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Five things to know about Michigan’s Medicaid work rules

work letter

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.

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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