Snyder signs 80-hour Medicaid work requirement law

Jonathan Oosting
The Detroit News
Gov. Rick Snyder

Lansing — Most adult Medicaid recipients who receive health care insurance through the state’s Healthy Michigan plan will be required to work at least 80 hours per month or risk losing coverage under a new law signed Friday by Republican Gov. Rick Snyder.

Five years after he led the push to expand Medicaid eligibility under the federal Affordable Care Act, Snyder signed the new work requirements over protests from Democrats and advocacy groups who decried it as a legislative effort to strip health insurance from low-income residents.

But the term-limited governor said the proposal 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.

The program "has improved the lives of hundreds of thousands of Michiganders, and I’m very proud it has been so successful,” Snyder said in a statement announcing the anticipated bill signing.

“The original estimates were that 400,000 people without health care would be able to obtain it after the creation of Healthy Michigan, and today more than 670,000 people have coverage. I am committed to ensuring the program stays in place and that Michiganders continue to live healthier lives because of it.”

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

Snyder’s signature met swift condemnation from the Michigan League for Public Policy, a nonprofit advocacy group that said the governor “betrayed the Healthy Michigan Plan he worked so hard to build.”

“He also betrayed the people it serves,” President and CEO Gilda Jacobs said.

Michigan will need federal approval to implement the new work requirements, and critics note the new law includes a trigger to end the Healthy Michigan program if the state is not able to obtain a waiver.

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.

Snyder said he has met with officials at the Center for Medicare and Medicaid Services and expects federal approval. Without it, his office said, the program would still continue through at least Feb. 1, 2020.

The governor opposed an earlier version of the work requirements legislation but publicly backed revisions earlier this month after negotiating changes with sponsoring state Sen. Mike Shirkey, R-Clarklake.

Shirkey, who was not immediately available for comment Friday, has championed Medicaid work requirements as an economic tool to help employers struggling to fill open positions. But opponents argue most Medicaid recipients who can work already do.

Pending federal approval, the law will require Healthy Michigan beneficiaries to work at least 80 hours per month in a paid job, job training program, volunteer position, internship or undergo substance abuse treatment.

Disabled residents, pregnant women, full-time students, children and one parent in a household with a child under the age of 6 would be exempt from the work requirements.

The law also seeks to tighten a four-year coverage limit for Healthy Michigan recipients, who would need to pay a 5 percent premium and complete healthy behaviors to stay on the plan.

Health care and patient groups including the American Heart Association, American Lung Association and Cancer Action Network had called on Snyder to veto the bill.

Signing the bill will jeopardize “healthcare coverage for 670,000 Michiganders, including those living with serious and chronic health conditions,” the coalition said earlier this month.

“Administering these requirements will not help low-income families improve their circumstances but will lead them to battling administrative red tape to keep coverage. With no way to circumvent this penalty, patients could face serious — even life or death — consequences.”

An earlier version of the legislation would have required all adult and able-bodied Medicaid recipients to work at least 29 hours a week. It also included an exemption for rural counties that critics called racist but was stripped from the bill before it was sent to Snyder earlier this month.