Shannon Perkins, a Hancock, Mich., native with lasting injuries from an auto accident, warns that the reforms passed for auto insurance come with a price. Michigan has become a leader in treating traumatic brain injuries in medical facilities because of the higher payments that accompany lower premiums.

Perkins said that some of these treatment centers are already closing, which will affect rural residents the most.

Since July 2, when the latest law came into effect, more than 40 facilities have already closed. One of the facilities that closed locally was Paradise House. Paradise House was a rehabilitation center for people with neurological disorders. The Eisenhower Center, located in Ann Arbor, is associated with the project.

According to Perkins, a new fee schedule may also lead to a rise in medical bankruptcies. Accident survivors are receiving fewer payouts from insurers for many costs.

In neurology facilities, services are allowed at a 55% discount. It is possible for insurance companies to now reduce the rate they used to reimburse by 55% when something does not have a Medicare code. As a result, half of a wheelchair ramp is now covered.

Perkins has been forced to find creative ways to pay for her travel expenses to Ann Arbor to undergo surgery at the University of Michigan Hospital despite requiring medical care. 

Medicaid and Medicare often don't cover what they consider luxury costs, even basic adjustments such as adjusting the height of a prosthetic to match a new pair of shoes. There are copays associated with Medicare, and the elderly, in many cases, are reliant on supplemental insurance plans.

Currently, Perkins is advocating legislation to close some of the holes left by the insurance reform package, and she is happy to work with both parties to find solutions.