Chad Selweski covered state and regional politics for The Macomb Daily for nearly 30 years. He contributes to Deadline Detroit and blogs at Politically Speaking.
By Chad Selweski
The Michigan Senate has laid down the gauntlet, demanding that recipients of health care provided by the Medicaid program face a requirement to work 29 hours a week to continue their coverage.
A GOP controlled Senate committee on Wednesday approved the legislation along party lines. It comes months after the Trump administration announced it would permit such work requirements under a waiver process.
This represents a view that will appeal to conservatives across the state as the November elections for the state House and Senate approach.
But the obvious flaw in this approach is that most of those who rely on subsidized Medicaid coverage consist of senior citizens, the disabled or chronically ill, and poor children. Among the rest, about 70 percent work, even if their hours and wages are minimal.
More importantly, the Republican-controlled Senate of 2018 seems ready to undermine the Medicaid policies of the 2015 Senate. GOP senators just a few years ago, at a time when they did not face imminent re-election challenges, took a very different view of Medicaid.
Three years ago, the Legislature accepted GOP Gov. Rick Snyder’s Medicaid expansion plan while embracing reasonable, conservative requirements for Medicaid patients. New Medicaid recipients were mandated to pay 5 percent of out-of-pocket medical costs, and 7 percent after 48 months. The four-year penalty exempted those who are frail or suffer from chronic diseases or mental health problems.
At the time, the Senate also established: More flexibility for the state Department of Community Health to determine eligibility; incentives for healthy habits, such as not smoking and receiving an annual physical evaluation; and consequences for individuals who fail to contribute co-pays.
These well-crafted reforms gained simultaneous support from Michigan conservative business groups and liber social welfare organizations. In other words, the innovations, compared to many other states, received bipartisan praise.
Healthy Michigan
The Medicaid expansion program known as Healthy Michigan, combined with Obamacare coverage overall, at one point cut the state’s uninsured rate in half, from 14 percent to 7 percent. Some 600,000 signed up for the Healthy Michigan coverage and hundreds of thousands of people have received medical care, particularly preventive care, that previously was unattainable.
Fast forward to 2018 and Republican legislators locked in an election year have latched onto crude talking points about “welfare queens” that date back to the 1980s.
What is lost in the Senate debate today is that families who receive welfare benefits – whether cash payments or food stamps or Medicaid – mostly stay on the dole for a relatively short period of time as they weather a financial crisis, such as a job layoff or an eviction.
The senators’ reversal, compared to 2015, seems fueled by recent Trump administration rhetoric that favors new restrictions on aid to the poor, even as the biased mentality behind such moves fails to match the public policy data. For example, a 2015-16 pilot program in Michigan, mandated by the Legislature to test welfare recipients for drug use ,failed to net one violator.
As for Medicaid work requirements, Michigan, of all places, is ready to apply to the Trump administration for approval of the most stringent rules of any state.
The question is: Will Gov. Rick Snyder, the chief advocate of Medicaid expansion in Michigan, veto the pending measure if it reaches his desk? And if that action creates a backlash among conservative Republicans, will it hurt his preferred successor, Lt. Gov. Brian Calley in the August gubernatorial primary against Attorney General Bill Schuette?
One issue that deserves campaign debate over the coming months is the 29-hours-per week minimum work rule for able-bodied Medicaid recipients. The Senate sponsor of the proposed regulations concedes that no more than 300,000 of the state’s 2.4 million Medicaid recipients would face a crackdown under his bill -- a mandate to either work at least 29 hours a week or be enrolled in job training or education classes.
Leave Child Alone?
Still, the strict exemptions within the legislation indicate that only a sole caretaker -- such as a single mom -- of a family member under age 6 would remain eligible to receive Medicaid’s fairly minimal family health coverage. Does that mean that an adult caring for a 6-year-old is expected to leave the child alone on a daily basis while the family member goes to work?
Make no mistake: This is one of those visceral issues that could sway the gubernatorial elections for an open seat as term-limited Snyder prepares to step down.
Stay tuned.
