Government and Health Care

Court ruling puts Medicaid work requirements in peril

Judge calls similar laws in other states 'arbitrary and capricious.'

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A U.S. district judge’s ruling that work requirements for Medicaid recipients should not have been approved in Kentucky and Arkansas could lead to a similar ruling in Michigan, according to critics of the requirements lawmakers approved last year.

Judge James Boasberg in Washington, D.C., recently ruled work requirements to receive Medicaid in Kentucky and Arkansas are “arbitrary and capricious.” That also may affect states with similar laws, according to Families USA, a nonprofit health care organization.

Michigan is one of those. Republican lawmakers pursued work requirements for Medicaid recipients enrolled in the Healthy Michigan Plan last year, said Alex Rossman, the communications director for the Michigan League for Public Policy. They take effect next year.

Sen. Mike Shirkey, R-Clarklake, sponsored the bill that added the work requirements after President Donald Trump gave the OK for states to do so in 2017, said Rossman, whose agency opposed them.

“Michigan has very similar laws to those in Kentucky and Arkansas since we followed through with passing these laws so soon after,” Rossman said. “A lot of the reasons that the judge decided work requirements shouldn’t be there applies to Michigan, as well.”

The Healthy Michigan Plan expanded Medicaid health care coverage to another 600,000 people whose income would be too high to receive federal Medicaid, said Bob Wheaton, a public information officer for the Michigan Department of Health and Human Services.

“There was a study done by Manatt Health that said the work requirements will reduce the number of recipients of Medicaid in Michigan by 61,000 to 183,000 people,” Wheaton said. “We see the value of promoting work, but we also hope to preserve Medicaid for those receiving it.”

Gov. Gretchen Whitmer asked the federal Centers for Medicare and Medicaid, which approved the work requirements, to work with the Legislature to improve the law, Wheaton said.

“Originally, Michigan Republican lawmakers wanted to add work requirements to all Medicaid beneficiaries, but they settled for Medicaid recipients through the Healthy Michigan Plan,” Rossman said. “And although the ruling doesn’t directly affect Michigan, it’s telling states that work requirements are not being seen as legal.”

The Michigan Center for Civil Justice is interested in pursuing legal action if there isn’t a similar ruling against the law’s approval in Michigan, said Mario Azzi, the center’s public benefits attorney.

“We hope this will get Michigan a similar ruling or persuades legislators to amend the law,” he said. “But it’s very possible this could do nothing at all.”

Supporters of the work requirements include the Michigan Chamber of Commerce that last year described Healthy Michigan as overenrolled and underfunded.

The Michigan chapter of the National Federation of Independent Businesses also supports the law, said Amanda Fisher, assistant state director for the National Federation of Independent Businesses in Michigan.

Healthy Michigan Plan recipients must report 80 hours a month of “qualifying work activities.” Qualifying work requirements include employment, self-employment, unpaid workforce engagements like internships, and job and vocational training.

Michigan officials are “concerned about the potential for people to lose health care not because they won’t work but because of bureaucratic work reporting requirements,” Wheaton said.

Michigan’s work requirements are slated to take effect in January 2020.

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