Gretchen Whitmer asks to stop Michigan Medicaid work rules; 80,000 at risk

Gov. Gretchen Whitmer wants a court to suspend Medicare work rules. (Bridge photo by Dale Young)

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With 80,000 Michiganders at risk of losing health care coverage in the coming months, Gov. Gretchen Whitmer asked a federal court Tuesday to suspend the program that requires Medicaid beneficiaries to prove to the state they’re working — or give a documented reason for why they are not — as a condition of coverage.

Since Jan. 1, more than 238,000 Michiganders ages 19 to 62 have been required to work at least 80 hours a month or provide a legitimate reason why they are not working, such as being pregnant or enrolled in school. 

With the first of the monthly reports due Saturday, roughly 80,000 people (or 1 in 3 Medicaid recipients the state has deemed able to work) have not yet filed documents on their work status, according to a statement released Tuesday by Whitmer’s office. 

That puts them one step closer to losing health coverage under Healthy Michigan, the state’s expanded Medicaid program.  Beneficiaries who fail to properly document their activities for three months in a 12-month period can lose coverage.

Related:

For now, Michigan has the nation’s only active program requiring those who get state Medicaid expansion coverage to work for those benefits, engage in activities like school or job training, or prove they are otherwise exempt from the rules. 

This month, the U.S. Court of Appeals for the District of Columbia upheld a lower court’s order striking down a work rules program in Arkansas. In a unanimous decision, the appeals court found that the imposition of work rules do not fit within the primary objective of the Medicaid Act, which is to provide health care coverage to the poor.

That decision, according to Whitmer’s office, means the Michigan program is unlawful, too, according to the Tuesday statement.

“This opinion leaves little doubt that Michigan’s Medicaid work requirements are also unlawful…. If there was any doubt about the future of work requirements then, that doubt is now erased,” it read.

On Tuesday, the Michigan Department of Health and Human Services asked U.S. District Court Judge James Boasberg in Washington, D.C., to suspend the program as part of a case before him, Young v. Azar. In it, four Michigan women argue the state’s Medicaid work requirements are politically motivated and run counter to the mission of Medicaid and the 2010 Affordable Care Act, which established Healthy Michigan as part of expanded Medicaid.

The Trump administration opened the door to work rules in 2018 when it issued guidelines that allowed states to compel working age, able-bodied Medicaid recipients to work or meet other requirements to receive benefits. 

The first attempt went badly in Arkansas, where more than 18,000 people lost Medicaid benefits under rules similar to those in Michigan. A report in the New England Journal of Medicine concluded that half of Arkansas’s Medicaid recipients were confused, incorrectly believing they did not meet the work requirements. Others didn’t have Internet access to meet that state’s reporting requirements. (Arkansas, unlike Michigan, only allowed online filing of work documentation.)

MDHHS director Robert Gordon had worried about a similar scenario in Michigan.

“We remain concerned about loss of coverage,” department spokesman Bob Wheaton said Tuesday. “We still think there will be more than 100,000 people losing coverage in 2020 if the law remains in effect. This is only one month of data and there are many people who will come onto the program throughout the year that will not comply.”

 

Whitmer also sent a message to the Legislature Tuesday, asking lawmakers to immediately suspend the program, but it’s not likely to find a sympathetic ear in the Republican-led bodies that passed the work rules under a GOP governor, Rick Snyder, in 2018.

Some consumer advocates and attorneys have said those subject to the rules are often already working and that giving people coverage helps them remain healthy so they can continue holding down a job. 

While Whitmer and Gordon oppose work rules, Michigan’s Legislature has given them little choice but to enforce them. Senate Majority Leader Mike Shirkey, a Clarklake Republican who sponsored the 2018 work rule law and co-sponsored a 2019 law to ease compliance reporting rules, has said implementation “can’t happen fast enough.”

Amber McCann, Shirkey’s spokeswoman, told Bridge Magazine on Tuesday his support for the program “has not wavered” and the Senate has no intention of backing off the work requirements 

“He believes fostering a path of independence and supporting an individual in pursuit of his or her highest level of personal productivity is essential to the health and productivity of our entire population,” McCann said.

Others support the rules, too, including the Michigan Chamber of Commerce, which said the rules are likely to boost the state’s employment ranks and shrink a “workforce shortage and talent gap.”

Lindsay Killen, who writes about health policy for the Mackinac Center for Public Policy, a Midland-based nonprofit advocating for free markets and limited government, noted the court decision this month in Washington did not directly rule on the Michigan program. 

“As no courts, and especially not the Michigan Supreme Court or the United States Supreme Court, have ruled yet that these requirements are unconstitutional, we believe strongly that [Michigan] must continue to move forward,” Killen told Bridge on Monday.

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Comments

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Tue, 02/25/2020 - 5:39pm

"With the first of the monthly reports due Saturday, roughly 80,000 people (or 1 in 3 Medicaid recipients the state has deemed able to work) have not yet filed documents on their work status, according to a statement released Tuesday by Whitmer’s office."

This comes as no surprise, I figured many people would not be informed or misunderstand what the whole thing was about and just didn't bother to do anything about it.

Kevin Grand
Tue, 02/25/2020 - 5:42pm

So, Michigan Taxpayers are expected to punch a time-clock to pay for their insurance, but the governor feels the same doesn't hold true for those receiving Snydercaid???

She REALLY must not want to remain governor after 2022!

middle of the mit
Wed, 02/26/2020 - 3:06am

Yet you are referring to it as Snyderly whiplashcaid? LOL!!!!

Kevin Grand
Wed, 02/26/2020 - 7:04am

Yet another ticking time-bomb in the state's budget.

Gov. Snyder knew at the time that his program wouldn't be free. He deliberately understated the numbers in order to help support its passage.

Now, the current state government needs to prioritize its spending because of his actions.

Which is interesting since the money for everything the current governor wants to promote just isn't there.

Pete
Wed, 02/26/2020 - 1:05pm

Michigan taxpayers shouldn't have to punch a clock for insurance either - it should be provided to everyone via taxes.

Kevin Grand
Wed, 02/26/2020 - 8:31pm

Look up the NHS' track record and then get back to me how well that government plan has worked for its citizens.

Bones
Thu, 02/27/2020 - 10:29am

Despite having been purposefully underfunded for decades because of myopic sods like you in order to sell it off, the NHS still functions better than the US' collapsing system that is literally the most dysfunctional in the developed world. Be honest, just once in your life

Rose
Wed, 02/26/2020 - 9:43am

The never-ending war on the poor waged by Republicans at the national and local level is heart-sickening and disgusting. What kind of country have we become with no understanding or concern about the real challenges faced by many of our fellow citizens?

As someone who worked two jobs for over 10 years in order to pay for my health insurance (since it was not provided to me by my employer), I do understand that it can be galling to see people you think are lazy or whatever getting things you are working for. However, in most cases the poor are not lazy. If you are fortunate enough to have a stable life with a roof over your head, food, and health care yet resent others, please read a little to understand what others who are not as fortunate as you are contend with. Read the book, Maid, by Stephanie Land, read David Shipler's work, and/or read these articles. This society needs more understanding, not less as we are all in it together-like it or not.

https://thecorrespondent.com/283/poverty-isnt-a-lack-of-character-its-a-...

https://www.theguardian.com/society/2014/sep/21/linda-tirado-poverty-han...

Philip Mollica
Wed, 02/26/2020 - 9:47am

The decade of austerity is well under way. Attacking those who are the most vulnerable. Neo-liberalism hangover in full swing. This is abhorrent. Productivity is not the end-all, be-all. Jobs are not a panacea.

Arjay
Wed, 02/26/2020 - 1:08pm

I'm sorry, but a previous Bridge article stated there were 1.6 million Michigan residents receiving Medicaid who were not affected by the work rules. Then from this article there are 660,000 Michigan residents receiving Medicaid through Healthy Michigan. Not clear if those 660,000 residents are a subset of the 1.6 million, or in addition to the 1.6 million on Medicaid. And of that 660,000, there are 238,000 who are required to work, and of that, 158,000 figured out how to report whatever is necessary to stay on Medicaid. So the Gretch wants to abandon a law for 80,000 who for whatever reason did not do what they were supposed to do. To the remaining 7,000,000 Michigan residents who are not on Medicaid, just continue toiling away every day or dipping into your retirement funds because 80,000 did not want to do even a simple thing like report their status.

Bones
Thu, 02/27/2020 - 10:31am

It's so telling that you have so much disdain and venom for the poor and sick mooching off the public coffers, but you never have a word to say for the ghouls at the top skimming off the majority of the working class' wealth

Arjay
Sun, 03/01/2020 - 10:16am

Sorry, but I’ve worked and saved since I was 14. Now retired with only social security and my savings to support myself. Excuse me if I’m trying to save what I have put aside and not be required to have the government support me. When I support myself, I have a choice just how I will support myself. When the government supports me it is they who decide how I will be supported. And social security, I would have gladly gotten out of it 50 years ago when the gov decided that it would not be used to pay back what people have put in, but rather be used to support the general fund.

Who dat
Thu, 02/27/2020 - 3:10pm

According to michigan.gov there are a total of 2,914,951 total Medicaid recipients as of fiscal year 2019. While I'm not opposed to Medicaid programs the people on here trying to make us sound inhumane or heartless aren't living in reality. I work in the healthcare industry and the amount of fraud is what should be disgusting people

middle of the mit
Fri, 02/28/2020 - 8:17pm

I would like to know who is committing this fraud you speak of. Because the way you are speaking, it seems that you are putting the fraud on the patient. And how does a patient defraud the Government without the help of a medical professional?

From my experience and from news sources, doctors and insurance companies are more liable for any kind of Medicare or Medicaid fraud. Ask Rick Scott!

https://floridapolitics.com/archives/276048-how-much-responsibility-did-...

https://www.politifact.com/factchecks/2014/mar/03/florida-democratic-par...

Rick
Fri, 02/28/2020 - 4:25pm

Ah, the usual hate, envy and fear of 'the other' stirred by the GOP. But none of that for Amazon, Bezos, Walmart and so many thousands of wealthy individuals and huge corporations who pay little or NO taxes? Please don't give me the 'they earned it' stuff - they bought loopholes and huge tax breaks with 'campaign contributions' (legal bribes) that we now pay for big time. We fix the roads for their huge trucks, educate their workers, provide healthcare, etc.

I guess you never realized that Walmart (that destroyed our local stores and businesses that cared for their workers) used Medicaid so they could avoid providing any health insurance for their workers (and kept them 'contractors' and part-time workers on purpose).

Perhaps you forgot the $1.8 billion Governor Snyder gave to our businesses to 'create jobs' (it didn't) that ended up with us getting the bill (for billions) for the roads.

Who Dat
Thu, 02/27/2020 - 3:36pm

According to michigan.gov there are over 2.9 million total Medicaid recipients in fiscal year 2019. I am not opposed to Medicaid and welfare programs for those people that truly need them, but the amount of fraud in the system is what should be disgusting people. I work in the healthcare industry and see it all the time.