Michigan Passes Medicaid Work Requirements Bill

On Friday, June 20, 2018, Governor Snyder signed the Medicaid work requirements bill.

The final bill applies to the Healthy Michigan expansion population–Michiganders who are between 100-138% of the federal poverty limit, about 670,000 people in the state.

The bill requires those who do not qualify for an exemption to work, train, and attend school for 80 hours a month to receive benefits. It is important to remember that not all Medicaid recipients will be subject to the work requirements. If you receive traditional Medicaid due to disability or income below 100% of the federal poverty limit, you will see no change.

The bill also includes exemptions for disability caretakers, parents of children under six, pregnant women, people receiving disability benefits, and those who are medically frail, which includes patients diagnosed with hemophilia, VWD, and other factor deficiencies.

A few caveats…

• The passage of this legislation does not immediately change Medicaid. The work requirements legislation requires the Michigan Department of Health and Human Services to apply for an 1115 waiver that will allow the state to make the intended changes. (Medicaid is a joint state and federal program, so Michigan must get approval from the federal government–the Centers for Medicaid and Medicare–for changes to the program.) If the federal government approves the waiver, Michigan will begin to implement changes to the Medicaid program.
• There is language in the bill that would end the expansion altogether if the federal government does not approve the waiver within one year.
• After patients are on Healthy Michigan for four years, their premiums will be increased from 2-5% of their income.

On July 9, Michigan released a Section 1115 Demonstration Extension Application for the Healthy Michigan Plan. However, the state failed to adhere to federal rules for the comment period by not including an estimate of expenditures. HFM and the Hemophilia Federation of America signed on to a letter requesting that the comment period be reopened for 30 days.

HFM is monitoring the waiver’s process and will keep the community informed.