MI HB4598

Modifies Medicaid expansion enrollment procedures by requiring individuals to be enrolled into contracted health plans with cost-sharing accounts where enrollees and others may deposit funds to pay for health expenses and co-pays.

Establishes cost-sharing requirements of 2% of annual income for individuals between 100-133% of federal poverty level, with potential reductions based on healthy behaviors like completing health risk assessments and addressing substance use, tobacco use, and immunization status.

Requires contracted health plans to track co-pays, provide quarterly account statements, implement co-pay structures encouraging high-value services, and ensure enrollees have primary care access within 60 days of enrollment.

Allows individuals with 48 months of continuous Medicaid coverage between 100-133% of poverty level to choose between transitioning to private insurance with federal subsidies or remaining in Medicaid with increased cost-sharing up to 7% of income.

Adds new section 105g freezing new enrollments in Medicaid expansion effective October 1, 2017, while permitting renewal of existing enrollees who remain eligible.