Column: As budget negotiations continue, here are top health and human services issues
Michigan Capitol | Susan J. Demas
The legislative action taken in the first quarter of 2023 has felt like a combination of a sprint and a marathon.
Full disclosure: I’m not a runner, so it’s possible this analogy doesn’t hold up, but I think we can all agree that the pace of legislation passed in these last few months has been extraordinary.
And more importantly, the legislation itself has centered Michigan’s people, not wealthy corporations. From the boost to the Earned Income Tax Credit to the improvements to the Elliott-Larsen Civil Rights Act to gun violence prevention to the repeal of an archaic abortion ban, the Legislature has focused on the issues that matter to the people at the heart of our state.
Now comes the next leg of the race as state budget negotiations ramp up.
We are entering the Fiscal Year (FY) 2024 budget under a complex landscape. The federal public health emergency is ending, but lives are still disrupted daily by COVID-19 and other health threats. Unemployment remains low, but many people — especially women — who left the workforce during the pandemic have yet to return.
State revenues have recovered, but families are still struggling to make ends meet and cover rising costs due in part to inflation.
At the Michigan League for Public Policy, we always look to our state budget for the opportunity to improve access to the services that Michigan people — kids, workers, and families — need and rely on.
Here’s how we can make sure the FY 2024 Department of Health and Human Services budget provides solutions and more positive health outcomes for Michiganders who are working hard to make ends meet.
We can support cost-effective policies that allow more children and pregnant people access to health care coverage. The FY 2024 budget should join 25 other states and take up the Immigrant Children’s Health Improvement Act (ICHIA) option by appropriating state matching funds to eliminate the five-year waiting period for children and pregnant people who are lawfully present immigrants. There are 3,000 to 4,000 children and thousands of adults who are otherwise eligible for these programs save for their immigration status.
We must also make sure all kids enrolled in Medicaid have continuous eligibility. This would reduce the number of children who lose coverage at renewal due to temporary fluctuations in family income, confusion over requirements or paperwork lost in the mail.
We can improve access to affordable, quality health care in Michigan. The League supports Gov. Gretchen Whitmer’s budget proposal to increase Medicaid reimbursement rates for specific Medicaid services such as labs, anesthesia and more. The League also supports allowing young adults up to age 26 to benefit from the Children’s Special Health Care Services (CSHCS) program.
We can continue support for reproductive health. The League supports the executive proposal to build on the success of the Healthy Moms, Healthy Babies initiative, including funding to restore Plan First — a program that would increase access to affordable family planning services for individuals with lower incomes — and for Centering Pregnancy (group-based prenatal care).
We can provide additional support for Essential Local Public Health Services. Michigan’s local public health departments protect communities from much more than infectious diseases like COVID-19 alone, as they are mandated to provide seven essential services including preventative care and environmental safety, among others. But they are extremely underfunded.
The FY 2024 budget is an opportunity to increase local public health funding, bolstering the work of health departments to connect more families to affordable health insurance, prevent foodborne illness and more.
We can provide adequate, dedicated funding for lead poisoning investigations and response by local health departments (LHDs). Following a federal funding slash in budget year 2012, many LHDs in Michigan have had to scale back or discontinue elevated blood lead (EBL) investigations. Lead exposure is a serious problem throughout the state but response varies based on the resources individual LHDs can cobble together. A dedicated state-level revenue stream for local EBL investigations and other critical lead response activity would address the patchwork and ensure that all children affected by lead receive the attention they deserve.
We can fund critical investments in water quality and safety. The League supports the governor’s recommendation to strengthen DHHS’ ability to address threats to water quality, and also support community water systems in providing income-based assistance to residential customers at risk of losing service.
We can establish a program to help make homes for families with low incomes safer, healthier and more energy efficient. For struggling families, an affordable rent or mortgage payment often means living in an older home with outdated systems and structural issues that lead to energy waste. In addition to improving housing stability, affordability, and health, this investment would help the state achieve its long-term goals laid out in the MI Healthy Climate Plan and promote the growth of Michigan’s workforce.
And we can support meaningful improvements to Michigan’s basic cash assistance program (Family Independence Program, or FIP) to help families and children living in deep poverty. The cash benefit has not been raised since 2008 and is so low that it cannot bring families out of poverty or cover basic needs. The FY 2024 budget provides us the opportunity to make the first meaningful improvements to Michigan’s cash assistance program in over a decade.
Let’s keep the momentum of last quarter’s race going! We encourage all Michiganders to become involved in the state budget process and to advocate for these and other wins for the people of our state.
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