Michigan voters will face a slew of ballot proposals this November. None of them are about healthcare, per se, but some healthcare leaders are worried one ballot proposal could have a big impact on doctors, clinics and hospitals in northern Michigan.
Proposal 5 is a state constitutional amendment that would make it harder for Michigan lawmakers to raise taxes. If it passes, members of the state House and Senate would have to approve of any new tax increase by a two-thirds super-majority vote.
Government insurance, paid with tax money, accounts for a big chunk of the bottom line in the healthcare sector.
“And the Medicaid program for hospitals has got several components of it that are funded through complex taxing arrangements with the state of Michigan and then the federal government,” says Paul Shirilla, Vice President and General Counsel at Munson Healthcare in Traverse City.
“We’re very concerned that these kinds of funding mechanisms could be stalled,” he says. “I think other businesses have similar concerns about how it would gridlock state government, and then Michigan.”
The hospital system is not the only group arguing this proposal is designed to cause gridlock. That’s also been the complaint of the Michigan League for Human Services, for example, The group advocates for programs that serve the poor and they’ve called it a type of “superminority” proposal because, under the plan, just 13 senators would have the power to stop a tax increase.
But the spokeswoman for Proposition 5 says the initiative is about creating broad public consensus before there is a tax increase.
“We can’t keep relying on the Michigan tax payers as an ATM, which is what many of the special interest groups do. We need to understand that this tax increase has to be a last resort,” says Lana Theis, president of the Michigan Alliance for Prosperity.
“The language in Prop 5 says that if they can’t achieve the two-thirds majority then they can take it to the people. And 50 percent plus one of the people the following November can make that decision and that is, by definition, a democracy and a broad public consensus.
Theis says – if health spending is worthy of a tax increase, it can make it through the hoops that would be created under Prop 5.
But at Munson, Shirilla says the Medicaid question grows even more of a concern when this proposal is paired with federal health reform.
“It’s already sort of an underfunded program, and the eligibility criteria is going to be enlarged under the federal law, assuming the federal law continues,” he says. “So the Medicaid program is going to expand and this proposal would make it even – there would be concern about the instability of this growing program.”
The fate of Proposal 5 lies with voters November 6th.