Medicaid Work Requirement Bill Headed to Governor’s Desk
Posted on June 08, 2018
The Michigan Legislature on June 7 fast-tracked the approval of a revised version of Senate Bill (SB) 897, which would require able-bodied individuals between 19 and 62 years of age to work an average of 80 hours per month to continue qualifying for healthcare coverage under Medicaid expansion. SB 897 passed the House by a 62-47 margin, with all Democrats in the chamber and one Republican voting no. The vote followed the release of changes to the original bill, which were the result of closed-door negotiations between Gov. Rick Snyder and the bill’s sponsor, Sen. Mike Shirkey (R-Clarklake).
Upon its introduction, the MHA expressed its opposition to the legislation and advocated against many provisions in the bill. The MHA’s advocacy efforts included a meeting with Snyder and several members of the MHA Board of Trustees to discuss the hospital community’s concerns with SB 897 as introduced. Many of the concerns have been addressed in the final version of the bill.
The final bill contains several changes compared to the version that was originally introduced and approved by the Senate. A few of them are highlighted below:
- The work requirement is imposed on only Healthy Michigan Plan enrollees. The previous version of the bill applied to the entire Medicaid population.
- The required average number of hours of work a month was reduced from 116 to 80. Monthly, online reporting is required.
- The bill now includes a three-month-per-year exemption to the work requirement for any reason, aimed at assisting seasonal workers and individuals who might find themselves without work for an extended period.
- A new provision allowing community service to qualify as satisfying the work requirement for up to three months per year was added to the final version of the bill. The previous version of the bill did not allow community service to qualify.
- The current version reduces the penalty for simple noncompliance from one year to one month, as long as the individual meets compliance guidelines.
- The bill now adds a premium of 5 percent of annual income for individuals who are enrolled in the Healthy Michigan Plan for more than 48 months.
While the final version of SB 897 is less stringent than work requirement provisions adopted in other states and represents a significant improvement over its predecessor, the MHA and other health advocacy groups remain philosophically opposed to tying healthcare access to workforce development.
Under the first decade of the federal Affordable Care Act, Michigan hospitals will dedicate $7 billion to expand healthcare coverage, including the coverage currently available to more than 662,000 state residents under the Healthy Michigan Plan. This effort has been recognized nationally for its success, particularly regarding the inclusion of personal responsibility requirements, such as health risk assessments, copays and premiums. Michigan hospitals have also played a critical role in connecting those without healthcare coverage to health insurance options that best meet their personal and financial needs. That coverage and investment are now at risk for nonhealthcare reasons.
The MHA issued a media statement following the Legislature’s approval of the bill. The measure will now go to the governor for signature, which is expected. Once the governor signs the bill, the state will begin work on applying for final approval through the federal Centers for Medicare & Medicaid Services. If the waiver is approved, the work requirements would be slated to begin Jan. 1, 2020. Members with questions should contact Chris Mitchell at the MHA.
Posted in: Issues in Healthcare, Top Issues - Healthcare