Michigan Senate: Many Medicaid recipients must work 29 hours a week

LANSING – The debate ranged from experiencing the “joys of work” to a more spiritual take about helping the “least of these,” but in the end, work prevailed and the full Senate passed legislation Thursday that would require many recipients of Medicaid to be gainfully employed for at least 29 hours a week.

Sen. Mike Shirkey, R-Clarklake, said the work requirements were an essential element of keeping viable the Healthy Michigan program, which has 680,000 low-income Michiganders enrolled in an expansion of Medicaid.

“And those who are opposed to this legislation that encourages and enables someone on Medicaid to go find work or get degrees and still remain eligible for Medicaid are looking for reasons to prevent people from enjoying the joys of work,” he said in a speech right before the Senate voted 26-11 to approve the bill.

But Democrats said the legislation was both unneeded and immoral. The Kaiser Family Foundation has found that 60% of Medicaid recipients are already working.

“This is an insult to the working poor, who often work multiple jobs and still can’t make ends meet. They work a lot harder than a lot of people in this chamber,” said Sen. Curtis Hertel, D-East Lansing. “Basically, the working poor have become a giant social engineering experiment for Republicans. Let’s drug test them for benefits. … Just find the secret sauce. Just embarrass them enough so that they’ll find a way to choose not to be poor.”

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Michigan has about 2.4 million people who get health care coverage through Medicaid. A majority are elderly, disabled or children, but in 2013, the Legislature passed a law to expand Medicaid to low-income Michiganders and 680,000 people signed up. Shirkey estimated that about 300,000 of the Medicaid recipients will have to comply with the 29-hour-a-week work requirement.

“There is a likelihood that it will change. It’s the most stringent (work requirement) of any state that has applied so far,” Shirkey said. “The governor is uncomfortable with the 29.”

Indeed, the Healthy Michigan program was one of Gov. Rick Snyder's signature achievements and he doesn't want to jeopardize the success of the program that has allowed tens of thousandsto get heath care coverage.

"Despite our efforts to work with Sen. Shirkey, this version of the bill is neither a reasonable nor responsible change to the state’s social safety net," said Ari Adler, spokesman for Snyder. "We should not jeopardize the success of Healthy Michigan, which has helped hundreds of thousands of Michiganders who no longer have to choose between taking care of their health or paying their bills. Gov. Snyder will continue to collaborate with his legislative partners to see if this legislation can be improved before it comes to his desk for consideration.”

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.

The business community applauded the passage, saying it will help fill thousands of vacant jobs across the state. Charlie Owens, Michigan director of the National Federation of Independent Businesses, said 89% of small business owners in the state are having a hard time filling jobs and that 19% of those businesses plan to raise wages in response to the tight labor market.

"A robust economy and record job openings provide an unprecedented opportunity to encourage our able-bodied Medicaid population to join the workforce and become an active participant in moving themselves and Michigan forward," he said.

Democrats tried to amend the bill to reduce the work requirement to 20 hours, exempt veterans from the requirement, give an exemption for seasonal employees, increase the age to 13 — instead of 6 — for the children who are being cared for by a parent, provide a temporary exemption for a woman who experiences a miscarriage, and make legislators lose their health care coverage during the many multi-week breaks they take during the year. All the amendments failed.

The work requirement “is still unreasonable for a number of people. When you think about this population, many are very low-wage jobs,” said Sen. Rebekah Warren, D-Ann Arbor. “They may get 30 hours one week and 20 hours or less the next.”

Citing a Senate Fiscal Agency analysis of the bill that predicted the cost to the state to implement and police the program would be up to $30 million, Warren also offered an amendment that would require a cost benefit analysis of the change. But that also failed.

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.

Gilda Jacobs, executive director of the Michigan League for Public Policy, said other states have encountered burgeoning costs, not only from administering the work requirements, but from increased health care costs for people who lose their coverage and become too ill to work.

"Evidence shows that Medicaid is keeping people healthy and able to work, not enabling residents to avoid it," she said.

The bill — SB 897 — now moves to the House for consideration, where Speaker of the House Tom Leonard, R-Dewitt, said Thursday that he supports the concept of work requirements for Medicaid recipients.

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