Experts: Medicaid work requirement tweaks unlikely to stop many from losing coverage

CDC/ National Center for Emerging and Zoonotic Infectious Diseases

Bipartisan legislation introduced this week would tweak the reporting requirements for Michigan’s controversial Medicaid work requirements law.

Senate Bill 362 is sponsored by state Sen. Curtis Hertel (D-East Lansing), while Senate Bill 363 is sponsored by state Senate Majority Leader Mike Shirkey (R-Clarklake).

Taken together, the bills aim to grant Medicaid recipients more flexibility in reporting the number of hours they’ve worked as a condition of coverage, while also allowing the state Department of Health and Human Services (DHHS) to determine compliance using other data it may already have.

Both bills have bipartisan support and have been referred to the Senate Health Policy and Human Services Committee. That panel is chaired by state Sen. Curt Vanderwall (R-Ludington), a co-sponsor of both bills.

Meanwhile, House Bill 4522, introduced in late April and sponsored by state Rep. Bill Sowerby (D-Clinton Twp.), which only has Democratic co-sponsors, would make a number of technical changes to the state’s Medicaid law.

Gov. Gretchen Whitmer has previously said she planned to work with the Legislature on improving the state’s work requirements law. Her spokesperson did not immediately respond to a request for comment on the proposed changes.

Whitmer tells feds she wants changes to Medicaid work requirements

Adding work requirements as a condition of Medicaid coverage has been a key policy goal for many GOP state legislatures. The federal government approved Michigan’s plan late last year, as the Advance reported.

The addition of work requirements has been opposed by many progressives and policy groups.

Rachel Richards, legislative director for the nonpartisan Michigan League for Public Policy, told the Advance on Friday morning that the tweaks could marginally reduce the number of people who lose health care coverage due to work requirements. But she said the policy, in general, remains damaging.

“It’s a good first step in mitigating some of the harm, but this is just a bad law,” Richards said.

A February report from health care consulting and law firm Manatt Health estimated that as many as 183,000 of Michigan’s more than 650,000 Medicare recipients could lose coverage as a result of work requirements.

DHHS spokesman Bob Wheaton said the state agency does not yet have estimates on how many more people might keep coverage because of the proposed changes, but wrote to the Advance that the bills “would reduce the risk of lost coverage, which would be a positive because that’s one of our goals.”

Charles Gaba
Charles Gaba

It’s unclear how many fewer people might lose coverage as a result of the proposed tweaks. Charles Gaba, a Bloomfield Township.-based health care policy analyst, called the changes a little more than “lipstick on the Medicaid work requirement pig.”

In a blog post Friday morning, Gaba wrote that some of the proposed changes will have positive outcomes for recipients, but doesn’t expect that they will do much to ease the bleeding.

“The bad news is that none of these bills are likely to make more than a small dent in that estimated 183,000 people who are likely to lose coverage,” Gaba wrote.

“This feels very much like nibbling-around-the-edges territory … which is likely the only reason why the Senate bills have GOP support at all.”

Hertel, sponsor of one of the bills, told the Advance on Friday that he believes “health care is a right” and is fundamentally opposed to the idea of work requirements. But he said the legislation could prevent some adverse consequences.

Curtis Hertel | Senate Democrats photo

“These are relatively small changes, but they are a big change in the sense that when you look at what other states experienced, a large number of those that lost coverage are because of these reasons,” Hertel said. “We don’t want to see that same thing happen here in Michigan and it’s good that we can [have bipartisan agreement].”

GOP Senate Majority Leader Shirkey was the original sponsor of the legislation last year that added work requirements to Michigan’s Medicaid program, known as “Healthy Michigan.” A Shirkey spokeswoman did not respond to a request for comment on Friday about why he was open to the changes.

However, Shirkey previously told the Advance that adding work requirements to Healthy Michigan can help people get off the government-provided health care program.

Shirkey talks divided government, touts Medicaid work rules

“It was never intended to be a benefit of perpetuity,” Shirkey said in January. “It was intended to identify and address health-related obstacles prohibiting people from achieving their highest level of personal productivity. It’s a bridge; it’s a gap; it’s a help to get from here to there.”

Richards with the League for Public Policy disagrees.

“Medicaid is a health plan; it’s not a jobs plan,” she said.

Nick Manes
Nick Manes covers West Michigan, business and labor, health care and the safety net. He previously spent six years as a reporter at MiBiz covering commercial real estate, economic development and all manner of public policy at the local and state levels. His byline also has appeared in Route Fifty and The Daily Beast. When not reporting around the state or furiously tweeting, he enjoys spending time with his girlfriend, Krista, biking around his hometown of Grand Rapids and torturing himself rooting for the Detroit Lions.


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