Sara Swanson

GOP leaders: We won’t halt Michigan Medicaid work requirements

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Democrats argue the work requirements will cause thousands to lose coverage, as has happened in other states that have implemented work requirements in order to receive coverage. Republicans argue the program will promote self-sufficiency and push people to enter the workforce.

By Riley Beggin (Bridge)

LANSING –  Michigan Republicans are rebuffing calls from Gov. Gretchen Whitmer to postpone Medicaid work rules set to begin Jan. 1, amid a federal lawsuit challenging the policy.

Next month, Michigan will require most of the state’s more than 650,000 Medicaid recipients to prove they’re working, in school, amid job training or doing other activities like looking for a job at least 80 hours per month to receive healthcare coverage under legislation that passed in 2018. Critics argue the policy is likely to cause tens of thousands of people to lose coverage; proponents say it will boost employment during a labor shortage.

Whitmer told reporters on Monday she wants a delay, noting she doesn’t have the power to postpone implementation herself. House Democrats announced Tuesday afternoon they would introduce legislation to permanently remove the work requirements.

“I’m hopeful that Michigan will be wise and stay implementation of our work requirements,” Whitmer said. “We’ve seen that other states are taking that position because they’ve already seen how devastating it’s been to people’s lives.”

Senate Majority Leader Mike Shirkey and Speaker of the House Lee Chatfield said Tuesday that’s out of the question. In a joint statement, they called the policy “common sense” that Michigan taxpayers “who foot the bill for these programs expect.”

“These work requirements are also the right thing to do for people who need short-term help,” the two said. “Getting a job is the best way to become self-sufficient for a lifetime and escape poverty. Pausing the program takes that away and pushes people deeper into dependency, unhealthy behaviors and long-term poverty.”

The policy, passed under Republican leadership in 2018, was approved by the Trump administration, which loosened guidelines and allowed states for the first time to require recipients to work to receive Medicaid benefits.

The administration green-lighted similar plans in Arkansas, Indiana, Kentucky, Maine and other states under the new policy. Nine others are still awaiting approval.

Many of the approved states have faced legal disputes over work requirements, and a federal judge has struck down the policy in Kentucky, Arkansas and New Hampshire. Policymakers in Indiana and Arizona have suspended work rule policies as the lawsuits proceed.

States that implemented their programs saw thousands of people lose coverage. That includes people who work regularly but may not meet monthly reporting requirements due to the volatility of low-wage jobs. Others were dropped because of difficulty reporting their hours due to unreliable internet and other challenges. Whitmer and the Legislature attempted to address that by extending the reporting window in September, though Whitmer maintained the policy was problematic and among the “most onerous” work requirements in the country.

Other states “took the step a lot earlier than Michigan did [and] are feeling the consequences, so they voluntarily stopped implementing,” Whitmer said Monday. “The Legislature hasn’t had a chance to see firsthand how dramatic this is going to be for people. But I’m hopeful that we can avoid that.”

Speaking individually with reporters Tuesday, Shirkey said Michigan’s policy is “uniquely different” than other states, “so we’re going to let the process play out.”

Michigan’s policy includes exemptions that “are far broader than most other states,” Shirkey said, excluding people who are medically frail, have disabilities, have children under 6, are pregnant, are receiving unemployment benefits or were recently incarcerated. That will exempt hundreds of thousands of people, he estimated.

The work requirements have been a tug-of-war between Whitmer’s administration and the Legislature even before health care advocates challenged the law in court in November. Lawmakers left out of the budget $10 million intended to publicize the changes and hire staff to oversee the rollout.

Michigan Department of Health and Human Services Director Robert Gordon urged Whitmer to try to postpone implementation in any way she could.

Days later, Whitmer restored more than $15 million to ease the transition to the new rules as part of a $625 million transfer between state departments that upset Republicans. Both Whitmer and Shirkey also argued their plans would save the state the most money.

Whitmer said that the state has spent $28 million to date preparing for the requirements and will likely spend $40 million more in 2020, she said. If the court strikes down or blocks the work rules, as judges have in other states, that money will be wasted.

Shirkey pointed to a requirement in the original Medicaid expansion law that would automatically stop the expansion if the state’s spending outpaced savings gained from the program.

“So there’s a poison pill in [the] … statute,” he said. “My hope is that we create enough churn to keep that from happening… I don’t want to do that, I want to keep it in place.”

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