Whitmer in DC talks to ease Medicaid work rules

Melissa Nann Burke
The Detroit News
Gov. Gretchen Whitmer

Washington — Gov. Gretchen Whitmer has met with Trump administration officials about changes she hopes for in the state law that will impose work or job-related requirements on some Medicaid recipients in Michigan. 

However, Republican leaders in the Legislature aren't eager to ease the rules before they're implemented next year.

Whitmer said Sunday she is looking to incorporate some of the "best practices" learned by other states such as Arkansas, where thousands of people lost their Medicaid eligibility over confusion and other issues complying with the state's work reporting requirements. 

The Democratic governor said in an interview she's looking at lowering the age limit for the work requirement to 50, as Arkansas has done, and potentially eliminating the need to report hours worked to the state monthly. Michigan's rules apply to people between the ages of ages 18 to 62.

She intends to work with the Republican-controlled state Legislature on the revisions, which would also require amending Michigan's waiver with the federal government.

"There are best practices that have been learned from other states that if we incorporated into Michigan would help us actually promote work and preserve health care," said Whitmer, who is attending the National Governors Association annual winter meeting in Washington this weekend. 

"If the goal truly is to help people get into the workforce, I think that’s something we can all find some common ground around."

Whitmer opposed the controversial push last year to require able-bodied adults who receive health care insurance through the state's Medicaid expansion program to work at least 80 hours per month or risk losing coverage.

The Trump administration in December approved the state's request for a waiver allowing Michigan to impose the work and other requirements on nearly 663,000 people enrolled in the program known as Healthy Michigan. 

Whitmer said she met Saturday with Secretary of Health and Human Services Alex Azar, and that he was "somewhat receptive" to making the adjustment to Michigan's waiver regarding work reporting. 

"We’ve got the technology and data to do it well, without creating additional hurdles for people," Whitmer said.

"The secretary in our meeting yesterday said, you know, we don’t want someone who’s working to have to take time out to do this. Because they’re working — they’re doing exactly what we’re hoping for."

Republican Senate Majority Leader Mike Shirkey, who sponsored the work requirement  law last year, said he's not open to Whitmer's changes "out of the gate," but would consider reviewing the program after rules have been implemented for a while to see how everything’s working.

He encourages studying other states' processes and "shamelessly" picking out those that work well. But he stressed the dissimilarities between Michigan and Arkansas roll-outs. 

"Arkansas only allowed themselves a few months to implement, and we allowed 16 months for the department to implement on purpose because we wanted it to be an efficient process — not full of bureaucratic extra expense and constraints," Shirkey said.

As to lowering the eligibility age for the work mandate, Shirkey noted that people are working longer and retiring later in life. 

"And shame on us, shame on us if we make it difficult for people to report," Shirkey said.

"Nobody wants it to be an onerous problem. We provide a lot of latitude to the department in designing it. The fact of the matter is, under Michigan’s law, people can be out of compliance essentially for three months out of 12 and still stay eligible for coverage. So, there really isn't any reason at this time to make any changes."  

Whitmer this month highlighted a study by Manatt Health estimating that between 61,000 and 183,000 people in Michigan would lose coverage over a one-year period as a result of the law's changes. 

In a Feb. 8 letter to Seema Verma, administrator of the federal Centers for Medicare and Medicaid Services, Whitmer noted that 18,000 people in Arkansas lost their health coverage during the first seven months of similar work requirements. 

"Michigan’s statute is more sweeping than Arkansas' waiver, threatening a broader range of adults with more exacting reporting demands," Whitmer wrote. 

She noted Michigan's law provided no resources for job training, job search or job supports. 

Whitmer noted that Arkansas's work requirements are limited to people age 50 or younger. Michigan's apply to people between the ages of ages 18 to 62.

"They have found that it approved their ability to provide care and promote work," Whitmer said of Arkansas' age limit. 

"Ours was written at the end of the year, and I think we’ve already learned some things between when it was written and today in terms of what works better. It’s really about updating it with best practices."

Trump's national emergency

Infrastructure has been another top priority for Whitmer, who said she's concerned about how President Donald Trump's emergency declaration to build a border wall could affect projects and resources important to Michigan. 

"A lot of states have raised various concerns about what it means in terms of commitments on the National Guard and other things that are happening," she said. "Obviously, I do have that concern. We’ll see."

Some Democrats in Michigan's congressional delegation have worried that Trump could transfer money from Army Corps of Engineers projects such as the planned Soo Locks upgrade. 

"I’m hoping that we can ensure that doesn’t happen," Whitmer said. 

Whitmer said she was asked to join Michigan Attorney General Dana Nessel's lawsuit with 15 other states suing Trump over his emergency declaration

Whitmer did not join because she only had about 45 minutes to make the decision before a deadline imposed by the plaintiffs in the case. 

"I thought it was too important to take the time and understand what it was, and also to say what exactly our concerns were," Whitmer said. 

"So we let the attorney general proceed on her own on this. It doesn’t mean that we’re not supportive. It doesn’t mean that we are. It’s just that there was not enough time to do it in a thoughtful way."

She and other governors are scheduled to have breakfast with Trump at the White House on Monday.

Infrastructure needs

Whitmer noted that when she met with Trump and other new governors in December, she and other Great Lakes state governors talked up the need to stop the invasive Asian carp, which Trump had never heard of.

"The president at that time indicated they were going to go full bore and do everything they can to help," she said. "So, we are now all writing our budgets and as states having that conversation about what are the next steps we can take together on that front."

In December, Trump also asked the governors for help in urging Congress to support an infrastructure package — something Whitmer is eager to see, also. 

"It would mean greater investment in our infrastructure and in Michigan our infrastructure is about the most dangerous and worst in the country, and so we are in a crisis," she said. 

"We are now in February and, obviously, the seasons are changing and the roads are going to be very clearly deteriorating with the freeze and the thaw, so we’re anxious for some resolution here. Everyone talks about it but we need action."

Whitmer, who campaign on a promise to "fix the damn roads," said she'll propose a road-funding solution in her budget proposal next month, and she hopes the state Legislature enacts it before recessing for the summer.