This column originally appeared in the Alpena News
Medicaid is not a jobs plan.
You probably know that. It’s a plan designed to provide access to health care for people who are struggling. And, although it isn’t perfect, it’s a pretty good health plan, covering more than 2.5 million Michiganders. It plays an especially important role in rural America, where one in four adults uses Medicaid for health care.
Despite the fact that Medicaid expansion has done such good things for rural Michiganders and others, the state Legislature voted last summer to impose work requirements on enrollees in the Healthy Michigan Plan — the state’s Medicaid expansion plan.
Despite the fact that the majority of people on the plan who are able to work already do so. Despite the fact that getting a job won’t magically make someone healthy. Despite the fact that there are no provisions in place to help people find child care, transportation, job training or other resources necessary to find work, because — as mentioned–Medicaid is not a jobs plan.
Oh. And it’s going to cost the state millions of dollars to oversee the work requirement policy.
Former Gov. Rick Snyder signed off, and the Trump administration approved the state’s request for a waiver in December. That means the health care of 650,000 Michiganders on Healthy Michigan could be threatened. And our state is now part of an experiment that is failing miserably around the nation.
Let’s look at Arkansas, for example. It was the first state to enact a work-requirement policy for Medicaid.
Arkansas’ work-requirement policy was approved by the Trump administration in March and continues to be slowly rolled out to Medicaid beneficiaries. If the experience in Arkansas is what could happen in Michigan (or any other state set on rolling back health care coverage), both the federal government and those states should seriously reconsider this policy. The logistical issues alone are putting people’s health at risk.
Some employers don’t schedule enough hours for beneficiaries to meet the work requirement. Complicated systems are making it difficult for people to report hours they have worked. Exemptions are difficult to report. Arkansas’ website reporting system shuts down daily at 9 p.m. (seriously, websites shut down?). Workers are losing their jobs because they are sick and can’t get the medication they need. People are returning to the emergency room as their primary source of care. And the list goes on.
Lawmakers, I hate to say we told you so, but we did. For a year, we’ve been warning Michigan officials that Medicaid work requirements won’t work because of those very issues. And, unfortunately, the cost of the bad policy in Arkansas has been over 17,000 residents losing health care coverage (so far).
Let’s make sure Michigan doesn’t make the same mistakes.
There are some inherent problems with the way Arkansas, dead-set on being the first state, rolled out their policy. Advocates have stressed the problems with communications and complicated computer systems. Michigan’s recently approved plan is not slated to start until Jan. 1, 2020, hopefully giving the state Department of Health and Human Services ample time to communicate with beneficiaries and to develop the necessary systems.
Don’t get me wrong, the Michigan League for Public Policy will continue to be vocal opponents to the Healthy Michigan Plan work requirements. But we also have to make sure that now that the requirements are approved and will be put in place, we do whatever we can to lessen the blow for people. And one way we can do this is to ensure that the state has ample funding for child care, job-training programs and transportation. We also encourage the Department of Health and Human Services to make the work requirements process as easy to comply with as possible and that Healthy Michigan Plan enrollees are well aware of these new requirements
Michigan is often in the news for some not-so-great things (can you say lame duck?), so let’s make sure that we don’t become the next Arkansas and limit the adverse impacts of work requirements as much as possible.