UPDATE: Michigan: "God's Safety Net" Medicaid work requirement bill passes; will Snyder veto?

2018 MIDTERM ELECTION

Time: D H M S

UPDATE 4:30pm: (sigh) As I expected, the stripped-down version of SB897 passed the state House

SB 897, to impose Medicaid work requirements, passed the House 62-47. #mileg

— Lindsay VanHulle (@LindsayVanHulle) June 6, 2018

The revised version of the bill still has to be kicked back over to the state Senate for a final vote, but that's almost certain to pass, so the only thing stopping it at this point is the possibility of Gov. Rick Snyder vetoing it, which is what I figured it would come down to in the the first place.

UPDATE 6/11/18: So much for that prospect:

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.

As far as I know he hasn't actually signed it as of this morning, but it sounds like it's likely a done deal, I'm afraid.

Original post below.

UPDATE x2: WHOA. It appears that while the final bill as passed is less awful in some ways (from 29 hours/week to 20, no more racist exemptions), it's worse in other ways. I touched on one of them below but it appears to be worse than I thought...

It also adds a harmful new provision raising premiums on beneficiaries with incomes above the poverty line (about $1,000 a month for an individual) — mostly working people in jobs that don’t offer health coverage.  They now pay a monthly premium of 2 percent of their income, which is in line with what people with similar incomes pay for coverage in the ACA’s marketplaces in states that haven’t expanded Medicaid.  The bill would more than double these premiums to 5 percent of income, or about $50 per month, for people who’ve had Medicaid coverage for more than 48 months — that is, to a level that’s likely unaffordable for many of these individuals.  No state has been allowed to charge Medicaid beneficiaries premiums at that level.

In addition, I completely missed this part:

Not only that, the new bill puts Michigan’s entire Medicaid expansion under the Affordable Care Act (ACA) — covering 670,000 people — at risk.  That’s because Michigan would be required to end its expansion if the federal Centers for Medicare & Medicaid Services (CMS) doesn’t approve an additional waiver that raises premiums on some Medicaid beneficiaries.

Yup. It's possible that all 670,000+ Michiganders who are currently enrolled in Healthy Michigan could be kicked off altogether if CMS Administrator Seema Verma decides to give the revised version the thumbs down. Lovely.


In spite of the protest from practically every healthcare advocate and public health expert in Michigan and nationally, it looks like Republicans in the Michigan state legislature are hell bent on pushing through their Medicaid work requirement bill (which bill sponsor Sen. Mike Shirkey justified by stating that "the best safety net ever invented by God is family").

As I noted a few weeks ago, ever since the outcry over the blatantly racist "rural white people are exempt, urban black people aren't!" provision, the MI GOP has gradually stripped down some of the more glaring provisions of the bill...and as of a week or so ago it looked like they had come up with a modified version of the bill which everyone with an "R" next to their names agreed was doable:

Shirkey confirmed that the 29-hour job requirement in the Senate bill has been pared back to 20 to which he says, "I was hoping Michigan could take a leadership position and set a new standard for that." But rather than jeopardize the entire package, he compromised.

Well, sure enough, it looks like the fix (so to speak) is finally in. Via MIRS News:

The Medicaid work requirement bill was changed today in a House committee to impact only able-bodied Healthy Michigan recipients who are between 19 and 62 years of age.

I didn't even realize that the prior version of the bill would apply to non-exansion enrollees as well, so I guess that's an improvement. Plus, they knocked 2 years off the age range, so that's about 4% fewer people subjected to this nonsense, anyway... 

...Healthy Michigan recipients must work 80 hours a month -- as opposed to 29 hours a week -- after being on the expanded Medicaid program 48 months. If these recipients don't get a job or go through a job training programming, they would need to give 5 percent of their income and engage in healthy behavior to stay in the program.

Knocking it down from 29 to 20 hours at the very least resolves the mathematical Catch-22 I noted awhile back. On the other hand, being charged 5% of your household income for Medicaid makes no sense whatsoever, seeing how those earning 100-138% of the Federal Poverty Level in non-expansion states only have to pay about 2-3% for a 94% Actuarial Value ACA exchange plan as it is.

...Healthy Michigan recipients who are chronically misrepresenting the facts in their monthly reports will lose their coverage for one year. The Department of Health and Human Services would receive an extra $5 million under the bill for the additional personal auditors needed to track these recipients.

Hey, look at that--the Michigan Republican Party is now in favor of Big Government Jobs Programs! Who'da thunkit? Maybe they'll hire 300 Healthy Michigan enrollees as auditors at $16,000/year apiece (so they'll stay below the 138% FPL cut-off level!) to keep an eye on the other enrollees? (That's sarcasm, by the way...)

Anyway, as I expected...

SB 0897 was reported out of the House Appropriations Committee 17-10 with all Republicans voting yes except Rep. Jeff YAROCH (R-Richmond), who passed. All Democrats voted no. The bill is on the House calendar for possible passage later this afternoon.

Yup. This stupid bill could be on its way to the Governor's desk by 5pm.