GOP lawmakers push mandatory Medicaid work plan

Jonathan Oosting
Detroit News Lansing Bureau

Lansing – Michigan would join a small but growing number of states requiring Medicaid recipients to work or continue school to maintain government health care coverage under Republican legislation introduced this week.

Sen. Mike Shirkey, R-Clarklake, is proposing a 30-hour work or school requirement for poor but able-bodied adults. Rep. Jim Runestad, R-White Lake Township, wants the Michigan Department of Health and Human Services to develop similar requirements.

“It’s a dignity issue to me,” Shirkey told The Detroit News. “We have upside down incentives in many of our support and social programs here that cause people to have to make choices that I just don’t think they should have to make.”

President Donald Trump’s administration opened the door to Medicaid work requirements and has approved plans from three states since January, but the new rules have prompted criticism from health care advocates and lawsuits alleging they violate federal law.

Republican Gov. Rick Snyder has not yet taken a position on Medicaid work requirements, but Shirkey said he has had multiple conversations with Snyder’s office about his legislation, which he formally introduced Thursday afternoon.

Data shows that “work is one of the best things somebody can do for their healthy and particularly for their family’s health,” Shirkey said, suggesting the proposal could also benefit employers struggling with worker shortages.

Snyder encouraged Michigan legislators to expand Medicaid eligibility under the federal Affordable Care Act in 2013. The state now allows enrollment by able-bodied residents who earn up to 133 percent of the federal poverty level, which is roughly $16,000 for an individual or $33,000 for a family of four.

More than 670,000 lower-income residents have signed up for the Healthy Michigan expansion program since it launched in 2014, according to the state, and more than 2 million residents are enrolled in Medicaid overall.

Shirkey said he wanted work requirements to be part of the original Healthy Michigan program. With the Trump administration now approving requests from other states, he expects “wide support” from majority Republicans in the House and Senate.

Democrats are likely to oppose the effort, including Sen. Curtis Hertel Jr. of East Lansing, who had a lengthy floor conversation with Shirkey on Thursday.

Hertel told The News he is concerned the legislation would subject the state to costly lawsuits and unfairly punish people who live in areas like the Upper Peninsula where seasonal unemployment is prevalent and job training programs may be harder to find.

“Beyond all that, I personally believe that health care is a right, and we should be working to get more people covered, not less,” he said. “I think by cutting off access to basic primary care, we end up actually costing taxpayers more.”

About 49 percent of residents enrolled in the Healthy Michigan program already have jobs, and 11 percent can’t work due to issues like serous physical or mental health conditions, according to a recent study by researchers at the University of Michigan. About one in four are out of work, but many suffer from poor health or impairments.

The Michigan League for Public Policy, a nonprofit focused on economic equality, says Medicaid work requirements would burden residents in need and could cost the state more than it would save.

“Too often we see politicians burdening Michiganders in need with harsh requirements and confusing red tape,” league president and CEO Gilda Jacobs said in a statement.

Shirkey’s bill includes language stating the intent is to “utilize workforce demand to prepare an able-bodied adult for a life of self-sufficiency and independence from government interference.”

Snyder spokeswoman Anna Heaton said Shirkey has provided some information about his Medicaid work requirement plan with the governor’s office. But “we haven’t reviewed his full proposal yet,” she said, indicating Snyder does not yet have a position.

The administration has been “receptive” to the conversation, said Shirkey, who acknowledged it’s not yet clear whether the governor will support the proposal. Senate Republicans are expected to discuss the bill behind closed doors next week, and Shirkey said he thinks it will “easily” pass the House and Senate.

“We’ve sent things to the governor before where we were not sure whether he would sign them or not,” Shirkey said. “So this could be another one of those.”

The Trump administration on Monday approved Arkansas’ plan to require thousands of people on Medicaid to work or volunteer. It previously approved plans by Kentucky and Indiana and is considering proposals from other states.

Michigan state Rep. Gary Glenn, R- Williams Township, introduced a Medicaid work requirement bill in January 2017, before the Trump administration made clear it would consider such state proposals.

House Speaker Tom Leonard said Thursday he has not reviewed the House or Senate legislation but is open to the idea. “In concept, I believe that government assistance ought to be a hand up versus a hand out,” the DeWitt Republican told reporters.

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