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The Healthy Michigan Plan isn't broken, why are legislators trying to fix it?

Mar 20, 2018

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Five years ago, Governor Rick Snyder got the legislature to agree to accept a federal program that expanded eligibility for Medicaid to some of the poorest people in this state. Prior to that, except for seniors, only people at or below the poverty level were eligible. The new program increased that to include those just a bit better off.

We aren’t talking about rich or even middle-class people. We are talking about those whose incomes are no more than $16,000 a year for a single adult, or $33,000 for a family of four. As the governor saw it, this program, which he named the Healthy Michigan Plan, made perfect sense, even if you didn’t have a charitable bone in your body.

For one thing, it meant a healthier workforce. For another, it was an incredible bargain. Washington paid all the costs for the first few years. The feds are still paying 94 percent, and Michigan taxpayers will never pay more than 10 percent. The savings are astronomical on many levels. The year before Healthy Michigan began, hospitals in this state spent $627 million dollars on uncompensated care provided to sick poor people.

A year after Healthy Michigan took effect that had fallen by half. All indications are that it has fallen more since then. It was originally thought that perhaps 400,000 people would take advantage of this plan. The latest figures show that 672,000 have signed up.

This has been a win-win situation for everyone. Aside from that it is good to give people access to medical care, a University of Michigan study last year indicated that the positive economic effects of Healthy Michigan will generate more than enough money for the state budget to pay all the costs.

But some see this as people getting something for nothing. State Senator Mike Shirkey, a Republican from rural Jackson County, wants to force able-bodied adults in Healthy Michigan to either work at least 30 hours a week or be in school in order to

“help them keep their dignity.”

He has no statistics as to how many people this would affect. He also doesn’t say how this would be enforced, though presumably it would require the creation of a new bureaucracy and some mechanism for spying on people to make sure they are really working.

By the way, current Medicaid law doesn’t allow states to make working a requirement for eligibility, so Michigan would have to ask for a waiver from the federal government.

Emily Schwarzkopf, an analyst for the Michigan League for Public Policy, put this in needed perspective, telling the Gongwer News Service that “Medicaid is a health care plan, not a jobs plan.” If the legislature wants to create more jobs, they should create programs to do that.

By the way, adult Healthy Michigan recipients don’t get totally free coverage; they have a copay charge equivalent to two percent of their income. And yesterday, the Michigan Information and Research Service reported that it costs the state more to move people off Healthy Michigan than it does to keep them on. Senator Shirkey, a mechanical engineer by training, may have forgotten one of the cardinal rules of his profession:

If it ain’t broke, don’t fix it.

Healthy Michigan is working fine, and we would do well to let well enough alone.

Jack Lessenberry is Michigan Radio’s Senior Political Analyst. Views expressed in his essays are his own and do not necessarily reflect those of Michigan Radio, its management or the station licensee, The University of Michigan.