Newly introduced auto no-fault amendment bills, HB 5980 and HB 5981, aim to give people access to care after catastrophic crashes that they often can't get now.
Michigan's 2019 auto no-fault law set reimbursement rates for care so low, that policies with lifetime unlimited medical coverage are often on paper only. Bill sponsors say severely injured people and their families are shocked to discover they have little or no access to what they paid for.
Margaret Kroese is President of CPAN, a non-profit group seeking to improve car crash survivors' access to necessary medical care. She's also an executive with Hope Network Neuro Rehabilitation. She said Hope Network is in the same situation as many neurorehab facilities in Michigan.
"The reality is, reimbursement is so low that we're losing money every single day that we serve someone under the current law, that we have to make decisions about who we admit," she said.
Kroese said timely access to specialty care to remediate spinal cord and brain injuries is crucial, because the brain is more conducive to rewiring early on.
"As soon as you're medically stable, you want to start intensive rehabilitation," she said. "The longer you wait, the less the brain is in that healing mode. You can make gains later, but not the leaps and bounds you'd expect in that first six months to a year."
Kroese said people who can't get the rehab they need can end up in "tragic" situations, at home with loved ones struggling to deal with their complex medical care needs, or in a nursing home. She said even young people in their teens, 20s and 30s have ended up being placed in nursing homes for the elderly, without adequate care and rehabilitation.
Kroese said ironically, people who are paying the least for car insurance are the most likely to be quickly accepted by rehab clinics for treatment. She said the state's no-fault law allows people on Medicaid to select only $50,000 in medical care coverage on their policies. Medicaid, not insurance companies, covers the medical costs above that $50,000 for car crash injuries. And because Medicaid pays significantly more than auto no-fault policies, rehab clinics can afford to treat them.
The bills were introduced in the state House by State Representative Mark Tisdel (R-Rochester Hills) and State Representative Julie Rogers (D-Kalamazoo).
The bills would require insurance companies to match the rate that Medicaid pays for brain and spinal cord injury treatment. The bills would also pay for family and friend caregivers of injured loved ones at home, for more than the current 56 hour a week cap, if more hours are medically necessary, and they would set statewide reimbursement rates for those caregivers.
In a statement, Erin McDonough, executive director of the Insurance Alliance of Michigan, said her group opposes the bills.
“While we’re still in the process of reviewing these bills, it’s clear this legislation would dramatically increase costs for Michiganders at a time when they can least afford it. Michigan residents are already struggling with the rising costs of gas, groceries and housing, and this legislation will increase auto insurance costs and make a bad situation worse. We urge policymakers to carefully review policy proposals for their impact on everyday families and their pocketbooks.”
But the Michigan Brain Injury Provider Council said it's not clear rates would go up very much.
Tom Judd, the group's executive director, said the House bills should primarily increase costs only for a portion of people's car insurance policies. That's the MCCA fee, which covers the most catastrophic injuries, and is currently a $65 a year per policy for those choosing unlimited lifetime medical coverage.
