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Michigan Governor Questions Upcoming Medicaid Work Requirements

April 29, 2019

Recently elected Michigan Governor Gretchen Whitmer wrote a letter to Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma claiming reporting requirements under the state’s Medicaid work rule could “take away health insurance from pe

In December 2018, CMS approved Michigan’s Medicaid work requirement waiver requiring able-bodied people with up to 133 percent of the federal poverty level in annual income to work in order to receive their benefits. In 2018, Michigan legislators approved a bill directing the waiver application, and shortly after, then-Governor Rick Snyder signed Public Act (P.A.) 208. The work requirement is scheduled to go into effect on January 1, 2020.

In her letter dated February 8, Whitmer claims P.A. 208 is more stringent than the waiver granted in Arkansas, where 18,000 individuals were removed from the Medicaid rolls in the first year. Whitmer called Michigan’s pending work reporting requirements “onerous” and said the law provides no resources for “job training, job search, or job supports.”

Whitmer concluded her letter by stating she will be working with state legislators to make changes to the Healthy Michigan Plan and while “new policies could change our requests from CMS,” Michigan accepts the terms of the waiver. Whitmer also wrote “technical corrections” may be forthcoming.

Work Requirements Under Fire

Medicaid work requirements are under attack in other states, too. Arkansas was the first state to require recipients to work to receive Medicaid benefits. Media coverage has focused on anecdotal reports of individuals not understanding reporting requirements or of having difficulty reporting their employment.

In June 2018, U.S. District Judge James Boasberg halted Kentucky’s Medicaid work requirement. Boasberg stated although Health and Human Services Secretary Alex Azar “is afforded significant deference in his approval of pilot projects like Kentucky’s, his discretion does not insulate him entirely from judicial review.” Boasberg ruled Azar failed to consider the adverse effects of the waiver on Kentucky’s low-income population.

Path to Prosperity

Doug Badger, a senior policy advisor at the Galen Institute, says Medicaid work requirements guide people toward self-sufficiency.

“A study by The Heartland Institute found that men who comply with Medicaid work requirements can expect to earn $300,000 more over a lifetime than those who don't,” Badger said. “Those whose earnings trajectories follow established patterns will see lifetime earnings rise by more than $1 million, compared with those who spend their productive years on Medicaid and don't work.”

Badger says work requirements provide an equally important benefit to taxpayers.

“This could lessen the costs paid by Michigan taxpayers, as many jobs offer health care benefits,” Badger said.

“The Michigan waiver holds the potential for lifting residents out of poverty,” Badger said. “The governor and legislature should give the waiver a chance to work, rather than assume the worst about the program and Medicaid recipients.”


Andrew Whitney ( writes from Lansing, Michigan.