| Michigan Medicaid Work Plan |
Asset forfeiture policy is all the rage in Maine, Kansas, Kentucky, you know.
Boy, these Privateers are serious!
It is just a shame the Michigan Senate did use the same ferocity when dealing with the child poverty or trafficking of tiny humans, but then again, it is the oldest form of survival.
This is worthy of a constitutional challenge to the entire concept of separation of powers.
Lansing — Michigan’s
Republican-led Senate is pressuring Gov. Rick Snyder to back sweeping
changes to the state’s Medicaid health insurance system, including proposed work requirements and a tougher 48-month benefit limit for the Healthy Michigan plan.
The
Senate on Thursday approved a $56.6 billion budget that would suspend
salaries for Director Nick Lyon and other top officials in the Michigan
Department of Health and Human Services if the Snyder administration
does not request and secure a federal waiver to implement Medicaid work
requirements.
The provision follows last month’s
Senate approval of a controversial 29-hour weekly work mandate for
able-bodied adults. The legislation is now before the House, and “we
just want to send a message that it’s important for the administration
to also take it seriously,” said Senate Appropriations Chairman Dave
Hildenbrand, R-Lowell.
The budget includes a
separate provision directing the state to end expanded eligibility for
residents who earn between 100 percent and 133 percent of the federal
poverty level after they’ve been on the Healthy Michigan plan for 48
months, eliminating an option to extend coverage by completing healthy
behaviors.
Democratic
Sen. Curtis Hertel of East Lansing called the budget language “severely
unconstitutional,” arguing the executive branch is supposed to
implement laws. The budget would diminish that role by threatening
salary reductions “if they don’t interpret the laws the way we want,”
Hertel said.
The salary penalties are unlikely to
remain in the final 2019 budget that lawmakers will negotiate with
Snyder. But they are the latest tactic in the Senate’s bid to reform
Medicaid less than five years after agreeing to expand eligibility under
the Affordable Care Act. Nearly 700,000 residents are now enrolled in
the Healthy Michigan plan.
Under
the budget, the state would withhold a combined $294,000 in salaries
from “unclassified” employees in the state health department until a
work requirement waiver is submitted. The state would withhold another
$294,000 unless or until the federal government approves the waiver.
Current
unclassified employees include Lyon, Senior Assistant Nancy Grijalva,
Chief Medical Executive Eden Wells, senior communications deputy Geralyn
Lasher and Cindy Kelly, a design coordinator at the state-operated Caro
Center psychiatric hospital, department spokesman Bob Wheaton said.
“This issue is still being worked through,” Wheaton said of the Medicaid provisions.
Coverage limits
The Healthy Michigan law,
as signed by Snyder in 2013, discouraged residents from staying on the
plan for more than four years but gave them the option to continue
coverage with higher cost-sharing payments that could be reduced through
healthy behaviors.
The current federal waiver
directs individuals to seek private insurance on the federal marketplace
after 48 months on Medicaid, but it conflicts with state law by
allowing the state to subsidize those premiums, said state Sen. Mike Shirkey, R-Clarklake.
“This is personal for me, because I laid a lot of political capital on the line to try to get this done,” said Shirkey, who coaxed fellow Republicans to support the
Medicaid expansion in 2013 but is now leading the reform effort.
“I still believe it was the right thing to do, but I’m not going to go back on the promises that were made to get those votes.”
Senate
Democrats opposed the Medicaid work requirement legislation, and Senate
Minority Leader Jim Ananich said the salary penalties show the proposal
“is becoming more and more of a political gimmick.”
“I
thought it was wrong as a policy bill, and it’s wrong in the budget,”
said Ananich, D-Flint. “I hope that the governor puts pressure on them
by saying he’s not going to support this, but this scheme is just not
well thought out.”
A Snyder spokesman previously
called the Senate-approved Medicaid work mandate “neither a reasonable
nor responsible change to the state’s social safety net.” But the
governor has continued to negotiate potential changes with Shirkey ahead
of potential voting in the House.
Able-bodied
Medicaid enrollees could lose government health insurance if they fail
to document at least 29 hours a week of work, job training or related
education. Shirkey estimates about 300,000 Medicaid recipients would be
subject to the Senate-approved work mandate, which includes exemptions
for parents with children 6 or younger, pregnant women, disability
caretakers and people recently released from prison or receiving
unemployment benefits.
Ongoing negotiations
The
proposal would also waive the work requirement for anyone who lives in a
county with an unemployment rate of 8.5 percent or higher. Critics note
the exemption would benefit rural parts of the state that might vote
Republican but not urban cities like Detroit or Flint that have
struggled with unemployment.
Shirkey dismissed the
criticism, calling the exemption a compromise after an initial draft of
the bill did not include any unemployment rate allowances.
“I
don’t know why anybody in Flint would say we need to be treated
separate than Genesee County,” Shirkey said. “I mean, is it too much of
an expectation to look for jobs if you happen to live in Flint, to look
for a job in Genesee County? And the same argument applies to Detroit
and Wayne County.
How granular do you want to get?”
More Poverty-Shaming: Opioid Moms, Michigan Children's Trust Fund, Medicaid Fraud & Residuals Of The Peculiar Institution
But
state Rep Fred Durhal III, D-Detroit, said low-income urban residents
face travel obstacles to work in another part of the county.
“We
have no regional transit system,” Durhal said. “If you live on the east
side of Detroit and there are jobs available in Plymouth, how the hell
are you supposed to get out there?”
House Democrats
are proposing unemployment exemptions based on zip code. Durhal called
the proposal that passed the Senate “discriminatory in nature.”
Democrats want to encourage people to work, he said, but “this seems
like it’s an attack on folks and trying to take health care away from
folks.”
Shirkey said he met with the Snyder
administration last week to discuss the work requirements and is
expected to meet again Wednesday with officials.
Negotiations
have focused on initial roll-out and administration, but Shirkey said
the 29-hour weekly mandate will likely be reduced to more closely mirror
a 20-hour work requirement for food stamp recipients.
“I
believe we’re getting very close to the governor, his staff and the
department being on board now finally,” Shirkey said, “and I’m happy
about that.”
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