Michigan poised to ease Medicaid work requirement reporting rules

Jonathan Oosting
The Detroit News

Lansing Michigan is poised to ease compliance reporting rules before starting to enforce its controversial Medicaid work requirement law next year under legislation heading to the desk of Gov. Gretchen Whitmer.

The state Senate on Wednesday gave final approval to a bipartisan plan negotiated by Majority Leader Mike Shirkey, R-Clarklake, and Sen. Curtis Hertel, D-East Lansing, that would simplify monthly reporting rules for able-bodied Healthy Michigan enrollees.

Sen. Curtis Hertel Jr worked with Majority Leader Mike Shirkey to ease reporting rules for Michigan's new Medicaid work requirement law.

The proposal is designed help lower-income residents keep their health insurance if they are attempting to comply with the law and prevent them from losing coverage because of overly complex administrative rules.

The unanimous Senate vote came just days after the Michigan Department of Health and Human Services began sending notices to more than 270,000 enrollees who will be required to meet work or related requirements next year as a condition of coverage through the Healthy Michigan expanded Medicaid program.

The proposal would extend the monthly reporting deadline, moving it from the 10th day of the following month to the last day of the following month. Residents would have an opportunity to prove monthly compliance at a later date if they miss the deadline.  

The legislation would also provide a reporting exemption for Medicaid recipients if the state can verify their work hours in other ways, such as income disclosure required for welfare programs.

Hertel touted the legislation in committee as a way to “streamline” reporting and limit the kind of “unintended consequences” that similar rules have produced in states like Arkansas, where thousands have lost coverage and struggled with reporting.

The East Lansing Democrat opposed the Medicaid work requirement law that Shirkey sponsored, but “we both agree that no one should be unintentionally kicked off the system, and certainly those that are meeting the spirit of the law should not be harmed in any way,” he said.

Hertel estimated the revised reporting requirements could protect an estimated 83,000 Michigan residents from losing coverage while saving the Department of Health and Human Services $3 million a year in call center and compliance monitoring costs.

“Staffing a call center to manage an influx of calls in just 10 days is inefficient and costly,” he said in testimony before the House Government Operations Committee. The full House approved the legislation Tuesday in a 105-4 vote.

Shirkey has said lawmakers studied Medicaid work requirement laws implemented in other states that had “very cumbersome processes” for people to verify compliance.

The new proposal will “make sure we don’t get into the same pickle that other states had been in terms of people just falling off the edge because of some ridiculous compliance requirement,” he told reporters earlier this year.

Whitmer opposed the Medicaid work requirement law signed last year by her Republican predecessor, suggesting it could result in between 61,000 and 183,000 residents losing coverage after the new rules take effect.

GOP President Donald Trump’s administration opened the door to Medicaid work requirements for the first time in 2017 and invited states to submit waiver requests.

Work requirements adopted by other states have prompted legal challenges from critics who contend the rules inappropriately bend a program designed to provide medical coverage to low-income residents.

Federal judges have blocked Medicaid work laws in Kentucky and Arkansas, where more than 18,000 enrollees lost health coverage in 2018 after failing to meet work or reporting requirements.

The Michigan law applies only to Medicaid enrollees in the Healthy Michigan program, created under a 2013 law championed by GOP former Gov. Rick Snyder that expanded eligibility to low-income adults who earn up to 133% of the federal poverty level.

Beginning in January of 2020, able-bodied Healthy Michigan beneficiaries will be required to work at least 80 hours per month in a paid job, job training program, volunteer position, internship or undergo substance abuse treatment.

Residents subject to the rules will be allowed two months of “non-compliance” in any 12-month period. After their third month without proving work, they will lose coverage for at least one month until they can again prove compliance.