Michigan Faces Potential Medicaid Coverage Loss Under Proposed Work Requirements
Proposed work requirements for Medicaid could result in nearly 200,000 Michigan residents losing their coverage, despite many being either employed or qualifying for exemptions. This development follows a proposal by congressional Republicans and is supported by findings from a recent analysis by the Urban Institute. The analysis highlights that a significant majority of adults aged 19 to 64, covered under Medicaid expansion, are already engaged in work or other exempt activities.
Katherine Hempstead, a senior policy officer at the Robert Wood Johnson Foundation, emphasized that many might lose coverage due to difficulties navigating complex reporting systems. “The way it makes money is when people are not able to comply with the clunky, kludgy system that every state sets up for people to report their hours,” she stated.
According to the Michigan Department of Health and Human Services, estimates of coverage loss are consistent with their predictions. Meghan Groen, senior deputy director at the department, noted in a briefing last week, “Sixty percent of people in the Healthy Michigan plan are already working, students, or homemakers, and many others are medically frail.”
Despite the coverage concerns, proponents of the work requirements, like key figures in the Trump administration and congressional Republicans, argue that these measures are necessary. They believe the focus should be on assisting the genuinely needy, as highlighted in a New York Times op-ed by Robert F. Kennedy Jr., Mehmet Oz, Brooke Rollins, and Scott Turner.
Financially, the Congressional Budget Office projects that implementing these work requirements could save the federal government $30 billion in the first year alone, according to a KFF analysis.
Understanding the Proposed Work Requirements
The recent proposal requires adults aged 19 to 64 to demonstrate 80 hours of work per month, with several exemptions available. These exemptions include attending school, job training, volunteering, or caregiving responsibilities. Katherine Hempstead detailed that exemptions also extend to those with physical or mental health issues that prevent them from working.
As discussions continue, the timeline for implementing these requirements is still being determined, with some Republican leaders advocating for an earlier start than the proposed 2029, according to The Hill.
The Healthy Michigan Plan, introduced in 2014, currently provides coverage to over 700,000 residents. It includes adults aged 19 to 64, with incomes up to 133% of the federal poverty level, who do not qualify for Medicare or traditional Medicaid. A state health department analysis outlines these criteria.
Previously, work requirements were introduced in 2018 under then-Governor Rick Snyder but were deemed illegal by a federal judge in 2020. The state had already invested over $30 million in implementation efforts at that time.
Currently, state officials predict that enforcing work requirements for Healthy Michigan recipients could cost around $75 million in administrative expenses. Potential broader impacts include an increase in uncompensated care, strain on rural hospitals, and a decline in Medicaid coverage for children, as outlined by the state’s analysis. Research indicates that Medicaid coverage for children correlates with better health outcomes and higher educational and economic achievements.
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