Michigan Senate OKs Medicaid work requirement

Jonathan Oosting
Detroit News Lansing Bureau

Lansing — Hundreds of thousands of able-bodied Medicaid enrollees could lose government health insurance if they fail to document at least 29 hours a week of work, job training or related education under a controversial measure approved Thursday by Michigan’s Republican-led Senate.

Sen. Mike Shirkey, R-Clarklake, comments on his bill, as the Michigan Senate debates and then passes a bill that will require Medicaid recipients to work every week.

The legislation faces a potential roadblock in GOP Gov. Rick Snyder, whose office said the version now headed to the House is “neither a reasonable nor responsible change to the state’s social safety net.”

The Senate push comes three months after President Donald Trump’s administration opened the door to unprecedented Medicaid work requirements. The federal government has approved waivers for three states since January and is considering several other requests.

GOP supporters say the work mandates could help employers struggling to fill job openings and ensure the growing taxpayer-funded program remains a sustainable way to help the neediest Michigan residents.

“This is not about taking things away from people,” said sponsoring Sen. Mike Shirkey, R-Clarklake. “Study upon study supports the notion that one of the best things a person can do for their own health, and in particular, their family’s health, is to be productively engaged in work.”

But critics argue the work requirement legislation, approved in a 26-11 vote with support from all but one Republican, would punish low-income residents and force them to navigate bureaucratic red tape in order to maintain important health coverage.

Poor people have become subjects in a “social engineering experiment for Republicans,” said Sen. Curtis Hertel, D-East Lansing, who called the proposal “willfully ignorant” of economic conditions created by the majority party.

“This bill operates on the assumption that those on Medicaid want to be relying on the state, that they are choosing their current condition, that people choose to be poor,” Hertel said.

The legislation, now heading to the House for further consideration, would apply to able-bodied adults between the age of 19-64, who would be required to verify compliance monthly and report any changes in family income. Those who fail to do so on at least two occasions would be disqualified from Medicaid for a full year.

More than 2 million Michigan residents are on some form of Medicaid insurance, including more than 670,000 enrolled in the Healthy Michigan plan that expanded eligibility 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.

Snyder’s office, in criticizing the legislation, said the governor will continue talk with legislators in the hopes of improving the plan before it reaches his desk.

"Despite our efforts to work with Sen. Shirkey, this version of the bill is neither a reasonable nor responsible change to the state’s social safety net,” said spokesman Ari Adler. “We should not jeopardize the success of Healthy Michigan, which has helped hundreds of thousands of Michiganders who no longer have to choose between taking care of their health or paying their bills.”

Shirkey told reporters after the vote he intends to continue negotiating with Snyder, who he said has “heartburn” over the 29-hour work requirement. Shirkey acknowledged it would be the “most stringent” hour mandate among any state that has applied to the federal government and expects it will be lowered in the House.

Without reforms, the Healthy Michigan program will “probably have to be closed down” within two years under a provision triggered if state costs outweigh savings, said Shirkey, who voted for the Medicaid expansion in 2013.

“This is about saving dollars to be spent on people who need it,” he said. “It is about saving Healthy Michigan, quite frankly.”

House Speaker Tom Leonard, R-DeWitt, has not reviewed recent changes to the legislation, said spokesman Gideon D’Assandro, but “overall, conceptually he is in favor.”

Shirkey estimates about 300,000 Medicaid recipients would be subject to the Senate-approved work mandate, which includes exemptions for parents with children 6 or younger, pregnant women, disability caretakers and people recently released from prison or receiving unemployment benefits.

Senate Republicans rejected other exemptions proposed by Democrats, including an amendment that would have waived the work requirements for military veterans.

University of Michigan researchers, in a report published in the Journal of American Medical Association, concluded that most Healthy Michigan enrollees already do work. Their 2016 survey of 4,090 enrollees found most who were unable to work had “significant barriers to employment, such as poor health, chronic conditions, older age or functional limitations.”

Senate Republicans on Thursday rejected a series of other work mandate exemptions proposed by Democrats, including an amendment that would have waived requirements for military veterans on Medicaid.

Sen. Rebekah Warren, D-Ann Arbor, proposed failed amendments that would have required a cost-benefit analysis, exempted caretaker parents with children up to 13 years old and reduced the work requirement to 20 hours a week.

“Should a single mom who’s working 28 hours a week be penalized because that’s all her employer would give her?” Warren asked. “Or perhaps that’s all the time she has in order to meet her child care needs.”

The Medicaid work requirements are projected to cost the state about $20 million to $30 million a year in administrative costs, according to the nonpartisan Senate Fiscal Agency, which said it is difficult to estimate how many individual enrollees the legislation could impact.

The Michigan Chamber of Commerce and other business groups are backing the legislation, arguing that it would encourage residents to join the workforce and boost the state economy. But the measure has faced criticism from health care and patient advocacy organizations.