state building projects last year, total value ~$1.2 billion. This bill tasks DTMB to select and rank firms in order of qualifications and enter into contract negotiations with the highest-ranked firm. If negotiation fails, it would be formally terminated and would begin with the next highest-ranked firm until an agreement is reached or the process is terminated. PLUS annual legislative reports. (HFA) No wonder DTMB dislikes it – and 17 architect/ engineering orgs support it.

Amends the Comprehensive School Safety Plan Act to eliminate the current School Safety Commission, effective December 31, 2024, and repeal the section that established that commission. The bill would create a new commission, the School Safety and Mental Health Commission, in the Department of State Police, effective January 1, 2025. Local needs vary, and local responsibility is paramount to safe and accessible healthcare.

Requires medical consent and supervision for medical exfoliation, dermaplaning, and dermabrasion beneath the stratum corneum. The American Medical Spa Association does not restrict this procedure to physician supervision. Exceeding necessary safety regulations unduly limits healthcare freedom for cosmetologists and would-be entrepreneurs.

Skin treatments undergo constant innovation, according to national experts. Legislating who may perform every treatment sets up a revolving door of new law, increasing the risk of violations. In addition, legislation creates protected classes and high barriers to new service providers. Safety is served by lesser market barriers, including consumer choice and judgment.

Increases the value of gifts life and casaulty insurance companies are allowed to give to induce buyers. The monetary increase is not of particularly great concern to healthcare freedom. However, the purposes specified in the bill include enhancing health and Incentivizing behavioral changes to improve the health or reduce the risk of death or disability of a customer. These attempts rely upon access to health records, creating privacy violations.

Attempts to leverage more federal Medicaid funds for local EMS. Limited to: "Eligible governmental entity" - eligible under federal law to provide ground medical transportation services and includes this state, a city, county, fire authority, township, ambulance authority, federally recognized Indian tribe, or a local unit of government. (SFA) The SFA offers details and a sample situation. (link below)

Would “require the DMVA to ensure that mental health and wellness resources are available to members of the National Guard and other military services.” (HFA) This is beyond the ability of state government. Quite simply, it's another layer of “make a wish” law atop hundreds of other programs. Not helpful.

Strongly encourages all schools to provide grades 7-12 with Stop the Bleed and CPR training, by adding these to the recommended common core courriculum. Requires certain school employees to take additional training. Adds nurses to the list of local resources for teaching. Local schools need local decision-making and autonomy. This is not a state decision; codifying it reduces local ownership and learning effectiveness.

Corrects an MCL reference in current law. No content change, but clarity serves freedom. However, the two-bill package is highly specific about bleeding, and serves to define health club owners/staff as Good Samaritan bystanders, instead of bearing a responsibility to help. It begs the question – is the an ex post facto attempt to alter the outcome a particular situation?

See previous bill comments.

The rationale is lacking for this decrease in public presence on the psychology licensing board, and increasing supervision for limited licenses. Also missing are root cause questions about today’s psychologist shortage. Why should the state distinguish between doctoral and masters’ prepared practitioners? Do patient outcomes support different legal status? Why do today’s master-levels need more supervised years/hours? Are we compensating for DEI vs merit-based college admissions?

Reduces barber education requirements from 1800 hours to 1500. This profession is grossly overregulated, and the bill would modestly improve healthcare freedom for barber students, clients, schools, and clients.

Requires health insurance policies in Michigan to issue rebates as required by the federal ACA. Insurers that file their medical loss ratio and other rebate information with the United States HHS would be required to concurrently file the information with MDHHS. Increases insurance paperwork and costs, raising barriers to patient autonomy through less competitive coverage options.

FY 2024-25 appropriations includes a one-time appropriation within the DHHS budget of $2.9 million for doula training and continuing education. Doula practice began as a local initiative, between individuals who developed trust and service. State payment follows state standard-setting, and reflects another step downward into state takeover of this essentially local service.

The bill creates a new category of patient surrogate, while Michigan law already provides patient advocates, power of attorney for healthcare, and guardians. It is unclear why an additional legal category is needed, and confusion seems a likely result. This opposes the clear, stable law required for healthcare freedom.

This drug is used with apparent safety and easy access in other countries. Abuse in Michigan does not rise to a level that warrants new law.

This drug is used with apparent safety and easy access in other countries. Abuse in Michigan does not rise to a level that warrants legal penalties.

Normalizing prostitution by renaming it “commercial sexual activity” says Yes to a form of slavery.

Normalizing child prostitution by renaming it “commercial sexual activity” says Yes to a form of slavery.

Downgrades soliciting a minor so it is no longer a registerable offense under the Sex Offenders Registration Act, administered by MDHHS /CPS. Treating children as sexual objects violates the life, liberty, and property rights of the vulnerable.

Insurance mandates oppose healthcare freedom because they raise insurance costs. Instead, ask why a common-sense change like this is not already common practice. Which market conditions or regulations stand in the way?

Discrimination here is unclear. Nurse Practitioners support the bill; are insurance companies caving to physician lobbies with a two-tier pay for services? Politically, the bill codifies an ACA provision. However, the true metric is individual life, liberty, and property rights. Which market conditions or regulations block common sense justice? Eliminating insurance control over primary care pay rates via HSA or a similar tool restores patient voice in fair pay.

The bill entrenches an unaccountable bureaucracy that duplicates state regulatory power. Healthcare freedom requires limited government.

The reality is that staff shortages everywhere are driving overtime. Mandating otherwise increases busywork and bureaucracy, rather than improving conditions. Instead, ask why nurses (and other clinicians) are staying out of the workforce. Which market conditions or regulations make healthcare employment unappealing?

Amends the Guardianship Assistance Act to allow child maintenance payments to relatives who are not licensed foster parents but have been approved by MDHHS. Expands definition of “relative” to the 5th degree, including spouses, to access federal title IV-E funding. (HFA) Simplifies qualifying for guardianship by leaving it to MDHHS judgment. May improve placement rates, the primary issue; along with risk of abusing the system. Will increase spending.

It’s an unfunded black hole. Would use the taxpayer’s money for an undefined purpose, with an open-ended new authority under Michigan State Police. Healthcare freedom requires limited government.

Creates a new, unfunded, MDHHS training and certification program. Healthcare freedoms thrive in local innovation, not by chasing federal funds and giving up control. “... could be implemented only to the extent that federal financial participation is available, and any necessary federal approvals have been obtained. The department would have to seek any federal approvals necessary..." (HFA)

This is a state and industry marketing bill. It requires MDHHS to notify Michigan Energy Assistant Program (MEAP) participants of their eligibility for other services under the MEAP, including energy waste reduction products and services offered by an energy provider or a home weatherization assistance program. (SFA) Individual healthcare freedom comes from economic choice, not dependence on state welfare. Increasing state welfare responsibilities means higher government costs and control.

Opens MI to more self-insurance, but leaves approval to the discretion of the DIFS director. Individuals may be arbitrary in their use of such power. Equal rule of law is the constitutional standard.

Expands self-insurance to affiliated groups by adding that the definition of participant(s) can apply to multiple entities. For example, piano teachers could come together to buy group health insurance.

Allows for report dates linked to fiscal year.

Reduces barriers to self-insurance. “... reduces the application processing fee for special purpose financial captives (SPFCs) from $10,000 to $5,000. Currently, no SPFCs exist in Michigan, so this bill would have minimal to no fiscal impact on DIFS.” In addition, allows for payment dates linked to fiscal year. (HFA linked in previous bill in this series.)

Enables special group insurance. “participants are allowed to insure risks of their affiliates or controlled unaffiliated businesses.” (HFA) Expands insurance options for innovation and savings, especially beneficial for small businesses.

Decreases application fee from $10,000 to $5,000, reducing barriers to self-insurance innovation and savings.

Requires annual CPA financial audit. This may be financially-prohibitive to smaller entities as CPA fees in the US are extremely high. The bill limits this service to CPAs certified by AICPA. Single-sourcing causes a monopoly effect, raising prices and limiting these startups, as well as CPA job entry. Legislators can avoid compounding this problem by referring to qualifications in general terms (as it does previously, in part 2 of this section of law).

Healthcare freedom requires limited government. This expands state powers into an employer’s freedom of association, and would wreak havoc in healthcare. It fails to recognize that one root cause of increasing violence in Michigan is excessive government power, combined with diminished individual freedom and responsibility.

Licensing can reduce services by raising barriers to entry, and imposing penalties for compliance failures. It cannot retroactively fix the SE Michigan system failure during COVID. The bills will exacerbate the existing problem that there are already too few providing this service. We need a more open market to provide competition and a cushion for rare situations of high need.

Licensing can reduce services by raising barriers to entry, and imposing penalties for compliance failures. It cannon retroactively fix the SE Michigan system failure during COVID. The bills will exacerbate the existing problem that there are already too few providing this service. We need a more open market to provide competition and a cushion for rare situations of high need.

Redefines government hospital financing and increases its complexity. It could be called a policy of scraping by, serving the status quo rather than individual healthcare freedoms. "Rural Hospitals" in Livingston, Muskegon, and Saginaw Counties would be included as a result of this bill, and hospitals that used to meet the definition of a “rural hospital” located in DeWitt Charter Township (Clinton County) and Traverse City would become ineligible due to 2010-2020 population growth. (HFA)

Increased MDHHS budget by $328,948,700, and staff by 80. For other healthcare freedom issues, see each department’s 2024 budget within this bill; comments under related appropriation bills in this report card; and extensive analysis at the MHF Forum thread linked below.

Increases by $122.6 million (12.9%) for a total of $1.1 billion School Aid Fund. Allows recipient schools to use up to 60% of funds to support retention and recruitment of instructional staff and staff providing services related to mental, emotional, or physical health. Care and education are two different things, and mixing them without a parent present incurs great risk.

Increases funding by $34,683,900 or 1.5%. Ties tuition incentives to Medicaid eligibility. Pulled funds for (among others) Michigan Tech’s BSN Program, which took over in Fall 2023 after the Finlandia program closed. Healthcare freedom grows best in conditions of local independence without the red tape that attends government funding, and the school has solicited donations elsewhere.

Mental and physical care should be limited to individuals appropriately in the corrections system, as part of the public cost of incarceration and public safety. The system oversees ~ 17% of Michigan’s population. Numbers, esp healthcare costs, are rising. Legislators are right to limit costs and require reports on healthcare utilization and program revisions for health-related recidivism. Medication by force and requiring local reporting are red flags: how do they aid self-governance?

Establishes a behavioral health administrator within State Court Administrative Office, possibly to replace directive to link Swift and Sure Sanctions Program to DHHS, LEO, and MDOC state programs for offenders. Given the lack of transparent effectiveness data for alternative veteran and mental health courts, this is premature. Positive change: detailed reports on alternative courts & Swift and Sure Sanctions; deleting funds for Prescription Compliance through Oral Fluid Testing.

“From the funds appropriated ... local governments shall report any action or policy that attempts to restrict or interfere with the duties of the local health officer.” $600K of federal funds increase in Emergency Management to recognize United State Department of Agriculture (USDA) Animal and Plant *and Health* Inspection Service (APHIS) grant for “incident command training”? Weaponizing government in the name of health violates the people’s trust and principles of healthcare freedom.

“From the funds appropriated in part 1, local governments shall report any action or policy that attempts to restrict or interfere with the duties of the local health officer.” Weaponizing government in the name of health violates the people’s trust and principles of healthcare freedom.

“From the funds appropriated ...local governments shall report any action or policy that attempts to restrict or interfere with the duties of the local health officer.” Weaponizing government in the name of health violates the people’s trust and principles of healthcare freedom. Positive changes: Deletes requirement for DOS to maximize Organ Donor Registry growth. House claws back FY 2022-23 appropriation $25M for community health campus pilot project in Clare County. Sen. does not include.

“From the funds appropriated in part 1, local governments shall report any action or policy that attempts to restrict or interfere with the duties of the local health officer.” Weaponizing government in the name of health violates the people’s trust and principles of healthcare freedom.

“From the funds appropriated in part 1, local governments shall report any action or policy that attempts to restrict or interfere with the duties of the local health officer.” Weaponizing government in the name of health violates the people’s trust and principles of healthcare freedom.

Weaponizing government in the name of health violates the people’s trust and principles of healthcare freedom. On the other hand, broad powers can be provided appropriately: “Sec. 704. ...(2) The state director of emergency management may expend money appropriated under part 1 to call on any agency or department of this state or any resource of this state to protect life or property or to provide for the health or safety of the population ..."

A one-time Health sector implicit bias study for $250,000. What exactly will be studied?? “From the funds appropriated in part 1, local governments shall report any action or policy that attempts to restrict or interfere with the duties of the local health officer.” Weaponizing government in the name of health violates the people’s trust and principles of healthcare freedom.

“From the funds appropriated in part 1, local governments shall report any action or policy that attempts to restrict or interfere with the duties of the local health officer.” Weaponizing government in the name of health violates the people’s trust and principles of healthcare freedom.

ocal governments shall report any action or policy that attempts to restrict or interfere with the duties of the local health officer.” Weaponizing government in the name of health violates the people’s trust and principles of healthcare freedom. $1 Million in grants for affordable housing for front line workers, including, but not limited to Healthcare workers, Teachers, Senior citizens, AFC providers, foster care age-outs, & veterans is special interest-driven and outdated 5 yr post COVID.

Increases previous year funding by $1,976,101,000. or 5.5%, and 28 full-time-equivalent employees. Includes local government mandate to report limits on health officer duties. Unlimited government always results in limited individuals. Weaponizing government in the name of health violates the people’s trust and principles of healthcare freedom.

“From the funds appropriated in part 1, local governments shall report any action or policy that attempts to restrict or interfere with the duties of the local health officer.” Weaponizing government in the name of health violates the people’s trust and principles of healthcare freedom.

Do we really want the state doing mental health training in schools to the tune of $684K? “From the funds appropriated in part 1, local governments shall report any action or policy that attempts to restrict or interfere with the duties of the local health officer.” Weaponizing government in the name of health violates the people’s trust and principles of healthcare freedom.

bill provisions subject home help, including family members, to being corralled into union dues skimming; and make MDHHS the dues-collecting agency. SBs 790 and 791 would provide that, for collective bargaining purposes, caregivers under the Home Help Program are public employees of the director of MDHHS.

Carves out union advantages by defining some healthcare workers as public employees solely for purposes of union membership. Besides opening the door to dues skimming (we’ve been here before!) and making the state serve a special interest, it would use state funds to bargain for higher wages, ie, against the public interest.

The bill eliminates the requirement that unwed fathers pay a portion of the birth expenses for mothers and children covered by Medicaid, if the Office of Child Support so requests the court. Increases MDHHS costs by $13.7 million, which has been accounted for in the 2024-25 DHHS budget. Freedom takes personal responsibility, and stable families are the foundation of society. The state is willing to pick up the slack, but that doesn’t make it healthy for it to do so financially or socially.

Moves Medicaid Disproportionate Share Hospital (DSH) payments to general Medicaid spending. DSH claims were subject to fraud, and $4.6M is peanuts to MDHHS. Still - freedom requires government accountability, and only $3M were accounted for in the budget omnibus bill. Did the other $1.5M just get washed into general spending?

Extending family dependence on the Family Independence Program (FIP) state cash assistance program from 4 years to 5 seems shortsighted. How about saving for a rainy day? How many families on the state self-sufficiency plan actually become self-sufficient? Is there evidence that another year will improve that metric? $20.0 million in additional federal TANF funds were appropriated in order to cover the costs of additional cases.