No-fault reform continues impact on families

On their last day at the home together, Teresa and Troy Hughes sat under the gazebo for 2 hours. They basked in the 64-degree weather and listened to country Western music. Troy smiled and danced in his wheel-chair, lifting his arm and up down to the beat of the music.

But it couldn't distract from the inevitable: Troy was being forced to leave his home at Spectrum Neuro Rehabilitation, where he has lived for the past 13 years. When Teresa asked Troy if he felt sad, he blinked twice, meaning yes. But he would not cry. Not in front of his mom.

"We need to stay badass till God says so," he wrote to her.

They told him he could bring 10 outfits and a few pictures to his new home at Spectrum Health Rehabilitation and Nursing Center. Teresa had to take everything else to her home in Middleville – his blankets, his radio, his CDs, his pin-up board, his Michigan State gear, his flowers from his father's funeral. And along with 30 other people, Troy said goodbye to his room on Nov. 10.

The adult foster care facility, as they call it, closed last week as a result of reforms to the state's no-fault auto insurance law. The changes cut reimbursement rates for Medicare patients by 55 percent. That change meant companies like Spectrum Health would not receive full payment for taking care of Troy and other people like him who have been catastrophically injured in auto accidents.

Before the reforms went into effect July 1, people who were injured in auto accidents received full coverage from insurance agencies. They received everything they needed for their care – from caregivers to wheelchairs to therapy.

Fourteen years ago, Troy was injured in a motorcycle accident that left him in need of 24/7 attention. He cannot walk or swallow and, although he can write, he cannot speak. His story was highlighted in a Oct. 14 edition of The Banner as he prepared to move from the rehabilitation home to a nursing home.

Now Troy has been in the nursing home for seven days, but Teresa hasn't given up. She has spent her weekends sending emails and mailing packets of information to every lawmaker in the state.

It has come to little avail. Sen. Gary Peters, a Democrat who lives in Oakland County, and Sen. Peter Meijer, a Republican from Grand Rapids, sent her advertisements in response. Gov. Gretchen Whitmer sent an auto-reply email. Her state representative, Julie Calley, R-Portland, has called Teresa twice. She spoke with Spectrum about getting Troy back in his room and offered to help her find a better situation.

But no matter how many emails Teresa has sent, no matter how many personal phone calls she has received, nothing has changed.

"I just, I don't understand why it's so easy to take it away, but nobody can make it the other way – nobody can fix it," she said.

***

For nearly a decade, the insurance industry tried, year after year, to reform the no-fault auto insurance law. And every year it failed, with little traction and little hope, said Sinas Dramis Law Firm personal injury attorney Steve Sinas.

"It failed in a really kind of embarrassing fashion to the insurance industry," he said.

That changed in 2019.

When Whitmer took office, the Republican party made it no secret that auto insurance reform was their No. 1 priority, Sinas said. They brought in experts like Sinas to learn more about the topic, but there was no movement on the issue.

Then, one day in early May, there was a bill.

At 2 a.m., the no-fault auto insurance bill passed through the House without a public hearing, Sinas said. A few weeks later, the Senate passed its own bill, again, without a public hearing. And a few weeks after that, both the House and the Senate passed a collective, finalized bill that cemented the changes to the no-fault auto insurance law.

Sinas was at the state Capitol the day they passed the law. He called it a "chaotic scene" with citizens cramming together and yelling.

"Where's the bill?" they asked.

The elevator doors opened and a stack of the 120-page bills rolled out on a cart.

No one had time to read the bill before it was passed.

"Everyone's trying to read this bill and, from what I remember, within about an hour after that cart came off the elevator, the vote was being called," he said.

The Legislature didn't hold a public hearing. The bill was passed and, in one day, the no-fault auto-insurance industry changed for good.

"This is why people get screwed over when governments pass laws that they don't even understand without time for public comment," he said. "And then the political parties convince everybody just to say yes, just because they think it's in their best political interest to do so."

The bill surprised Sinas. It counters the philosophy of both parties, he said.

"It's certainly not in the Democratic Party's interest to support the bill that goes against the care needs of people," he said. "And it's also not in the Republicans' interest to pass a bill that caps the number of medical providers that can be paid and implements government regulation of health care.

"So both political parties have totally contradicted their own principles in passing this bill, and they're just trying to convince themselves that they did something good."

Lawmakers across the aisle praised the bill as a success; they intended to lower some of the highest auto insurance rates in the county and allow people the choice to pick their own coverage. Before the legislation, everyone received full, lifetime coverage – regardless of preference.

But, to Sinas, the law represents the insurance industry's hold over Michigan legislators.

Since the reform passed in 2019, the connection between the insurance industry and the Michigan state Legislature has been documented.

A May 2019 report by Michigan Campaign Finance Report analyzed donations made to Michigan lawmakers over a five-year period from auto insurance interest groups on both sides of the debate.

It found that the Michigan Legislature had received about $2.71 million from political action committees or organizations in favor of the auto insurance reform, with multiple members, such as state Reps. Annette Glenn, R-Midland, and Lee Chatfield, R-Levering, and state Sens. Jon Bumstead, R-Newaygo, and Tom Barrett, R-Charlotte, receiving more than $100,000. State Sen. Lana Theis, R-Brighton, who chairs the Insurance and Banking Committee that oversees any changes to the current no-fault legislation, took nearly $80,000.

"From my perspective, the insurance industry of Michigan is so powerful that it really has a great influence on both political parties," Sinas said. "From what I can tell, there was much more of an interest in appeasing the insurance industry on both political parties than actually protecting people."

***

Two days after he moved to the nursing home, Teresa visited Troy in his new room. Unable to visit him inside, she walked around the building, around the generator and onto the grass. She kept walking until she found the window with the initials "T.H." where she saw Troy propped up in his chair.

"Just sitting there in the dark," she said. "No lights, no TV. Just sitting there. Sad, you know what I'm saying?"

Teresa stood on a grate and yelled through the window as snow fell on her. She told Troy about his brother's hunting trip up North and his sister-in-law's recent positive COVID test. From across the room, Troy blinked to let her know he was listening.

It's the isolation of the nursing home that most scares Teresa.

In the neuro rehab homes, her son was surrounded by people. He had a roommate. Caregivers came to check on him and hang out. Teresa could visit and take him to the gazebo outside the neuro rehab home. And if he didn't want to be in his room, someone could wheel him out to the common area, where he would be surrounded by his friends.

In the nursing home, Teresa said, he doesn't share a room with anyone. He can't go outside due to COVID restrictions and his window doesn't open. The nursing home has significantly fewer staffers and he cannot receive the same level of attention.

Teresa can't check on him either. Before, she could call his caregivers on their cell phones whenever she wanted. They would tell her when he had a urinary tract infection and when he was acting grumpy.

But when Teresa has tried to call the nursing station at the nursing home, no one picks up. She can only go on a window visit. Even so, "there's nobody to talk to about how he's doing, what's going on with him?" she said.

In response to the reforms, lawmakers said, they set aside $25 million to support people like Troy. Some had assumed they would be grandfathered into the system.

And, while those funds have helped those who are receiving at-home care, those funds don't cover the cost of care provided by facilities the size of Spectrum Health Neuro Rehabilitation, and the countless other similar institutions across the state, President of Continuing Care at Spectrum Health Karen Pakkala said in a Oct. 13 interview with The Banner.

"Even $25 million, it seems an extraordinary amount of money, it isn't going to sustain the program work in perpetuity," Pakkala said. "We want a long-term solution for patients. That might be a Band-Aid for a bit of time for some providers. It might help us over the next few months. But it's not going to sustain the program forever."

Even as providers go out of business and people lose their care, Sinas said he doesn't foresee any changes to the no-fault auto insurance reform.

"They're going to come up with all kinds of excuses why it's not the time," he said. "There's too much power within both parties that want to support these laws, that don't want to do anything to acknowledge they've done anything wrong.

"...I don't have any hope that there's going to be a good-faith attempt by either political party to change any of the fundamental unfairness."

Sinas said he has taken matters into his own hands: He is leading a court case that challenges the legality of the reform. The case currently sits in the Michigan Court of Appeals, but it will take a year or two before a final ruling.

In the meantime, Troy Hughes sits in the nursing home, sequestered in a room with 10 outfits, a few pictures and a window that can't open.