Five things to know about Michigan’s Medicaid work rules

work letter

If you’re among 238,000 people covered by Healthy Michigan and deemed able to work, you could lose coverage on May 1 if you do not properly document work-related activities, or show why you are exempt. (Bridge photo by Robin Erb)

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Thousands of Michigan residents enrolled in Healthy Michigan are now expected to work 80 hours a month — or tell the state why they can’t — to continue receiving health insurance under Michigan’s expanded Medicaid program.

Who’s affected?

The work rules apply only to a portion of Michigan’s 662,000 people who secured health insurance under Healthy Michigan. These are the roughly  238,000 people ages 19 to 62 who the state concludes are able-bodied adults receiving benefits through the state’s expanded Medicaid program made possible by the 2010 Affordable Care Act.

The majority of Healthy Michigan recipients are unaffected by the work rules, many because they are already known to be exempt from the rules because of a disability or pregnancy, for example. Healthy Michigan beneficiaries already listed as exempt received letters on their exemption. 

Beneficiaries who the state believes are subject to work rules received a different letter with information about working and reporting requirements.

An estimated 1.6 million beneficiaries in Michigan’s traditional Medicaid program — many of whom are seniors, blind or permanently disabled persons, living in foster care or pregnant — are not subject to the work rules.

How to continue receiving benefits? 

Those who fall under the work rules must show they work at least 80 hours a month. The work requirement can also be filled by being a student; looking for a job; volunteering (but only for three months each calendar year); participating in job training, vocational training or an internship; or participating in a tribal employment program or substance abuse rehab program.

Beneficiaries must document their activities to maintain eligibility for health insurance.

If they do not, they can lose health coverage beginning May 1.

Beneficiaries with a MiBridges account can log at to file their reports. Alternatively, beneficiaries can call 833-895-4355 between Jan. 25 and Feb. 29 to report January activities. 

Reporting is required every month.

What if recipients can’t work?

There are a number of exemptions to the work requirement, including for Michigan residents who are:

  • pregnant or were pregnant in the previous two months,
  • medically frail due to physical, mental, or emotional conditions that limits a daily activity, like bathing; have a physical, intellectual, or developmental disability
  • a chronic substance use disorder (SUD),
  • in a nursing home, hospice, receive home help services
  • homeless, or a survivor of domestic violence,
  • the main caretaker for a family member under 6,
  • full-time students
  • under age 21 and in Michigan foster care, prison or jail in the last 6 months,
  • receive State of Michigan unemployment benefits

Beneficiaries who believe they are exempt but didn’t receive an exemption letter may file a two-page paperwork application for an exemption by Jan. 31. After that, the exemption application must be filed at or by calling 833-895-4355, which will be staffed beginning Jan. 27.


State fliers warn low-income Michiganders at the Washtenaw Health Plan in Ypsilanti that they could lose health care unless they’re working, engaging in work-related activities, or have an exemption. (Bridge photo by Robin Erb)

How long will work rules last?

The work rules could be permanent, or they could be short-lived, as they have been in other states. There are a number of court challenges at the federal level. Michigan Gov. Gretchen Whitmer has argued against the program, but is bound by a 2018 state law to implement it. 

Who’s got more information?

The Michigan Department of Health and Human Services has produced a two-page overview of the requirements and exemptions.

For more information, visit a local DHHS office or find community resources by visiting or or call United Way’s help line at 2-1-1.

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Allan Blackburn
Tue, 01/14/2020 - 11:06am

It will cost a lot to administer this program, it is burdensome to require a monthly reporting requirement and it is designed to throw vulnerable people off of assistance. It's the cruelty that counts. It was never put in place during an all Republican government and Rick Snyder believed that Medicaid expansion was good for our state. It has been. It has created many middle class jobs with clinic creation and expansions, brought federal match monies in to the state and has helped keep a part of our population healthy and more likely to remain in the workforce. When you talk about such a low employment rate in this country these policies are designed for one purpose, to destroy social safety nets. If this was administered fairly you would make the ultra wealthy jump though numerous hoops to get those enormous tax give aways which cause the deficit to expand to epic proportions with none of the acrimony the Tea Party created over them during the last administration. Now deficits no longer matter. The give away is over a trillion dollars per year and you are looking at a potential saving of a billion dollars. Like I said; it's the cruelty that counts.

Tue, 01/14/2020 - 11:36am

00% agree with you, Allen. This program will cost dollars to save pennies. Uninsured people will just show up in the emergency rooms. Isn't this why we initiated programs under Medicaid in the form of primary the interest of keeping people with non-acute diagnoses OUT of the uber-expensive ER's. Another example of old men with no vision trying to exact blood from a stone and looking to the 1950's for a good idea. Moronic. We have other arenas to make more efficient but let's just pick on poor, sick people.

Sat, 01/25/2020 - 3:11pm

Yes...what Allan Blackburn said and phooey to the joker who spouted about how easy it is to get on programs. No, it is not and getting on Medicaid is NOT easy. Creating a whole new bureaucratic department to administer these enforcement rules will cost more than the very few people on Medicaid who fit the description of fit but not working. And once that department is created and deemed too expensive, they'll create some other use for it so that the Republicans won't be blamed for loss of jobs after creating a project that has "loser proposition" all over it. This money would be better spend on education so that we will be raising more citizens who be able to make enough money not to need Medicaid. Health care is big business now.

Kevin Grand
Thu, 01/16/2020 - 8:21am

So, let's see here...


Allan Blackburn
Fri, 01/24/2020 - 12:19pm

Kevin Grand: I have looked at your comments here for a long time. You always seem to imply that you are one of the few who pay taxes and that you should decide how they are spent. Many Medicaid recipients are the working poor who have stitched together a few jobs and healthcare is the one thing holding their lives together so they can work. The working poor also pay taxes and have a right to determine how they are spent as well. Your comments always remind me that Trumpism is alive and well in Michigan long before Trump was installed as our president.
I personally live from the motto: “Then he will say to those on his left, ‘Depart from me, you who are cursed, into the eternal fire prepared for the devil and his angels. For I was hungry and you gave me nothing to eat, I was thirsty and you gave me nothing to drink, I was a stranger and you did not invite me in, I needed clothes and you did not clothe me, I was sick and in prison and you did not look after me.’
The King will reply, ‘Truly I tell you, whatever you did for one of the least of these brothers and sisters of mine, you did for me.’