New work requirements for state health plan start this month. Here's what you need to know. | Michigan Radio
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New work requirements for state health plan start this month. Here's what you need to know.

Jan 6, 2020

About 240,000 people in Michigan face new work requirements to stay eligible for Medicaid health benefits.

The work requirement took effect at the start of the year, and affects people enrolled in the Healthy Michigan Plan.

Starting this month, people age 19 to 62 who depend on the plan must certify to the state that they’ve spent at least 80 hours per month either working, or getting trained to work.

Some people are exempt

Anyone who believes they are exempt from the new work requirement must file this form to the state Department of Health and Human Services by January 31.

According to the state’s website, you may be exempt from the work requirement if you are:

pregnant or were pregnant in the last 2 months

medically frail due to one or more of the following:

  • physical, mental, or emotional condition that limits a daily activity, like bathing
  • physical, intellectual, or developmental disability that makes it hard to do a daily living activity
  • physical, mental, or emotional condition that needs to be checked often
  • disability based on Social Security criteria (SSDI)
  • chronic substance use disorder (SUD)
  • serious and complex medical condition, or special medical needs
  • in a nursing home, hospice, or get home help services
  • homeless
  • a survivor of domestic violence

the main caretaker for a family member under 6 (one parent per household)

full-time student

under age 21 and were in Michigan foster care, in prison or jail in the last 6 months

getting State of Michigan unemployment benefits

getting temporary or permanent disability payments from a private insurer or the government

medical condition that limits work, approved by a doctor

caring for a dependant with a disability and has a doctor's order for full-time care (one claim per household)

caring for a person who cannot make decisions for themselves

good cause.  The beneficiary or a family member of someone that:

  • has a serious illness, or
  • is hospitalized, or
  • has a disability that meets the government definition.

For those who are not exempt

People who are age 19 - 62 and who do not meet any of the exemption qualifications must certify to the state that they've spent at least 80 hours per week on work, education or training for work. 

People who lose a job while on the health plan can still qualify. 

“If you lose your employment, you technically still are on the clock,” says Kate Massey, the state’s Medicaid director, who spoke on Stateside. “And you can engage in looking for a job or going through training or educational pursuits in order to make sure that you maintain your coverage.”

According to the state website, activities that can count toward the 80 hours include:

  • Having a job or income
  • Being a student
  • Looking for a job
  • Volunteering (this activity can only be used for three months each calendar year)
  • Doing job training
  • Participating in a tribal employment program
  • Participating in rehab (substance abuse)
  • Doing vocational training
  • Doing an internship

Thousands could lose coverage

"We are very concerned, yes, that any type of disruption in coverage could risk beneficiary outcomes," Kate Massey, the state's Medicaid director, told Stateside.

The Michigan Department of Health and Human Services has been preparing for the change for months. It held a series of informational meetings last fall, and has mailed out letters to people on the Healthy Michigan Plan who are affected by the new requirement.

Despite that, one study estimates tens of thousands of people could lose their health benefits because of the new requirements.

"We are very concerned, yes, that any type of disruption in coverage could risk beneficiary outcomes,” Massey told Stateside.

Massey says the Michigan Department of Health and Human Services is coordinating with other community groups to help anyone who loses coverage as a result of the new work requirements.

Some argue the new work requirements are illegal, and there is an ongoing lawsuit to try to overturn the requirement. That lawsuit is still working its way through the courts.

Massey says people who depend on Medicaid health coverage through the Healthy Michigan Plan will still have to comply with the work requirement while the lawsuit is pending.

If you still have questions or need help

For questions about the Healthy Michigan Plan and the new requirement, you can go to michigan.gov/healthyMIplan or call 1-800-642-3195.

If you need help finding a job or doing other activities to meet the new requirement, you can visit michigan.gov/MIbridges or call 211 to be connected to local services.

For more information on the lawsuit challenging the new work requirements, go here or call the Michigan Center for Civil Justice at (810) 244-8044.

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