Have Medicaid? New Michigan bill may force you to work

LANSING — Familiar fault lines formed Wednesday when the Senate’s Michigan Competitiveness Committee voted to require many Medicaid recipients to work.

Republicans aligned with the business community in supporting the bill, which passed on a 4-1 vote, while Democrats and social service groups roundly criticized the bill as both onerous for the state Health Department and punitive against a vulnerable population in the state.

The full Senate is expected to fast track the bill and take it up for a vote on Thursday.

The bill would require able-bodied adults who receive Medicaid health care coverage to either work at least 29 hours a week or be enrolled in a job training or education program. They would have to report their family income monthly to the state and within 10 days if there are any changes to that income.

There are exemptions for an individual who is the sole caretaker of a family member under age 6 or a family member who is disabled, pregnant, receiving long-term disability benefits, a full-time student or a person undergoing substance abuse treatment.

“Let’s not lose the fact that there is dignity in work. I remember back when there were very strong reforms with welfare and protesters were saying it was going to be the end of the world. Whenever we hear that over-the-top screaming and yelling, it never seems to come to fruition,” said Pete Lund, executive director of the Michigan chapter of Americans for Prosperity. “These are very reasonable requirements.”

But Claire Maitre, a 62-year-old Scio Township woman who helps take care of her two grandsons while her son and daughter-in-law work, said the work requirements would affect her Medicaid coverage.

“I can’t help my son and daughter-in-law in paying off their debt with money, but I can help keep their child-care costs at a minimum,” she said. “I am on government assistance for health care coverage. But if I have to choose between a paying job, instead of grandsons, I’d choose to go without health insurance. This will leave many children in unsafe conditions and rob them of their caregivers.”

State Sen. Mike Shirkey, R-Clarklake, was not particularly sympathetic to Maitre’s situation.

“The best safety net ever invented by God is family. I’m not sure that government is supposed to supplement that process,” he said. “I think the fact that she’s available to do so is awesome, but I don’t think those kinds of exemptions would qualify. The safety net by definition has a few holes in it.”

The Michigan Chamber of Commerce testified on the bill last month, saying it was crucial to reform the Medicaid expansion, also known as the Healthy Michigan program

“Healthy Michigan was a program that would be clearly targeted to low-income employees or the working poor,” said Rich Studley, president of the chamber. “The program is out of control, it’s over-enrolled, it’s underfunded. Employer support for this program will collapse if you don’t take advantage to strengthen and improve the program.”

Gilda Jacobs, executive director of the Michigan League for Public Policy, noted the organization’s research shows a majority of Medicaid recipients who can work are working.

“This will increase an undue burden on business and be a significant financial cost to the state,” she said, noting the cost to police the work schedules of thousands of low-income Michiganders. “And this harms families who are already on the edge.”

The movement toward requiring work for Medicaid coverage is growing across the nation with three states already requiring work for benefits and the administration of President Donald Trump reviewing requests from seven other states. The administration told Medicaid administrators earlier this year that it would support such requests and Trump signed an executive order last week asking for work requirements for recipients of federal benefits, such as food stamps and Medicaid.

In Michigan, the work requirements would affect about 300,000 people, Shirkey said. But he also said he expects the bill to change before it receives a final vote.

“The inferences that the sky is falling are a bit overplayed,” he said. “But anyone who expects (the work requirement hours) to stay at 29 is delusional, including me. I think there is room to move.”

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That was good news for Sen. Rebekah Warren, D-Ann Arbor, who voted against the bill in committee but hopes it will get tweaked before a vote in the full Senate, which has a 27-11 Republican majority.

“I understand the math — that not only this committee but the full Senate will be passing some version of Medicaid work requirements,” she said. “But the 29-hour work requirement is still unreasonable and grossly exceeds the 20-hours a week requirement in the SNAP (food stamps) program. Should a single mother working 28 hours a week be penalized because that’s all the hours her employer will give her or perhaps all the time she has in order to work her child care needs?”

In Washington D.C., U.S. Reps. Dan Kildee, D-Flint, Sander Levin, D-Royal Oak, Debbie Dingell, D-Dearborn, and Brenda Lawrence, D-Southfield, wrote a letter to Gov. Rick Snyder to proceed with great caution on any action that would change the requirements for Medicaid recipients.

"We urge any consideration of the measure be postponed until the state is able to conduct the analysis needed to provide a comprehensive assessment of how many Michiganders might lose health coverage under such a proposal," the letter stated.

They noted that a University of Michigan study showed that of those receiving expanded Medicaid benefits, 60% were either already working or unable to work.

"Among enrollees not currently working, 80 percent had a chronic physical or mental health condition," the letter said. "Cutting off health coverage for struggling people will undercut the historic gains our state has made in covering the uninsured through the bipartisan Medicaid expansion."

The Healthy Michigan program was narrowly passed by the Legislature in 2013 and has since enrolled more than 670,000 low income Michiganders who can now receive health care coverage.

The bill — SB 897 — now moves to the full Senate for consideration.

Contact Kathleen Gray: 313-223-4430, kgray99@freepress.com or on Twitter @michpoligal.