Biden administration pulls plug on Medicaid work requirements in Michigan

President Joe Biden's administration this week rescinded a Trump-era waiver allowing Michigan to require some Medicaid recipients to show they are working, looking for work or undergoing training as a condition of keeping their health insurance.

In a letter to the state, the acting head of the Centers for Medicare & Medicaid Services said Tuesday the plan is "infeasible" in light of COVID-19 restrictions that require the state to continue to cover beneficiaries. It also said the agency has "serious concerns about testing policies that create a risk of substantial loss of health care coverage" even after the pandemic ends, questioning whether they promote the program's core mission.

"Early experience with the community engagement requirement in Michigan and other states with similar demonstrations indicates that such a requirement risks rapid coverage loss," wrote Elizabeth Richter, the acting administrator. "Within the short span of the policy’s implementation, 80,000 beneficiaries, or about 1 in 3 of those subject to the community engagement requirement, were at risk of loss of coverage for failing to report."

As a practical matter, the work requirements, which were approved by the state Legislature in early 2018 and granted a waiver under President Donald Trump later that year, were already in limbo. Even though they went into effect in January 2020, a federal judge in Washington, D.C., blocked Michigan moving forward with the program two months later after invalidating a similar plan in Arkansas.

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Michigan's waiver was set to expire at the end of 2023. The Biden administration alerted Michigan and other states in February it was looking at rescinding the waivers to allow work requirements.

Michigan was one of 10 states that had had waivers granted by the Trump administration even though there had been questions from the start whether they would clear court challenges.

Michigan's plan applied only to certain people on the Medicaid expansion coverage plan, otherwise known as Healthy Michigan, which in total covers about 890,000 low-income people in the state. At the time of the judge's ruling, the state said it had sent letters to more than 230,000 people saying they fell under the requirements and as many as 100,000 recipients could lose coverage.

The plan called for requiring certain able-bodied adults between the ages of 19 and 62 with income above the federal poverty level to report at least 80 hours of work or training activities a month. Anyone who failed to report for three months in a 12-month period could lose their coverage until they proved they were in compliance.

The requirement didn't apply to people on traditional Medicaid, people who were pregnant, disabled individuals, caretakers of children under 6 or anyone deemed "medically frail." Critics said it could result in thousands of people losing coverage through no fault of their own, in some cases simply because they might not have the means to report or understand that they had to do so.

Supporters argued that the program was a reasonable way to encourage people to move back into work.

Contact Todd Spangler at tspangler@freepress.com. Follow him on Twitter @tsspangler. Read more on Michigan politics and sign up for our elections newsletter.

This article originally appeared on Detroit Free Press: Biden administration pulls plug on Medicaid work requirements in Michigan

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