Commentary: Gilbert lobbyist Jared Fleisher on why auto insurance reform is not perfect, but progress – Crain's Detroit Business

We now turn to this second — but unquestionably important — part of the reform story.

Attendant care generally refers to non-medical or non-rehabilitative care services that support an individual’s personal care needs.

Under the pre-reform system, charges for attendant care—either at a residential facility, by an in-home aide, or by a family member—were several times higher than under any other form of coverage, if other payers covered it at all.

For example, residential facilities serving those with unlimited auto insurance coverage would regularly charge between $25,000 and $35,000 per month—not counting covered therapies, which would be charged separately.

By contrast, the average skilled nursing facility charges $9,000 to $12,000 per month in total.

During the reform effort, policymakers faced the question of how to address these costs, as they are ultimately passed directly onto every Michigan driver through the MCCA’s annual assessment.

In the decade prior to reform, the MCCA’s annual assessment increased from $125 to $220 per vehicle as these long-term care costs ballooned.

Lawmakers faced a particular challenge: because Medicare does not cover non-medical or non-rehabilitative care, there was no fee schedule to rely on.

Without that — but with ample information on payment differentials like the one cited above — the law set future payments at 55 percent of what would have been paid prior to reform (and up to 78 percent for providers serving more vulnerable communities).

The data shows that the combined reforms have in fact bent the MCCA’s cost curve: the annual MCCA fee on drivers’ auto insurance bill, otherwise on an inexorable trend upwards, has been reduced from $220 to $86 per car.

Michigan drivers are also in the process of receiving an unprecedented $400 rebate check per vehicle. Of course, the MCCA savings are in addition to the premium reductions discussed in the first part above.

Even more importantly, the data shows that most individuals with complaints about lack of appropriate attendant care post-reform are seeing their complaints resolved.

DIFS created a rapid response hotline to make sure the 6,600 individuals receiving long-term attendant care continue to receive quality care.

Through March 18, DIFS received a total of 106 formal complaints, 95 of which have been resolved. While media stories and lobbying campaigns may lead to one impression, the actual channel to raise and resolve concerns over care tells a very different story.

I do not believe anyone would argue that the reform law is perfect.

But it is our considered opinion, based on the data outlined here, that the law is fundamentally sound and delivering on its promise of empowering consumers, lowering costs and eliminating abuse.

Lawmakers who have resisted changes that would take us backwards are right to do so.