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Michigan seeks federal approval for Medicaid work requirements

Karen Bouffard
The Detroit News
The Healthy Michigan plan, supported by Gov. Rick Snyder, is a model for the country, Bush writes. It’s helped more than 640,000 poor state residents get coverage and care.

The Healthy Michigan Plan that provides expanded Medicaid to about 655,000 Michigan residents would continue with work requirements under an amended waiver Gov. Rick Snyder submitted Monday to the federal government.

The waiver application needed to be submitted by Oct. 1 to avoid derailment of the Healthy Michigan Plan medical coverage when the current waiver expires on Dec. 31.  

If approved, the waiver would allow Michigan to impose work requirements effective in 2020 that were adopted this year by the state Legislature. The changes would include an increase in cost-sharing for Health Michigan enrollees, who are mostly low-income residents.

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.

Critics argue that most Healthy Michigan participants who can work already are unemployed. They say many of those who aren't working suffer from chronic health conditions that make it hard to hold a job, and the loss of health coverage will make it even harder for them to re-enter the work force.

"Work requirements will result in lost coverage, which means their health is not going to be as good and their employment outcomes may suffer," said Emily Schwarzkopf, a health policy analyst with Michigan League for Public Policy. 

But the new rules would encourage more underemployed residents into an economy in which tens of thousands of jobs go unfilled, work requirement supporters said. The requirements also ensure the Healthy Michigan Plan remains funded, they said. 

Under state law, the expanded Medicaid program will end if the federal government does not approve the amended waiver within 12 months of its submission.

“Our Healthy Michigan program has improved the lives of hundreds of thousands of Michiganders, and I'm very proud of the success we have seen," Gov. Rick Snyder said in a press release Monday. “Having health insurance allows Michiganders the ability to live independent and healthy lives, and in many cases tears down a barrier to employment.”

The new work requirements would be similar to those already in effect for Michigan residents who receive cash or food assistance. They would not apply to people enrolled in traditional Medicaid or who meet one of 12 exemptions that include being a family caretaker, a full-time student, a pregnant woman or an unemployment aid recipient.

Healthy Michigan was launched April 1, 2014, to extend health care benefits to eligible residents with incomes up to 133 percent of the federal poverty level. The federal government approved a second waiver in December 2015 encouraging beneficiaries to adopt healthy behaviors.