Feds approve Michigan's Medicaid work requirement

The federal government has approved Michigan's request for a waiver allowing the state to impose work and other requirements on the nearly 663,000 people enrolled in the Healthy Michigan Plan, Gov. Rick Snyder said Friday.  

The plan signed into law in June requires able-bodied adults enrolled in the state's expanded Medicaid program to work an average of 80 hours per month or risk losing health coverage. People at or above the federal poverty level will pay 5 percent of their income for health coverage.  

The waiver also lets Michigan impose requirements for healthy behaviors, such as getting a flu shot or an annual physical. Changes to the waiver go into effect in 2020.

The new work rules could apply to roughly 540,000 able-bodied adults, according to the nonpartisan House Fiscal Agency, which projects about 5 percent to 10 percent of recipients will drop out or leave the program as a result.

GOP legislators have championed the plan as a way to help employers struggling to find workers fill open jobs. But Democrats and health advocates have decried it as an attempt to strip away health insurance for vulnerable people by erecting higher barriers to health coverage. 

Snyder lauded the plan as a way to ensure that the Healthy Michigan Plan can continue for another five years. Medicaid expansion under the federal Affordable Care Act was initially opposed by the Republican Legislature. Snyder was among a small number of GOP governors who broke with their party in support of Medicaid expansion, which was implemented in Michigan on April 1, 2014. 

GOP President Donald Trump’s administration opened the door to Medicaid work requirements for the first time last year and invited states to submit waiver requests.

Michigan is the sixth state to receive a work requirement waiver from the federal Centers for Medicare and Medicaid Services. Ten other states have applied for similar waivers and are awaiting federal approval.  

Snyder said the waiver will ensure continued operation of his flagship Healthy Michigan plan, which is available to residents in households with earnings between 100 percent and 133 percent of the federal poverty level, which is about $33,000 a year for a family of four.

But Democrats and many health advocates argue the requirements unfairly target a population of low-income residents that includes those with chronic health conditions or other issues making it difficult for them to work.  

“The approval of this waiver puts into place work requirements for Medicaid recipients, affecting our state’s most vulnerable residents," said Gilda Jacobs, president and CEO of the Michigan League for Public Policy. 

"It also imposes a premium hike for folks just over the poverty line, charging low-income earners an unprecedented five percent of their income for healthcare."

Jacobs cited data from the University of Michigan that shows a majority of people who are enrolled in Healthy Michigan are already working, and unemployed recipients face barriers such as chronic illnesses, poor health, advanced age or other limitations.

"Medicaid is a health care program, not a jobs program, and this attempt to change that is terribly misguided."

Kbouffard@detroitnews.com

Twitter: @kbouffardDN