Commentary

Worries Over Medicaid Costs No Reason to Oppose No-Fault Reform

Any increased costs would be dwarfed by the savings drivers will achieve

Several news articles and press releases from politicians have highlighted the fact that the proposed changes to Michigan’s auto insurance laws may result in increased costs for both Medicaid and private health insurance. There’s no denying this possibility — a key feature of these reforms is to allow drivers to limit or opt out of buying medical coverage through their auto insurance plan. While this is a valid concern, it is minor compared to both the savings motorists will realize and to the overall state spending on Medicaid.

The Michigan Senate Fiscal Agency estimates that the potential increased cost of Medicaid from these no-fault reforms may be $66 million in 10 years’ time. This sounds like a large sum, until it is put in the context of the total amount the state spends on Medicaid and overall. In fiscal 2017, Michigan spent about $16.8 billion on Medicaid. Even if the state had to spend that $66 million immediately, it would only represent an increase of about 0.4% of Medicaid spending. Moreover, total spending from state sources is about $33 billion — spending $66 million more would boost this by only 0.2%.

As these comparisons suggest, it is unlikely that the $66 million more that may have to be spent on Medicaid will have a meaningful impact on other state spending priorities. In fact, it’s smaller than the amount of uncertainty lawmakers regularly handle when determining the budget.

For instance, lawmakers rely on estimates of tax revenue that are published a few times a year to determine how much money they will have available to spend. Just yesterday the Senate Fiscal Agency published its monthly revenue report and found that the revenues just for the month of April were $323 million more than had been anticipated. Revenue estimates for the state’s general fund are now $150 million more than they were at the beginning of the year. The $66 million in potential increased Medicaid costs amounts to less than regular adjustments that are needed based on fluctuations in these revenue estimates.

But it’s not just Medicaid costs that will be impacted. Some worry that private insurance premiums may go up too. This is true: If more drivers opt to use the medical coverage provided through their employer-sponsored health insurance plan, it could potentially increase the premiums of these plans. There’s no way of estimating how much of an impact this might have, especially considering the multitude of factors that can impact the price of a health insurance premium. Nevertheless, it’s important to remember that any increased costs that employers or employees may experience as a result of these reforms will be but a tiny portion of the amount they’ll be able to save on their auto insurance premiums.

A final bit of context is needed to put this problem into perspective. No other state requires drivers to purchase unlimited medical coverage as part of their auto insurance. The proposed reforms may slightly increase the costs of other insurance programs, but only to the extent that is common in every other state. In other words, these changes would at worst amount to Michiganders paying similar rates for Medicaid and private health insurance as everyone else in the country.

The bottom line is that these potential increased costs are not a reason to oppose reforming Michigan’s auto insurance laws. Michiganders will be far better off with these reforms, even if they produce a minor increase in costs for other insurance programs.

Michigan Capitol Confidential is the news source produced by the Mackinac Center for Public Policy. Michigan Capitol Confidential reports with a free-market news perspective.

News Story

Dems Cite U-M Report To Knock Similar GOP Auto Insurance Reform

Legislature’s reform bills contain key medical cost, coverage cap features recommended by U-M unit

Democrats in the Michigan House reacted with nearly uniform revulsion last week to the auto insurance reforms passed by the chamber’s Republican majority.

Democratic Leader Christine Greig, D-Farmington Hills, called it “another ... handout” to an insurance industry she said was “one of the least regulated in the U.S.”

In support for her claim, Greig cited a March 2019 report from the University of Michigan’s Poverty Solutions project on Michigan’s insurance rates, which are the highest in the nation.

Her comments were echoed in statements by more than a half-dozen of her caucus colleagues, each referencing the U-M report.

But the report, “Auto Insurance and Economic Mobility in Michigan: A Cycle of Poverty,” is silent on the question of whether Michigan’s insurance industry is among the least regulated in the country.

In explaining why insurance is so expensive in Michigan, the report cites a mix of policies and what it calls “lax regulations.” But its prescription for reform tracks remarkably close to the Republican-passed legislation (which, not incidentally, contains a raft of new insurance regulations).

“A clear way to reduce rates would be to rein in PIP (personal injury protection) payouts,” said the report, which suggested replacing unlimited lifetime coverage with “coverage that best fits (consumer) needs.” The proposal approved by the House does that.

Michiganders would also, the report said, benefit if lawmakers imposed fee schedules on health care providers for treating auto accident injuries, much as schedules exist for care given under workers’ compensation insurance.

“Doing so would immediately reduce costs associated with the system,” it said. The House legislation mandates such a fee schedule.

The legislation also authorizes state insurance regulators to set rules prohibiting the use of factors, such as credit scores, not related to driving. That’s another approach recommended by the U-M report.

Joshua Rivera, a co-author of the report, said his group commends the Legislature for seeking to address the state’s high insurance rates, but it doesn’t take positions on specific legislation.

“We hope policymakers look at the data and consider solutions,” Rivera said, “We tried to set some goalposts for reform. We know the status quo is a barrier” to economic mobility for the poor, he said.

Grieg and several of her House colleagues did not respond to multiple requests for comment on the U-M report.

The House last week passed House Bill 4397, and the Senate passed Senate Bill 1, insurance reform bills that eliminate mandatory unlimited medical coverage, restrict medical care prices charged to crash victims, and more. The House bill authorizes regulators to prohibit the use by insurers of using factors in pricing that are not rationally correlated with insurance losses. It's unclear if that criteria would include credit scores.

Michigan Capitol Confidential is the news source produced by the Mackinac Center for Public Policy. Michigan Capitol Confidential reports with a free-market news perspective.