[Congressional Record Volume 142, Number 141 (Thursday, October 3, 1996)]
[Senate]
[Page S12329]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




       THE WELLNESS PLAN OF DETROIT, MI, AND HEALTHSOURCE SAGINAW

 Mr. ABRAHAM. Mr. President, with the 104th Congress coming to 
a close, this Senator wanted to come to the floor and express his 
disappointment at the failure of Congress to act on a couple of 
extremely important issues affecting the State of Michigan.
  One of the matters is a Medicare 50/50 enrollment composition rule 
waiver for the Wellness Plan of Detroit, MI. The Wellness Plan is a 
federally certified Medicaid health maintenance organization located in 
Detroit, MI. It currently has 150,000 enrollees--141,000 of whom are 
Medicaid, 12,000 commercial and 2,000 Medicare. Since 1993, the 
Wellness Plan has had a health care prepayment plan contract with 
Medicare. However, technical changes enacted by Congress effective 
January 1, 1996, unintentionally prevent the Wellness Plan from 
enrolling additional Medicare beneficiaries under the HCPP contract. So 
while the Wellness Plan now is positioned to become a full Medicare 
risk contractor, it currently is precluded from doing so due to the 50/
50 Medicare/Medicaid enrollment composition rule.
  My colleague from Michigan, Senator Levin, and I introduced 
legislation recently to grant this waiver to the Wellness Plan. It is 
important to note that even the Health Care Financing Administration 
[HCFA] supports the Wellness Plan receiving this plan-specific 50/50 
waiver. Because this legislation is noncontroversial, only affects the 
State of Michigan, and is supported by the entire State delegation, it 
was our hope that we could either include this measure in the omnibus 
appropriation bill the Senate passed this week.
  Regrettably, we were unable to include this language in the omnibus 
appropriation bill due to opposition from the Finance Committee to the 
addition of any Medicare or Medicaid provisions. While this Senator 
intends to pursue this initiative in the next Congress, it is truly 
disappointing that we were not allowed to enact this provision this 
year. This may appear to be a relatively minor, technical legislative 
issue, but it would have had a profound impact on the ability of 
Medicare beneficiaries in the State of Michigan to participate in this 
effective health care plan.
  Mr. President, the other matter has to do with HealthSource Saginaw 
hospital facility in Saginaw, MI. For the past 2 years, several of us 
in the Michigan delegation have been working diligently to provide a 
temporary extension of the moratorium that Congress had enacted and 
previously extended that prohibits the Department of Health and Human 
Services from considering HealthSource Saginaw to be an institution for 
mental diseases [IMD]. The most recent moratorium expired on December 
31, 1995. We were able to get a moratorium extension in last year's 
reconciliation bill. Obviously, the President's veto of that bill 
dashed our hopes of solving this problem through that mechanism. In the 
interim, however, the State of Michigan has been forced to subsidize 
the losses incurred by HealthSource Saginaw since the expiration of the 
most recent moratorium. Reportedly, this has cost the State of Michigan 
$902,000 to date since January 1, 1996, it is estimated that amount 
will increase to $1.2 million by the end of the year.
  The fiscal year 1997 Labor-HHS-Education appropriation bill passed by 
the House of Representatives contained legislative language providing 
an extension of the moratorium through the year 2000 or until the first 
day of the first quarter in which Michigan's State plan would become 
effective under the new MediGrant program. It was our hope that such 
language would be included the omnibus appropriation bill or any 
continuing resolution that was sent to the President. Once again, the 
Finance Committee's opposition to any such Medicare or Medicaid 
provisions prevented us from succeeding in enacting this moratorium for 
HealthSource Saginaw this year. That is very unfortunate for the people 
of Saginaw, who risk losing an important health care facility in their 
area, and for the people of Michigan, who continue to have to subsidize 
this facility's operation because of the unwillingness of some in 
Congress to address this matter prior to adjournment.
  As with the waiver for the Wellness Plan, this Senator intends to 
continue to press for the moratorium for HealthSource Saginaw in the 
105th Congress.

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