Federal Funding Bolsters Muskegons Access Health

March 4, 2002
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MUSKEGON — Funding secured in the federal budget will help a health plan designed to provide coverage to the working uninsured in Muskegon County shore up its risk pool as it matures and grows.

The Muskegon Community Health Project will use $375,000 of the $500,000 received through a line-item appropriation in the 2002 federal budget to underwrite the risk pool for Access Health, a health plan the community-based organization formed two years ago to extend health coverage to the estimated 17,000 people in Muskegon County who are employed but lack insurance. The remaining $125,000 will go to examine the effectiveness of Access Health and study future initiatives to improve people's access to health care.

Underwriting the risk pool through re-insurance will cover Access Health against catastrophic claims that could threaten the entire program, Executive Director Jeff Fortenbacher said. The stop-loss policy is needed because Access Health subscribers tend to have heavy utilization rates when they first enroll in the health plan, he said.

Enrollees in the non-profit health plan typically have not had health insurance before and as a result may have some lingering or unknown health issues that require diagnosis and treatment, ringing up sizable bills and medical claims, Fortenbacher said.

The health plan presently has a half-dozen claims that have exceeded $30,000, one of which exceeds $40,000.

"When they do hit the physician offices, they have a lot of things they have put off for years medically that they can now get attention to," he said.

Access Health - funded through low-cost premiums paid by participating employers and employees, private grants and donations, and Medicaid funding - provides health coverage to nearly 1,000 people at more than 300 small businesses in Muskegon County. The program seeks to provide enrollees with basic, affordable health coverage until they are able to afford commercial insurance.

The health plan has received national attention as a model for using existing Medicaid money to extend some form of health coverage to the estimated 39 million people nationwide who are without health coverage. In Michigan, an estimated 1.1 million people - about 75 percent of whom are employed, typically by small businesses or in low-paying service-sector jobs - lack health insurance, according to the Access to Health Care Coalition, a statewide group of health care and business interests.

Seeing the need to expand its role locally, the Muskegon Community Health Project will soon commission a new survey to gauge the public awareness of Access Health and examine the need for further initiatives to improve people's ability to access the local health care system.

The organization used a similar approach in the 1990s that led to the formation of Access Health and other initiatives, Project Director Vondie Woodbury said.

"There are still a lot of uninsured people in our community, and we need to help," Woodbury said. "We need to look at other options to getting them care."

The Muskegon Community Health Project secured the $500,000 in federal funding with the aid of Democratic U.S. Sens. Debbie Stabenow and Carl Levin, and U.S. Rep. Peter Hoekstra, R-Holland.

Access Health "really caught the eye" of Stabenow, said Dave Lemon, the senator's communications director.

Stabenow saw securing support for Access Health as a way to help the program extend coverage to more people and use it as a national demonstration project for other communities to replicate in an era of escalating health insurance costs.

"We like the idea and the concept. It's a good program that works today in Muskegon," Lemon said. "We think it can certainly be used as a great model."

With one year's funding secured, the Health Project is considering whether to pursue a second round of funding in the federal budget for 2003, Woodbury said. She hopes that the federal support garnered so far will bring further attention to Access Health as a better way to spend federal funds to address a growing problem in the number of people nationally who lack insurance.

"It's important we start to explore other financial mechanisms with the feds," Woodbury said. "We are paving better policy here and somebody needs to come out and take a look at it."

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