Lansing — Republican Gov. Rick Snyder on Thursday endorsed an 80-hour-per-month work requirement for some Medicaid recipients, signaling his intent to sign a measure headed to his desk despite veto requests from opponents.
More than a half-million able-bodied adults on the Healthy Michigan expanded Medicaid plan would be required to work an average of 20 hours per week or risk losing coverage under the plan that won final approval in the state Senate.
GOP legislators have championed the plan as an economic stimulus that will help employers struggling to find workers to fill open jobs. Democrats decried it as an attempt to strip away health insurance from low-income residents.
Snyder criticized earlier drafts of the legislation but said the final version negotiated with Sen. Mike Shirkey, R-Clarklake, is a framework that “ensures the continuation and sustainability of the Healthy Michigan program.”
The Senate on Thursday signed off on House changes in a 25-11 vote, with opposition from all Democrats and GOP Sens. Margaret O’Brien of Portage and Tory Rocca of Sterling Heights.
Democrats bashed the bill prior to the vote, arguing that Medicaid is not a work program and should not function as one.
The proposal “amounts to a twisted social experiment that will rob thousands of Michiganders of basic health care,” said Sen. Steve Bieda, D-Warren.
As of Monday, 662,913 residents were enrolled in Healthy Michigan, an insurance program available to residents in households with earnings between 100 percent and 133 percent of the federal poverty level, which is about $33,000 a year for a family of four.
The new work rules would apply to an estimated 540,000 able-bodied adults, according to the nonpartisan House Fiscal Agency, which projects about five to 10 percent of recipients would drop out or leave the program.
Shirkey has said the legislation is not designed to save the state money, but the fiscal analysis indicated it would result in net savings of between $7 million and $22 million.
The Senate in April approved a version of the legislation that would have applied the work rules to the state’s entire Medicaid population rather than just Healthy Michigan. It also included an exemption for rural counties that critics called racist but was stripped from the bill prior to a Wednesday vote in the House.
The final version of the legislation is “a shiny turd, but still a turd,” said Sen. Coleman Young II, D-Detroit, calling the proposal “a twisted joke.”
Under the revised plan, Healthy Michigan recipients would be required to self-report “work engagement activities,” which could include a job, education, vocational training, community service or unpaid internships.
“I don’t think there’s any problem when you’re receiving free health care for the government to say you gotta do a little bit of work to receive that,” said Sen. Joe Hune, R-Fowlerville. “I think it’s the right thing to do. It’s what this country was built on. Let’s pull up our bootstraps and get to work.”
U.S. Rep. Sandy Levin, D-Royal Oak, is among those urging Snyder to veto the bill, saying it “puts at risk the entire Healthy Michigan program.”
The proposal includes a new “trigger” that would end the expanded Medicaid program if Michigan is unable to secure a required federal waiver within one year of submission. The state would give recipients a four-month warning before ending their health coverage.
GOP President Donald Trump’s administration opened the door to Medicaid work requirements last year, and several states have filed for waivers. Michigan would also need federal approval to tighten a four-year coverage limit for Healthy Michigan recipients, who would need to pay a 5 percent premium and complete healthy behaviors to stay on the plan.
“I strongly urge Gov. Snyder to reject this misguided effort to turn back the tremendous progress we have made in dramatically reducing the number of Michiganders without health insurance — a concern that he also has expressed in the past,” Levin said in a statement.
Under the legislation, Medicaid recipients would lose coverage for a month if they fail to meet work or training requirements for more than three months in a 12-month period. The bill also suspends health care coverage for a year when Medicaid recipients cheat or purposefully misrepresent their work, education or training efforts.
Snyder pushed Michigan legislators in 2013 to accept federal funding to expand Medicaid eligibility under the Affordable Care Act. The term-limited Republican governor touts the resulting Healthy Michigan program as one of his flagship accomplishments.
“Healthy Michigan has been integral to improving the health of Michiganders,” Snyder said in a statement. The reform legislation will ensure the continuation and sustainability of a program that has “has saved lives, improved lifestyles and reduced overall costs for the entire health care system as well as for taxpayers.”
The Michigan League for Public Policy and other groups that advocate for low-income residents, the disabled and children also urged Snyder to veto the measure.
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