Families worry they'll fall through the cracks of no-fault insurance reform

Jun. 6—TRAVERSE CITY — Kris Ruckle-Mahon calculates back in time, minute by minute, to make sure everything her daughter Brittney needs will get done on time and in the right order.

If it's a weekday, for example, a 7:15 morning wake-up call works.

That's enough time for Ruckle-Mahon to help her daughter out of bed and into her power wheelchair, make her coffee — Brittney, 23, really likes coffee — cook her an egg, cut it up, help her use the bathroom, get dressed and groomed, and then to the Life Skills Center on Parsons Road by 8:30 a.m.

Classes end at 1:30 p.m., and from there, if it's a Monday, Brittney takes aqua therapy in the pool at Grand Traverse Pavilions. The water exercises are designed to improve balance and muscle strength and Ruckle-Mahon says it's one of Brittney's favorite activities.

Tuesday through Friday, a health care aide visits the family's South Creek neighborhood home to help with daily living skills. A trainer specializing in brain injury recovery also visits, and works with Brittney on range of motion, balance and strength, sometimes using a treadmill in the basement.

"She played softball before the accident," Ruckle-Mahon said. "On weekends she plays on the dream team — baseball for people with disabilities. She loves that, too. Everything, and I mean everything, changed for us after the accident."

In 2007, Brittney was a passenger in a car driven by a family member, when she suffered life-threatening injuries in a crash.

She was only 9 years old then and spent a month in the hospital, followed by four months at a Mary Free Bed Rehabilitation Hospital before coming home.

Brittney was diagnosed with a traumatic brain injury. Her physical injuries necessitated the use of a power wheelchair. She can use her left hand and arm, she can feed herself and bear her own weight long enough to help with a pivot transfer, yet requires 24-hour care.

Care that's paid for via the auto insurance claim Ruckle-Mahon filed in 2007, but that she says is jeopardized by auto insurance reforms passed by the state legislature in 2019, set to take effect July 1.

Many of the state's 7 million licensed drivers cheered the bipartisan change, anticipating lower car insurance premiums once they weren't forced to carry coverage they not only didn't want, but that no other state in the country required.

The Zebra, which compares insurance rates on its website and released a report that found the cost of auto insurance in Michigan did drop, about 18 percent in 2020.

Yet physical therapists and the approximately 6,000 families like Ruckle-Mahon's, who care for someone who will need the lifetime medical care previous insurance laws mandated, say they feel forgotten.

"People were led to believe anyone badly injured like Brittney was, were 'grandfathered in' and wouldn't lose care but that isn't true," Ruckle-Mahon said.

After July 1, auto insurance companies will no longer be obligated to pay family members for more than 56 hours per week of care, and the reimbursement rate for therapy and home health care services not covered by Medicare will be cut by 45 percent.

"There is a fix for this and I wish our legislators would bring it up for a vote," Ruckle-Mahon said. "Instead, I feel like they are giving insurance companies a pass because they contribute to their political campaigns."

Supporters of House Bill 4486 and Senate Bill 314, including the Michigan Brain Injury Provider Council, say passage of the bills would keep service provider rates at 2019 levels without adding costs to the system.

"Against the backdrop of record-shattering profits across the country, Michigan's largest auto insurance companies are the only winners when it comes to this new fee schedule," Rep. Julie Rogers (D-Kalamazoo) said in a May 26 online press conference.

"This is despite the fact that Michigan residents have been faithfully paying their premiums year after year and upholding their end of their agreement," Rogers said.

Rogers, a licensed physical therapist and one of 39 co-sponsors of the bipartisan bill, which includes John Roth (R-Traverse City), predicted the new fee schedule would force owners of rehabilitation centers, many of which are locally-owned small businesses, to close.

Jessica Stark, a recreational therapist at The Lighthouse Neurological Rehabilitation Center in Kingsley, said she worries about that too.

"The owners have said they are going to stay open if they can, but if nothing changes we can't make it on a 45 percent reduction," Stark said. "We may have to tell clients they have to find housing elsewhere and I don't' know where they are going to go."

Stark said people who've been injured in a car crash, live with family and receive therapy at home, aren't the only ones who will be negatively effected.

The Lighthouse currently cares for 23 in-patients, she said, and all but two are there because of injuries sustained in a car crash, their care paid for by no-fault insurance claims.

"Do you want to tell a 20-year-old he has to go live in a nursing home?" Stark asked. "I sure don't."

Roth told participants of a Traverse Connect-sponsored remote "coffee talk" gathering Friday, which included Stark, that HB 4486 had been referred to the insurance committee and would likely not be sent to the floor for a vote before the summer break scheduled to begin July 2.

Ruckle-Mahon tried to join the Zoom call but was told it was for "investors only," though an original listing of the event on Facebook did not include that limitation.

Roth said he and others are pursing an alternative, a kind of temporary stop-gap measure that would provide funding until a fix can be agreed upon.

"We've got to do something," Roth said. "The insurance companies want to take a wait and see approach but I don't think they fully understand what that means for these families."

He said a group of state representatives planned to approach Speaker of the House Jason Wentworth next week to discuss approving a special appropriation before changes take effect July 1.

Sen. Wayne Schmidt (R-Traverse City) a co-sponsor of SB 314, was also on the remote call. That bill is also still in committee, he said, advising families like Ruckle-Mahon's to seek legal representation.

Ruckle-Mahon said she had already done so, but with the courts backed up from COVID-19, any legal decision would likely be years from now.

"What am I supposed to do in the meantime?" Ruckle-Mahon asked.

Not everyone is in favor of a fix — the director of the National Federation of Independent Business previously said in a press release issued last year, that Michigan's insurance reforms had reined in what he said was overcharging by some brain injury clinics.

Roth said so much work had gone into getting the reform passed, that many were hesitant to adjust what had taken years of back and forth negotiation to pass.

Those opinions, said Ruckle-Mahon, who quit a 20-year career at the Grand Traverse Resort, might interest Lansing, but don't help with the day-to-day care of her daughter.

"Unless it happens to you, you really don't understand it," Ruckle-Mahon said. "When I paid those premiums, I was promised a lifetime of care for my daughter. And now that promise is being broken."