A healthier Michigan without red tape

A version of this column originally appeared in The Alpena News.

Michigan has a critical opportunity to protect the health of our residents by repealing Medicaid work reporting requirements.

These requirements were enacted in 2018 and declared unlawful in 2020, but are still on the books and pose a threat to healthcare access. By repealing the language around work requirements, we can protect the Healthy Michigan Plan (HMP) from shifts that might jeopardize coverage for millions. It’s a chance to prioritize health and well-being over unnecessary red tape.

This effort underscores an important truth: Medicaid is a health insurance program, not a jobs program.

At its heart, Medicaid exists to provide health insurance to people and families with low incomes. The Healthy Michigan Plan exemplifies this mission, offering affordable health coverage to Michiganders ages 19-64 with incomes below 138% of the Federal Poverty Level. For context, that’s about $21,000 annually for a single person or $43,000 for a family of four. 

More than 82% of HMP enrollees live below the poverty line, underscoring the program’s crucial role in supporting Michigan’s most vulnerable populations. That’s why this program is so essential—it supports communities in Michigan that are most in need. Leaving outdated work requirements on the books puts all of this at risk, potentially causing families to lose vital healthcare coverage.

Leaving work requirements in statute jeopardizes the health and financial security of thousands of Michiganders. If reactivated, they’d create confusing rules and bureaucratic hurdles that could strip many people of their coverage. Arkansas provides a cautionary tale: when it implemented similar policies in 2018, over 18,000 beneficiaries—nearly a quarter of those subject to the rules—lost their coverage within seven months. Many were disqualified due to administrative hurdles, not because they failed to meet work standards.

Michigan’s own estimates show that—had work requirements taken effect—approximately 80,000 residents would have lost coverage. Beyond the human cost, the state has already spent $28 million on preparations for these requirements, and additional expenses would have been required if the requirements were actually implemented. These funds could have been better directed toward initiatives that genuinely support health and employment.

The idea behind work requirements is flawed: that taking away benefits will somehow “motivate” people to secure employment. But real life is much more complicated. Most Medicaid enrollees are already working or are in school. Others face challenges like limited job opportunities in rural areas, unreliable transportation or a lack of affordable childcare.

More than 700,000 Michiganders rely on the Healthy Michigan Plan for healthcare. Over 17% of covered individuals are young adults between the ages of 19 and 24, who often have low-wage jobs with inconsistent schedules—leading to high poverty rates—and a lack of access to other health insurance.

The Healthy Michigan Plan has been a game-changer for our state. Between 2013 and 2016, Michigan’s uninsured rate for people under 65 was cut in half. Medicaid expansion improved access to care, helped detect serious health issues earlier and made it easier for people to manage chronic conditions. It also reduced medical debt and financial stress for countless families.

And the benefits go beyond health. Stable healthcare coverage gives people the security they need to focus on finding and keeping jobs, helping them build better lives for themselves and their families. In short, Medicaid expansion is not just a safety net—it’s a foundation for a stronger, healthier Michigan.

Let us seize this moment to prioritize people over paperwork and health over bureaucracy. Access to healthcare should never depend on navigating a maze of reporting requirements—it is a fundamental right that underpins the well-being of individuals and the strength of our state.