- Associated Press - Monday, January 30, 2017

The Detroit News. January 24, 2017

Prepare now for Obamacare shakeup

President Donald Trump isn’t delaying his promise to repeal and replace Obamacare. On his first business day in office, he signed an executive order offering some relief from the law’s oppressive regulations. Congress is equally eager to take action, but any major shakeup will create challenges for the states - especially the ones that expanded Medicaid under the Affordable Care Act.

Michigan must be ready for a plan B, depending on how Congress acts.

This state is one of 32 (including Washington, D.C.) that agreed to expand the federal health insurance program for lower-income Americans. And while Gov. Rick Snyder has maintained support for the expansion, touting the state’s Healthy Michigan plan as a role model, there are concerns about the program’s long-term viability.

In 2013, Snyder and the Legislature decided to participate in the Medicaid expansion. The offer of “free money” from the feds was too good a deal for Snyder to pass up. The federal government promised to cover 100 percent of the cost until 2017. By 2020, the federal government will only pay 90 percent, costing Michigan more than $220 million, according to the House Fiscal Agency.

Repeal of the Affordable Care Act will likely roll back federal assistance for Medicaid expansion, if not scrap it completely. Michigan will have two choices: pay the higher bill or drop coverage for some, or all, of the 640,000 people enrolled in the Medicaid expansion. That’s more than 30 percent higher than originally projected.

The state government needs to begin saving for increased Healthy Michigan costs - something it was supposed to do from the beginning - while preparing to close the plan in the long run. It’s too costly and hasn’t delivered on its promises.

Those costs could rise dramatically, depending on what happens to Obamacare. Repealing the law won’t increase the coverage costs of Healthy Michigan, and it won’t force the state to kick anyone off the plan. But it would transfer the bill from the federal to state government.

Michael Cannon, director of health policy studies at the Cato Institute, says Michigan and other states that expanded Medicaid will likely be unwilling and unable to pay the increased costs.

“The states don’t think Medicaid is worth it. The voters don’t think it’s worth it,” Cannon says. “It’s not a better policy to keep people on Medicaid and drive up the federal deficit than it is to drive up state deficits.”

Along with the increased costs, Cannon says that Medicaid is failing to keep people healthy. For example, the Oregon Health Insurance Experiment found that “Medicaid coverage resulted in significantly more outpatient visits, hospitalizations, prescription medications and emergency department visits.”

Offering Medicaid to a broader population was supposed to reduce the high number of ER visits among the uninsured. But that hasn’t happened. Although the study further reported that Medicaid “significantly lowered medical debt” for beneficiaries, this came with negligible improvements in care.

Michigan’s Medicaid expansion will simply cost too much if the state loses federal funding. The state needs to prepare now to make this transition as painless as possible for Medicaid recipients and taxpayers.

Congress must also keep this potential hardship for states and individuals in mind as it reworks the law.

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Times Herald (Port Huron). January 25, 2017

Grant for Mid City would fulfill HUD goals

The U.S. Department of Housing and Urban Development has been handing out Community Development Block Grants since 1974 to states and local governments. There are strings attached: Block grants must address one of three identified national needs. They must primarily benefit low- and moderate-income people, must prevent or eliminate blight or slums, or must address an urgent development need that threatens the health or welfare of a community.

Since 1974, community officials have had a lot of practice stretching the interpretation of those three needs. Community Development Block Grants have paved a lot of bike paths in low- to moderate-income neighborhoods because they supposedly provided recreational opportunities in places where cities or townships couldn’t otherwise afford to repair sidewalks.

In Port Huron last year, HUD money helped repave a downtown parking lot on the theory that loft tenants needed someplace to park their cars.

This year, as the city considers how to use its next share of block grants, it has received two proposals that seem closer to HUD’s goals than does the East Quay parking lot.

The big one comes from Mid City Nutrition, the soup kitchen that has spent most of its 20 years crammed into a space inside St. Martin Lutheran Church on Chestnut Street. The nonprofit has asked for $100,000 of the city’s share of block grants to help it move into a larger space where it can better serve Port Huron’s most vulnerable residents.

The economy may have improved for some of us, but Mid City Nutrition is still providing life-saving services for those who depend on its daily meal program and who rely on it for other needs. Mid City serves about 300 meals a day, and at peak times there is barely room to lift a fork at St. Martin Lutheran Church.

Helping Mid City Nutrition in its mission is clearly what the HUD block grants were designed to city. We hope City Council gives the request serious consideration.

In a separate request, City Councilman Ken Harris has asked that $24,000 of the grant be set aside to help low-income seniors with their city utility bills. The proposal also matches HUD’s goals, plus it would help keep seniors in their homes. It, too, should be considered.

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The Mining Journal. January 27, 2017

Students solicited for ideas as part of NMU’s UC project

Northern Michigan University, and an engineering firm in its employ, are taking well-advised steps to determine what students might want in a renovated university center.

NMU has committed to spending $17.5 million to complete all phases of the renovation of the Don. H. Bottum University Center. Of that amount, $1.3 million has been earmarked for design, being handled by Nuemann(backslash)Smith Architecture. Getting good ideas on what students are looking for is layered into that phase. On Monday, one of several student feedback sessions was held.

“We are really excited about the possibilities,” Kathy Richards, associate vice president of Engineering and Planning and Facilities at NMU, said for a Mining Journal story on the project. “That’s why we are asking the students here today, to make sure that if we build it, they will come.”

Presently, the UC houses a fairly wide variety or student-related offices and services including a bookstore, a cafeteria-style restaurant, a U.S. Post Office branch and the student radio station and newspaper, among other things.

Generally, the new, modern design is expected to create more open spaces, theoretically making it easier for students to navigate and use. The new design would also allow for a number of break-out spaces for separate meetings during large conferences and would expand conferencing capacity to 940 and theater-style seating for 1,300 people.

On the UC’s second floor, changes are also expected in the familiar Great Lakes Rooms, which, according to NMU officials, would be replaced with a single, large ballroom and partitions.

Chalk all of this up to solid planning and development. NMU and its engineering firm seem to be going about this substantial redevelopment project in the right way.

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Petoskey News-Review. January 27, 2017

City, township on the right path

Area residents can be encouraged by ongoing discussions between Charlevoix city and Charlevoix township officials as they search for a better way to provide emergency fire services within the city.

Charlevoix City Manager Mark Heydlauff, Police and Fire Chief Gerard Doan and Charlevoix Township Supervisor Chuck Center have been negotiating an agreement that would turn over fire coverage to the township, which is better equipped at this point to serve the city.

The city’s roster of firefighters has been decreasing in recent years and the problem was accentuated late last year during a pair of building fires in downtown Charlevoix.

Local departments already have mutual aid agreements to help each other out in case of such catastrophic events, but during one of the fires Charlevoix’s ladder truck was noticeably absent while trucks from three neighboring departments battled the blaze.

It is not known why numbers continue to decrease in the city while the roster for volunteer paid-on-call firefighters is on a steady increase at the township. The pay for firefighters in the township and the city is the same rate - $25 for the first hour and $15 per additional hour, according to city and township documents.

The city transitioned to a complete paid on-call fire department in June 2015. The move allowed city officials to redirect money toward emergency medical services, which at the time Doan said was the main need for the community. The change, though, eliminated three full-time firefighter positions and ever since the city has struggled to retain firefighters.

According to Charlevoix Township Fire Chief Dan Thorp, two township trucks and 17 personnel from the department were sent to the November fire at Johan’s in downtown Charlevoix and two trucks along with 21 personnel responded in December to the fire at the Cherry Republic store.

Joining forces at this point makes sense.

The city hasn’t been able to provide adequate fire services for its residents and the result has been to bring in others for help. If an agreement can be reached, the township can put the necessary resources at the downtown Charlevoix station and maintain adequate services on both sides of the bridge.

Despite their historical differences, it appears leaders in the city and the township are ready to move forward on a deal that is probably already a few years overdue. They deserve credit for coming to the negotiating table, though, and here’s hoping they continue on this path.

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