a:3:{s:16:"field_story_body";a:1:{i:0;a:2:{s:5:"value";s:18710:"<span style="color: rgb(128, 0, 0);"><strong><em>(The following is an excerpt from Senate Journal No. 91, from November 10, 2011&nbsp; after the Senate passed the bill on a vote of 25-10. The excerpt contains the short title of the bill, the record roll call vote, and statements made for and against passage of the bill by Senators.)</em></strong></span><br />
<br />
<span style="font-size: medium;"><strong><span style="color: rgb(0, 0, 128);">Senate Bill No. 693, entitled</span></strong></span><br />
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&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; A bill to provide for the establishment of the MiHealth marketplace as a nonprofit corporation; to create the board of the MiHealth marketplace and prescribe its powers and duties; to provide for assessments and user fees; and to provide for the powers and duties of certain state and local governmental officers and agencies.<br />
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; The question being on the passage of the bill,&nbsp;&nbsp;&nbsp; <br />
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; The bill was passed, a majority of the members serving voting therefor, as follows:<br />
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<strong>Roll Call No. 663 </strong>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp; &nbsp;&nbsp; <strong>Yeas 25</strong><br />
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&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Anderson &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Gregory&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;  Jansen &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Pappageorge<br />
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Bieda &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Hansen &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Johnson &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Richardville<br />
&nbsp;&nbsp;&nbsp;&nbsp; &nbsp; &nbsp; Booher&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp; &nbsp; &nbsp; Hildenbrand &nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Jones &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Smith<br />
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Caswell &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Hood &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Kahn &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Warren<br />
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Emmons &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Hopgood &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Marleau &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Whitmer<br />
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Gleason &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Hunter &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Meekhof &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Young<br />
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Green<br />
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<strong>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp; Nays 12</strong><br />
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&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Brandenburg &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Hune &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Nofs &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Rocca<br />
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Casperson &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;Kowall &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Proos &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Schuitmaker<br />
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Colbeck &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Moolenaar &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Robertson &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Walker<br />
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<strong>&nbsp;</strong><strong>&nbsp;&nbsp;&nbsp; </strong><strong>&nbsp;&nbsp;&nbsp; </strong><strong>&nbsp;&nbsp;&nbsp; </strong><strong>&nbsp;&nbsp;&nbsp; </strong><strong>&nbsp;&nbsp;&nbsp; </strong><strong>&nbsp;&nbsp;&nbsp; </strong><strong>&nbsp;&nbsp;&nbsp; </strong><strong>&nbsp;&nbsp;&nbsp; </strong><strong>&nbsp;&nbsp;&nbsp; </strong><strong>&nbsp;&nbsp;&nbsp; </strong><strong>&nbsp;&nbsp;&nbsp; </strong><strong>&nbsp;&nbsp;&nbsp; </strong><strong>&nbsp;&nbsp;&nbsp; </strong><strong>&nbsp;&nbsp;&nbsp; </strong><strong>&nbsp;&nbsp;&nbsp; </strong><strong>&nbsp;&nbsp;&nbsp; </strong><strong>&nbsp;&nbsp;&nbsp; </strong><strong>&nbsp;&nbsp;&nbsp; </strong><strong>&nbsp;&nbsp;&nbsp; </strong><strong>Excused - 1</strong><br />
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&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Pavlov<br />
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<strong>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </strong><strong>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </strong><strong>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </strong><strong>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </strong><strong>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </strong><strong>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </strong><strong>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </strong><strong>Not Voting - 0</strong><br />
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&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; In The Chair: Schuitmaker<br />
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; The Senate agreed to the title of the bill.<br />
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Senator Colbeck moved that his name be removed as co sponsor of the bill.<br />
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; The motion prevailed.<br />
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<strong>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </strong><strong>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </strong><strong>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </strong><strong>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </strong><strong>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </strong><strong>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </strong><strong>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </strong><strong>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </strong><strong>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </strong><strong>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </strong><strong>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </strong><strong>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </strong><strong>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </strong><strong>&nbsp;&nbsp;&nbsp;</strong><strong>Protests</strong><br />
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&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Senators Colbeck, Kowall, Schuitmaker, Robertson, Moolenaar and Proos, under their constitutional right of protest (Art. 4, Sec. 18), protested against the passage of Senate Bill No. 693.<br />
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Senator Colbeck moved that the statement he made during the discussion of the bill be printed as his reasons for voting&nbsp; no.<br />
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; The motion prevailed.<br />
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&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Senator Colbeck s statement, in which Senators Kowall, Schuitmaker, Robertson, Moolenaar and Proos concurred, is as follows:<br />
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; I rise in strong opposition to Senate Bill No. 693. My original cosponsor commitment was predicated on the understanding that this bill would provide a free-market alternative to the Affordable Care Act. As a co sponsor, I have worked hard to ensure that this bill would live up to this promise.<br />
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; My concerns have not been addressed in this version of the bill, and I have read it thoroughly. Rather than serving as a free-market alternative, I have come to the conclusion that this bill would simply further enable the implementation of the federal Affordable Care Act, commonly known as Obamacare.<br />
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; I have worked hard to earn a reputation in my short tenure for not simply saying&nbsp; no&nbsp; to legislation that fixes real problems. I have worked hard to provide alternative solutions. Such is the case in Senate Bill No. 693. Our citizens do need access to affordable health care. Our state would have more jobs if we implemented a health care system that provided lower cost and higher-quality care for our citizens rather than the citizens in other states. I regret to say that this bill does not provide an effective solution to these very real needs that is consistent with the free market principles that made us a great nation.<br />
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; I would liked to have had time to submit a vetted substitute that would have addressed the concerns that myself and others who believe that the government should establish a single exclusive marketplace for private health care plans, but the timeline procedure did not allow for such a proposal in the Senate. My alternative solution would rein in the scope of the exchange to focus on the determination of eligibility for government assistance to citizens and the definition of data exchange standards that would enable private exchanges to provide consumers with apples-to-apples comparisons of health policies.<br />
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Instead, we have before us a bill that creates a Michigan health marketplace that performs all exchange duties and a bill with no definition of what an exchange is. It also performs a certification of private health care plans. It provides plan enrollment, plan purchasing, grants for navigators that threaten traditional insurance broker roles, and call centers to direct consumers to government ombudsmen. By serving as a middle man for financial transactions, I am concerned that the exchange may actually increase insurance costs because of the potentially significant payment delay to insurance providers.<br />
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; In short, I have no confidence that this bill will yield a free-market solution. The Michigan health marketplace would be a nonprofit organization that is a product of our state and federal government with overarching control of health care delivery within our state. A free-market solution which focuses government organization on improving the effectiveness and efficiency of government programs, such as Medicaid, Medicare, and VA services, and leave the comparison, enrollment, and purchase of private health insurance options to private vendors, including private exchanges.<br />
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; The majority of us were elected on the platform that included fighting the federal Affordable Care Act, commonly referred to as Obamacare. Make no mistake, colleagues, a&nbsp; yes&nbsp; vote on this bill, as currently drafted, is a&nbsp; yes&nbsp; vote to support it.<br />
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&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Senators Caswell and Gleason asked and were granted unanimous consent to make statements and moved that the statements be printed in the Journal.<br />
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; The motion prevailed.<br />
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&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Senator Caswell s statement, in which Senator Booher concurred, is as follows:<br />
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; In reference to the bill before us, there are a huge number of unknowns that none of us in this chamber are going to be able to control. Those unknowns involve Supreme Court decisions. Potentially, these involve next year s election and the time frame which has been set up for implementation of the Accountable Care Act. In light of these unknowns, the one thing that I believe is good in this bill is the ability to repeal things that are in it should the Accountable Care Act go away.<br />
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; I have seen firsthand in my time up here in Lansing what happens when the federal government takes over anything in the state. We had a situation years ago through a court case where the federal government took over some of our prisons. It costs the taxpayers of this state tens of millions of dollars to comply with what the federal government decided was the proper way to run prisons. We are currently involved in a children s lawsuit settlement, again, through the federal government a federal judge, and it is costing us tens of millions of dollars to comply with the federal mandates.<br />
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; I do not support putting this body in this state in the position of having the federal government come in and basically take over regulation of health care and also take over all of the administration of our Medicaid program because I know what it will cost the citizens of this state based on previous experience. For the things we can t control, I believe we have put into place a mechanism to allow us to back out of this particular exchange in the future should that be what happens.<br />
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; This is an ongoing process, and this is simply a first step. As with all legislation in Lansing, the first step, obviously, is not the final step. There have been other ideas advanced which I believe are worthy of open and honest discussion in committees. But I believe these ideas are very complicated, and I believe it is imperative upon this body to put forth the best effort we can at this time, turn this over to the House of Representatives, and allow the discussions to continue. That is the reason we are acting today to move this forward. I have things that I will be taking to the House of Representatives that I believe make sense, but I also believe that it is extremely important that we allow a full and coherent discussion of all these issues in committee. As we move forward, that is what we need to do.<br />
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; So I will simply say this: I will support the bill as we move forward, but I don t particularly relish the idea of the federal government coming in and spending our money in any way it sees fit. The political stage, the discussion about whether or not this Affordable Care Act will go forward, is out of our hands. That will be decided on a national stage. So I urge my members in this chamber to support this bill. We are controlling what we can, and as we move forward, we need to continue serious and thoughtful discussions.<br />
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&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Senator Gleason s statement is as follows:<br />
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; I rise today to support this legislation that established the MiHealth Marketplace Act. I would like to begin by also thanking the chair. This is an overwhelming responsibility to establish access to Michigan citizens to probably the most-needed resource that we have, which is health care.<br />
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Under this proposal, 536,000 uninsured Michigan residents would gain access to health insurance. Two million fifty-six thousand Michigan residents have pre-existing conditions like cancer, heart disease, and diabetes. The people who are suffering from these chronic illnesses can be denied health insurance. All of us know someone or live with someone who is battling these illnesses today, and we understand the enormous cost that these lifetime commitments cost our families. People with pre-existing conditions often require the most intensive and ongoing medical care. It is absurd that insurance companies can deny health care coverage to those who need it the most. To the ladies, women are being discriminated against because they are women. The so-called reproductive years standard allows insurance companies to charge women one and a half times the premium charged to a man. I know, Madam Chairperson, that you would find this appalling.<br />
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Placing a cap on lifetime benefits, knowing full well about these enormous costs, they also hurt Michigan residents with ongoing medical issues. These would allow insurance companies to continue to deny reasonable coverage for stockpiling costs. Placing the cap on lifetime benefits also hurts Michigan residents because they lose the confidence because of the cost, that they should go and take care of the condition they are facing. Many, and we know them ourselves, would shy away and hesitate to get the care required because of the enormous and burdensome cost of the health care.<br />
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Finally, this provision would allow 781,000 young Michigan adults to now remain on their parents&nbsp; insurance until they are 26 year old. This is reasonable and it is necessary.<br />
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; I believe the most compassionate thing that any of us can do as representatives of the citizens of the state of Michigan is help the sick, infirmed, and disabled. This legislation that was arduously worked on on behalf of the chair and all the interested from the insurance industry to the consumers themselves, and I would like to thank the chair and those on the committee to allow a place at the table for consumers who will be set up on this panel. I think that was a much-needed addition, and I thank the chair for allowing the consumers to have a voice.<br />
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; This is much needed legislation. If any of us were hurting or sick, we would ask for help. So today, let s look upon this as the state of Michigan asking us to help the sick. This is the right thing to do, and the time to do it is now.<br />
<br />
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