Budget fight looms over changes in Medicaid mental health in Michigan

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Mental health advocates are pressing Gov. Gretchen Whitmer to veto budget provisions they say could “irreparably damage” care for 300,000 low-income people in Michigan with serious mental illness or developmental disabilities.

While overshadowed by other budget showdowns, their warnings are the latest in a long-simmering skirmish over who should manage care for these individuals.

Under a plan first proposed by GOP Gov. Rick Snyder in 2016, Michigan was to privatize its $2.4 billion public mental health system by turning over state funding to Medicaid physical health plans as part of a plan to integrate physical and mental-health services for low-income patients.

Proponents said that merger would save millions of dollars while improving care. Critics said the switch would leave care for mentally ill and disabled in the wrong hands.

Three regional pilot programs to test that proposal have been pushed back twice, the latest extending launch of the pilots to October 2020.

Mark Reinstein, president and CEO of the Mental Health Association in Michigan, a mental health advocacy group, contends that new language in the GOP-approved budget could accelerate a move to put mental health care under 11 mostly for-profit health plans that provide Medicaid physical health care.

“Our system has a lot of problems as it is now,” Reinstein told Bridge. “But this is one of the few things that could make a troubled system even worse. It’s about as bad an idea as I’ve ever seen.”

The GOP legislature on Tuesday approved a $59 billion budget for the 2020 fiscal year that begins Oct. 1. After calling the budget “a mess,” Whitmer is expected to veto portions of the budget.

Reinstein is urging Whitmer to either veto the entire budget boilerplate authorizing potential merger of physical and mental health care or new language added to it in the new budget.

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