Senate Candidate Mike Rogers Proposes Ending Free Preventive Care, Creating Catastrophic Health Pools

US Senate candidate Mike Rogers told supporters he wants Michiganders to pay $50 out-of-pocket for annual physicals and suggested establishing government-run "catastrophic funds" for the sickest Americans, proposals that would undo key provisions of the Affordable Care Act.

The remarks came during a March 21 event in Macomb County, according to a recording reviewed by Bridge Michigan. Rogers was responding to a question from an attendee who asked him what could be done to lower health care costs.

"You know, if you go up and have to pay the doctor $50 for your annual physical, that's probably okay, right?" Rogers told supporters.

Rogers said he'd be releasing a full health care plan in the coming weeks that would "embrace the freedom of the free market" to start lowering prices.

His comments on preventive care copays and creating separate insurance pools for sick patients would undo two promises of the Affordable Care Act.

"Mike Rogers' plan is to make health care more expensive and rip away care from Michiganders with pre-existing conditions," said Michigan Democratic Party spokesperson Joey Hannum. "Rogers thinks Michiganders should be forced to pay new out-of-pocket costs for basic services like blood pressure, diabetes and cancer screenings—meanwhile, he's fully on board with giving more handouts to multi-millionaires like himself. Price Hike Mike's health care plan is shameful, and Michiganders will reject it in November."

Preventive Care Costs

In the event with supporters, Rogers likened free preventive care—as guaranteed by the Affordable Care Act—to "an auto insurance plan that would pay for your blinker's light going out."

"That would be a great insurance plan, but one that would cost drivers more, he explained.

"We need to start changing the way we look at health care," Rogers said.

A major provision of the Affordable Care Act requires insurers to provide certain preventive care services, such as blood pressure, diabetes and cancer screenings—notably at no cost to the patient.

Dr. Mark Fendrick, who directs the Center for Value-Based Insurance Design at the University of Michigan, said that when physicals and screening have out-of-pocket costs, people get them less.

"Our work shows very clearly that even increasing cost sharing by a few dollars leads to decreased utilization of services," Fendrick said.

But Fendrick also acknowledged Rogers "is exactly right" when he suggested free preventive services increase costs, though it's something Fendrick has strongly advocated for for decades.

"In the short term, costs go down" if you charge copays for preventive care, Fendrick noted, but overall, "the health of individuals and populations get worse."

Anand Parekh, chief policy officer at the University of Michigan School of Public Health, argued that if people skip preventive care because of costs, undiagnosed chronic diseases can spiral out of control and require expensive treatment.

"We end up paying for more costly care for things that could have been prevented, or at least treated at less expense," said Parekh, who played a role in formulating the Affordable Care Act's prevention initiatives.

Preventive care is considered by health-experts a "high-value" medical service, meaning it can do a lot to improve health at relatively low cost.

To curb costs, Fendrick urged policymakers to instead focus on "unnecessary care," such as lots of lab tests and "CT scans for uncomplicated back pain."

'Catastrophic Funds'

In his remarks, Rogers also suggested the federal government establish "catastrophic funds" to lower premiums, appearing to embrace the concept of high-risk pools while noting "the sickest part of our society ends up consuming the most" medical services.

"So we're going to pay our premium based on what a normal life would be, not including these people who are really, really sick," Rogers said.

He added: "We take the really sick people and put them in this fund that we all pay a little bit. The government pays, the hospital pays, Medicare would pay a little bit."

Before the ACA, nearly three dozen states had high-risk pools for people with significant medical needs who couldn't otherwise get insurance.

The ACA essentially eliminated the need for those pools by mandating insurers cover patients with pre-existing conditions.

"This turns out to be expensive for consumers and government," said Parekh, who also served as the chief medical advisor at the Washington-based Bipartisan Policy Center.

Returning to high-risk pool policies would be "just so crazy," said Fendrick, telling Bridge the pools are among a series of ideas "that have been floated around conceptually for decades, but never had the policy or political chops behind" them.

Related Story

Health care has emerged as a key issue in the US Senate race, with Democrats focused on expanding government's role in protecting coverage.

With expired subsidies pushing premiums higher, 34,000 fewer Michiganders signed up for ACA health insurance plans this year, according to federal data.

Medicaid changes under President Donald Trump could lead to 300,000 fewer insured people in Michigan, according to a nonpartisan think tank analysis.

Rogers' campaign did not directly respond to requests for clarification about his remarks.

"Mike Rogers is exploring ideas with voters to increase affordability of health care, whether that's investing in rural hospitals, ensuring the wealthiest Americans cover their own copays, or improving transparency and access," communications director Alyssa Brouille said in a statement that blamed Democrats for high health care prices.