RED ALERT: Godawful "God's Safety Net" SB897 to be taken up in the state House WEDNESDAY MORNING.

2018 MIDTERM ELECTION

Time: D H M S

NOTE: Just to clarify, here's where the headline comes from:

...Sponsoring Sen. Mike Shirkey, R-Clarklake, created exemptions in the Michigan legislation that would waive the work requirement for parents with young children, pregnant women or caretakers for disabled family members. But asked about people like Maitre who could still lose health care, he told reporters the social safety net “by definition, has a lot of holes in it.”

“The best safety net ever invented by God is family,” Shirkey said, “but I’m not sure that government is supposed to supplement that process.”

Well, here we go:

#BREAKING tomorrow morning the House Appropriations Committee is taking up SB 897. Another Republican attempt to take away healthcare from Michigan families https://t.co/WsUhyntINj

— MI House Democrats (@MIHouseDems) May 2, 2018

As I reported a couple of weeks ago:

Dammit, sure enough, as I expected, the full Michigan state Senate has gone ahead and passed the state Senator Mike Shirkey's "God's Safety Net" bill which would impose 29-hour-plus work requirements on 680,000 low-income Medicaid enrollees even though the vast majority of them already work, go to school, are medically fragile, take care of other medical fragile family members, elderly relatives or children and so forth. It was, as you'd expect, a party-line vote:

Able-bodied Medicaid recipients in Michigan may soon have to choose between finding a job or losing health insurance.

...Democrats condemned the proposal as harmful to thousands of Medicaid recipients who would not meet the several exemptions spelled out in SB 897 and said such a move is also illegal. Majority Republicans brushed aside those objections, and the bill passed 26-11.

The bill now heads to the House.

More than 2 million Michigan residents use Medicaid, with more than 683,700 of those being enrolled in the Medicaid expansion program known as the Healthy Michigan Plan. Able-bodied nonpregnant adults without a disability between the ages of 19 and 64 would need to meet work requirements under the bill.

...Under the bill Medicaid recipients would have to meet a work requirement of 29 hours per week.

The effective date of the bill was set at Oct. 1, 2019 to provide the state more time to obtain a federal waiver.

Democrats proposed eight amendments, intended to add exemptions for individuals such as caretakers of a child under age 13, veterans, seasonal employees, caretakers of the elderly medically frail and even lawmakers' own coverage. All failed, as did amendments moving the 29 hours per week requirement to 20 hours per week and for a cost-benefit analysis.

In January the federal government issued guidelines allowing for the implementation of work requirements in Medicaid as a condition of eligibility. The guidelines are a departure, as the program has existed for more than 50 years without ever allowing such requirements.

As Jesse Cross-Call of the Center on Budget and Policy Priorities notes:

Michigan’s Medicaid Proposal Would Harm Low-Income Workers — And Can’t Be Fixed

Specifically, the Michigan bill, or any similar proposal, would:

  • Lead to large coverage losses. If the Michigan House lowers the hours-per-week requirement, it would only make it similar to the work requirement approved in Kentucky, which projects large coverage losses....
  • Harm working Medicaid beneficiaries. The industries that commonly employ Medicaid beneficiaries — such as health care services, restaurant and food services, and construction — generally feature variable hours, above-average levels of involuntary part-time work and irregular scheduling, and minimal flexibility....
  • Harm people with disabilities and other vulnerable groups. The Michigan bill, like proposals in other states, exempts people who are medically frail or have medical conditions that prevent them from working. Still, some people with disabilities and serious illnesses would inevitably fall through the cracks and lose coverage....
  • Create new state costs. Michigan would have to spend between $20 million and $30 million a year to administer a work requirement, the Michigan Senate Fiscal Agency estimates. This estimate is mostly a function of the size of the population affected, the Fiscal Agency says, which means that the time and cost to regularly verify each person’s eligibility under the new requirements would be the same regardless of the bill’s specific requirements....

Finally, as I also noted a few weeks back...

The minimum wage in Michigan is $9.25/hour. $9.25 x 29 hours = $268.25. Over 52 weeks a year (remember, you have to put in 29 hours per week...I don't think there's any vacation time allowed?), that totals $13,949 per year.

ACA Medicaid expansion covers people in households earning up to 138% of the Federal Poverty Line.

For one person living alone, that's $16,753/year, so they'd be OK.

For a single parent, 138% FPL would be even higher ($22,714 if they have one child, or $28,676 if they have two). The kids qualify for CHIP and the parent would still indeed qualify for Medicaid expansion.

However, what about a couple with no children? In their case, each of them would have to work at least 29 hours per week for both of them to qualify for Medicaid, right?

So, that's 2 people earning at least $13,949 apiece, for a combined household income of...$27,898. That's 169% of the Federal Poverty Line.

Unless I'm missing something, a couple without any children would have no way of being eligible for Medicaid expansion if they met the 29-hour/week work requirement.

Of course, that's their gross income; obviously their MAGI income may be lower than that, so I suppose it's possible that they could squeak in under the 138% wire...and of course, one or both of these folks could spend part of that 29 hours "volunteering" in some authorized way.

Even so, this sounds like an idea which hasn't been thought through very well, to put it mildly.

Granted, a couple with no kids earning $28,000/year combined wouldn't qualify for Medicaid expansion regardless of the work requirement...but that's also kind of my point: It sets up a pointless, cumbersome administrative oversight system to keep track of the day to day activities of a class of people who they don't even need to keep track of.

Michigan residents: Please visit the Action Network website to contact your state Representative to urge them to vote NO on work requirements for Medicaid.

The Moms Rising website also has helpful action items.

And yes, I intend on shlepping my ass out to Lansing early tomorrow morning.

UPDATE Wednesday afternoon:

Well, I'm back. Unfortunately, I arrived too late to actually get my public comment request in (there were 2 dozen ahead of me), but it was an interesting experience, anyway.

The GOP members of the committee were pretty gung-ho about the bill, of course, while the Dem members seemed pretty uniformly opposed.

I suspect that in the end they'll probably pass the bill on a party-line vote, though they'll likely drop the hourly requirement down from 29 hours to perhaps 20 or whatever to make it "more acceptable" to Gov. Snyder.

The committee didn't actually vote on the bill today, however. I presume they'll do so soon, and will likely then kick it over to the full state House.