Confused About Michigan’s New Medicaid Work Requirement? Read This
People covered by the Healthy Michigan Plan need to pay attention now, or they could lose coverage later.
Right now, more than 650,000 people across Michigan are having a strange moment with their health insurance.
Some of them could lose their health coverage if they don’t take certain steps, starting soon. They may be confused about what those steps are.
Other Michiganders may be worried that they could lose their coverage too. But their coverage is actually safe, or they just have to take a single step to keep it.
And everything could change, depending on what happens in a courtroom in Washington, D.C.
What’s going on and who does it affect?
With the dawn of the new year, a new law went into effect in Michigan. It affects many people who get their health insurance through the Healthy Michigan Plan. That’s Michigan’s name for its expanded Medicaid program.
Since 2014, this program has provided health insurance to hundreds of thousands of people with low incomes who don’t get coverage from any other source.
The new law is sometimes called a “work requirement” for short. It says that many people with Healthy Michigan Plan coverage must tell the state every month whether they’re working or doing something else with their time to meet the law’s requirements.
If they don’t report their activity for three months, they can lose their coverage. This could happen as early as June of this year.
Their first report has to cover what they did this month -- January 2020. The reporting period starts on January 25 and the deadline to report is at the end of February.
Not everyone can work, of course.
So the law makes exceptions for some people, including people over age 62, and people with serious health conditions, a disability or caregiving responsibilities.
They don’t have to report their work or other activities – but they may have to tell the state about their situation, and even send in a letter from a doctor.
Why is this a confusing time?
The law went into effect on January 1, so it’s now in effect. But a lawsuit is trying to stop it.
A court in Washington, D.C. has been asked to rule on Michigan’s law. Meanwhile, there’s another court case about Medicaid work requirements in other states; it may go as far as the Supreme Court.
Until there’s a ruling, or a court orders the state to pause, the law is in effect in Michigan.
“It’s an incredibly confusing time for consumers in Michigan, because every other state with a Medicaid work requirement either is enjoined from implementing the work requirements or has put a hold on it until the courts have spoken,” says Marianne Udow-Phillips, director of the Center for Health and Research Transformation, a nonprofit health policy organization based at the University of Michigan.
Though the Governor wanted to pause the work requirements in Michigan, the legislature didn’t agree. “However it appears that the state department in charge of the program is doing everything it can to make it easy for people to comply,” she says.
What kinds of work or other activities count?
There’s actually a broad range of activities that people with Healthy Michigan Plan coverage can do to meet the requirement and keep their coverage.
- working at least 80 hours a month (an average of 20 hours a week) for pay, or in exchange for things such as food and lodging
- going to school in person or online
- looking for a job
- getting job related training
- getting treated for a problem with drugs or alcohol
- volunteering at a nonprofit organization (though they can only use this for three months)
- doing unpaid job-related work to help them in a future job
Whatever they do, they must report it to the state every month, starting in February, or risk losing their coverage. The reporting period is special for this month. After that, people can start reporting on the 11th of the month, and can do it any time until the end of the next month.
People who have to report can sign up to get phone calls or texts to remind them to do it.
Very low-income people who get food assistance or monthly payments from the state already have to report these kinds of activities; they don’t have to report again for their Healthy Michigan Plan coverage.
The state sent out letters in December to everyone it believes will need to report. They looked like this.
What about people who can’t work or do these other things?
There are some people who qualify for an exemption to work requirements. They don’t have to report work or other activity to keep their coverage.
The state sent letters last fall to people that it knows are exempt for health or age reasons, so they know they won’t have to report work hours or other activities.
But other people who think they should be exempt because of their own health, or the health of someone they care for, must tell the state why using this form. They may be asked to provide a doctor’s order.
Exempt people include those who have a disability or a medical condition that makes them “medically frail”, as well as people whose mental or physical problems make it hard for them to do basic daily activities, or who have complicated health problems.
People who are taking care of young children under age 6 can also get an exemption, as can people who take care of someone who needs constant help, such as someone with dementia or a major disability.
So can pregnant women, people who are homeless or have survived domestic violence, and people who have been hospitalized recently.
How do people report their work or other activity, or ask for an exemption?
The state has a website, called MiBridges, that will let people enter their reports or reasons for exemptions on a computer, smartphone or tablet.
If someone hasn’t logged into the MiBridges site before, or recently, this is a good time to try, before deadlines start hitting.
“If someone isn’t computer-savvy, they should ask for help from a trusted friend or family member to help them log in or report,” says Krista Nordberg, who directs enrollment services for the Washtenaw Health Plan.
There’s also a phone line, 1-833-895-4355, for reporting work and asking for exemptions.
People can also go to their county office for the Michigan Department of Health and Human Services, which runs the Healthy Michigan Plan. Find a local office here.
The actual report doesn’t have to have details of what the person did that month – the report is on the “honor system” and uses what’s called an attestation. Basically, the person states that they met the requirement.
The state will do “audit” checks from time to time. They can ask people to show them documents related to work or other qualified activities.
So it’s important to have documents to back up each report – for instance paystubs, receipts from clients for self-employed people, proof that they’re enrolled in classes or training, job applications or a letter from the organization they volunteered for. Even those who work for cash should document their work in some way.
If someone doesn’t currently have such paperwork, it’s important to start collecting it now and keep it in a safe place in case the state asks for it. For instance, if someone is applying for jobs, they should make copies of those applications, with dates, and save them.
What else should people know?
The new law doesn’t affect people who get their health insurance through their jobs, or people who get coverage through Medicare or ‘regular’ Medicaid.
If someone doesn’t file a work report by the deadline, they actually still have 60 days to fix the situation by filing a late report.
If someone fails to report their work or other activity for three months of a year, they will lose their coverage. They have to wait a month before applying to get coverage again. So, the soonest someone might lose coverage is June.
Nordberg says her biggest concerns are for people who lose their health coverage and their access to necessary medical care that would have allowed them to stay healthy.
Research from the U-M Institute for Healthcare Policy and Innovation, which is studying the Healthy Michigan Plan’s effects, has shown that many people enrolled in the Healthy Michigan Plan say it helped their health, and their ability to work.
Where can someone get help?
Nordberg notes that the Washtenaw Health Plan team can help people in every part of Michigan, not just Washtenaw County. They’re at (734) 544-3030, and they also can take questions through the Healthcare Counts pages on Facebook, Twitter and Instagram.
The state government’s main help line for people with Healthy Michigan Plan coverage is also open for calls, and offers assistance with translation to other languages. It’s 1-800-642-3195. (People with hearing issues can use TTY to call 1-866-501-5656)
“The state is trying to do everything it can to make it easy for people to meet the law’s requirement, but it will still require action by many of them to keep their coverage,” says Udow-Philips. “And the program doesn’t include broader supports for things like transportation that can get in the way of working or seeking work.”
The state’s Michigan Works organization runs service centers in communities around the state to help job seekers and those who need job training.