Trump administration’s Medicaid changes could leave more than one million Michiganders without coverage

Photo: Drew Angerer/Getty Images


President Donald Trump’s administration has opened the door to work requirements for Medicaid, which could put more than a million Michiganders at risk of losing their health care.

The United States Department of Health and Human Services issued a letter to all state Medicaid directors outlining a new policy that would allow states to require Medicaid recipients who are not elderly, pregnant, or disabled to work or participate in community service — or lose their coverage.

“We’re estimating at this time that just over a million individuals in Michigan meet the criteria that CMS will consider,” said Lynn Sutfin, a spokesperson for the Michigan Department of Health and Human Services.

Suftin added there are 1,015,931 total Michiganders who receive government health care, with 673,786 enrolled in Healthy Michigan Plan, and 342,145 in traditional Medicaid.

No county in Michigan would escape being seriously affected by job requirements for Medicaid. With the smallest proportion of enrollees in Medicaid and Healthy Michigan, Livingston County could still see more than 11 percent of its population, or more than 20,000 people, affected.

The federal government will implement the proposed changes by granting “1115 waivers” that allow individual states to deviate from rules of Medicaid as written. The difficulty the Trump administration may encounter is that legally, it can only issue waivers if the rules changes “further the objectives” of Medicaid—that is, if they make people healthier.

In a letter from DHHS, the officials wrote that waivers should be for programs which are “designed to promote better mental, physical, and emotional health,” and points out that working people often have higher incomes, which leads to longer, healthier lives.

“One comprehensive review of existing studies found strong evidence that unemployment is generally harmful to health, including higher mortality; poorer general health; poorer mental health; and higher medical consultation and hospital admission rates,” DHHS officials argue.

But the connections the administration is making between work and health may well be backwards.

As the Washington Post has reported, Leonardo Cuello, the health policy director at the National Health Law Program said the association of the two is “totally contorted.”

“It’s a little like saying that rain causes clouds,” Cuello added. “It’s more that people [with Medicaid] get care, which helps them be healthy and makes them able to work.”

Given this administration’s record on health care law changes, it’s fair to assume that the best interests of health care recipients weren’t the impetus behind the rule change, which could save states who cut off recipients a pretty spot of cash.