Potential Enrollment Impacts of Michigan's Medicaid Work Requirement

In December 2018, the Centers for Medicare & Medicaid Services approved Michigan's Section 1115 waiver, mandating that Medicaid beneficiaries meet certain work and community engagement requirements to maintain Healthy Michigan coverage. CMS approved similar waivers submitted by Arizona, Arkansas, Indiana, Kentucky, Maine, New Hampshire, and Wisconsin.
While some of the waiver applications and approvals do not project the impact of these requirements, information is now available on the experience in Arkansas, offering key insights for other states.
A report published with support provided by the State Health and Value Strategies program—a grantee of the Robert Wood Johnson Foundation—provides estimates of the potential impacts of Michigan’s work requirement based in large part on the Arkansas experience.
Key Findings:
  • An estimated 61% of the 680,000 people enrolled in Healthy Michigan will be required to self-report an exemption or qualifying activities. For the remaining 39%, the state will provide exemptions using information it already has available on beneficiaries.
  • An estimated 174,000 people each month will be found noncompliant for failure to meet the reporting obligations of Michigan's work requirement.
  • Depending on how many months their reporting issues continue, an estimated 61,000 to 183,000 people—9-27% of the State's Medicaid expansion population—will lose Medicaid coverage in Michigan over a one-year period. The high end is consistent with the experience in Arkansas to date, but the range reflects the uncertainty of impacts as work requirements are implemented and policies and practices evolve over time.

Click here to read the brief in its entirety.