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"We're Paying the Price with Our Lives" — Families terrified No Fault Auto Reform will destroy access to care

A sub-section of Michigan's No Fault Auto Reform law going into effect in July slashes the amount of money that insurance companies will reimburse post-acute care providers by 55%
NFA Reform Bill Web Photo
Posted at 8:21 PM, Jun 02, 2021
and last updated 2021-06-03 08:52:23-04

LANSING, Mich. — Thousands of Michiganders who suffered catastrophic injuries in auto crashes and who rely on care provided via the state's no fault auto law, are terrified that they will soon lose access to care once a sub-section of the act goes into effect in July.

Up until July of 2020, when the first portion of the reform went into effect, all drivers in Michigan were required to purchase unlimited Personal Injury Protection (PIP).

This made Michigan the most expensive state in the country to purchase car insurance, but it came with the promise that if you were ever injured in a crash, you would be taken care offor life.

Governor Gretchen Whitmer signed the No Fault Auto Reform bill into law back in January of 2019. The intent behind the bill was good; to lower insurance rates for drivers in the state.

According to Nicole Buck, with The Zebra, "car insurance rates in Michigan are up about 14% since 2011, which obviously has outpaced inflation.”

In a sub-section of the bill are changes that have thousands in Michigan terrified for July.

A new set of fee schedules, as they are referred to, are introduced in the bill. This portion set to take effect on July 2, 2021.

“If you have a seriously injured person, who depends upon and receives certain health services that are not compensable under the federal Medicare law, then the provider of those services will have reimbursement slashed by 45%,” explained West Michigan attorney George Sinas, of Sinas Dramis Law.

As part of these new fee schedules, companies that provide post-acute medical care will now only be reimbursed by 55% of what they were previously being reimbursed in January of 2019, when the bill was signed.

“Politically they weren't able to get rid of the unlimited lifetime benefits, because they know that consumers are going to continue to choose those benefits,” said Tom Judd, board president of the Michigan Brain Injury Provider Council.

“So what they did instead was basically make those benefits worthless.”

If a care provider, like NeuroCare Home Health in Essexville owned by Nick Long, was previously being reimbursed (as of Jan. 2019) by an insurance company at $30 an hour for caregivers they are providing to a patient, then after the new law takes effect they would only be reimbursed $16.50 an hour.

"To be honest, that's a business ender for us,” Long told FOX 17.

He started the business almost a decade ago after he himself sustained a spinal cord injury in a car crash.

“We'll continue after July, as long as we can," Long said. "But, you know, mostly because we kind of have to. Our clients that we serve absolutely can't be by themselves.”

As part of the new law, family members will now only be able to be reimbursed for up to 56 hours of care a week. They could previously be reimbursed for 24/7 care, if it was determined to be an appropriate set up.

“Nobody wants to be in a catastrophic accident and end up with the, you know, a brain injury or spinal cord injury or amputation or any other kind of catastrophic injury," said Diane Mills-Gutierrez, whose husband Jesse has provided around 90 hours of care a week since she was paralyzed in a 2016 car crash.

"But, we knew that that insurance was there for us if we needed it.”

Diane worries that they simply won't be able to find care providers to supplement the hours Jesse can't be there.

“That's a serious blow to us and our family income,” she said. "It's very frustrating that so many of the legislators are saying, you know, let's just wait.”

Senate Majority Leader Mike Shirkey said in a statement to FOX 17, “The historic auto insurance reform is working. Rates are dropping. For the first time in seven years, Michigan is not the most expensive place in the country for auto insurance. We certainly must care for the most vulnerable among us, and we will look at taking up additional reforms that may be necessary when plan goes fully into effect in July.”

The wait-and-see approach just doesn't make sense to lawmakers like Senator Curtis Hertel, who supported the No Fault reform in the first place.

“I don't think anyone intended that to happen when we passed this law. We should admit that we made a mistake and fix it,” Sen Hertel said.

“At the end of the day, we don't work for the insurance companies, we work for the people of Michigan. I believe in lower rates, I believe in choice, but I don't believe in hurting these families.”

Sen Hertel introduced Senate Bill 314, which seeks to fix these medical fee schedules before they go into effect.

There is also House Bill 4486, introduced by Rep Doug Wozniak, attempting a similar fix.

“The fix that needs to happen, that are in these legislative bills, will not add cost to the system," Tom Judd told FOX 17.

"They will not skyrocket prices. This a reasonable fix to a very narrow part of the auto no fault reform law.”

A petition has been started for folks to show support for the 2 bills currently in the legislature. It had over 10,000 signatures as of Wednesday night.

Peg Campbell, who helps care for her sister Barbara Schoen, started the popular Facebook group We Can't Waita gathering place for those who will be affected by the impending changes.

The state of Michigan has put together this website to inform the public about the upcoming changes.

READ MORE: Lawmakers push for fixes to no-fault auto law as impacted families protest at the Capitol

READ MORE: New no-fault auto law could have devastating consequences for Grand Rapids family

WATCH: State Democrats discuss no-fault auto reform laws

Elle Meyers

Elle Meyers

6:12 PM, Apr 12, 2021

State Capitol

Neighborhood Reporter

Elle Meyers

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