Nomination #4: 2026 MHF Defender Award

The hearing from Nomination #3 was such a target-rich environment, we’re back for more.

Nomination #4 for the MHF Defender Award highlights two simple ideas. In order to work, a healthcare program needs two things: it must make practical sense in the real world, and it must be funded.

Representative Luke Meerman earns his nomination by raising both questions.

To recap:

HIE = Health Information Exchange
HDU = Health Data Utility
HIPAA = the federal Health Information Portability and Accountability Act

Bill sponsors and advocates want to add more segments of healthcare to Michigan’s Health Information Network (MiHIN).

Who does the bill add?

Today, MiHIN connects to patient data in hospitals, insurance companies, government agencies, and doctors’ offices.

According to testimony, planners want to add elder care, home care, foster care, plus your local food bank and Dial-a-Ride.

The practical workability questions are mind-boggling. I see two major problems.

One: Your local services may well be running on paper. It’s the cheapest, simplest to use, and often the most reliable.

But HIPAA applies only to electronic records – not paper. That’s important, because as we saw in last week’s nomination, HIPAA is where proponents hang all their claims to privacy protection.

Your privacy, or state referrals? Your self-governance, or government funding and interoperability?

If an HDU becomes law, your local services may be forced to choose.

Two: Electronic records consume massive amounts of time for data entry and retrieval.
In my experience, hospital computer time is 3X to 5X paper charting time.

Healthcare at all levels is understaffed, in part because of computerization. Nursing homes are especially prone to dangerously low staffing.

Food banks, senior meals, and transportation services are often staffed by volunteers.

But the powers that be want health data in real time. So who, exactly, will put in the computer time for local HDU participation?

Where’s the money?

The bill puts into law $6 million for the first year, $7 million for year two, $8 million for year three, with inflationary increases thereafter. A bill sponsor claims this represents no increase: it is the same as current funding. No one asks which amount. After all, what’s a million here or there?

“Who’s paying for MiHIN now?”

Many answers emerge, such as general fund, restricted dollars, user fees, etc. However, MiHIN’s answer to Rep. Meerman is especially interesting.

“We work with MDHHS to provide federal match.”

In other words, we’re paying with Medicaid dollars. Not just regular Medicaid, but the state provider tax that raises Medicaid billing, to leverage more federal Medicaid dollars.

Which is openly fraudulent, though most states do it.

And the Trump Administration has begun to set limits. Call me hypervigilant, but I don’t think they’re finished trimming this particular type of abuse.

When Rep. Meerman asks about provider payments, MiHIN puts him off.

What does the bill do to provider payments? “To be determined.”

In other words, pass the bill to find out what’s in it.