The idea of work requirements for Michiganders on Medicaid is rather abstract. Unfortunately, it would have significant negative consequences. Here are some real stories of people that we have worked with in the past year. (Names have been changed.)
What unites these families is that--even though, in each case, someone in the household is working--under the proposed work requirements for Medicaid, they wouldn't qualify for Medicaid. Here are their stories.
Marsha and Will: Bad Luck and Poor Health Means Medicaid is More Important Than Ever
Marsha and WIll are a married couple in their fifties, and their kids are now all grown. In 2016, they were both working low-wage jobs in the service industry. Their combined income was around $28,000/year. They could afford their rent, and their car, and they qualified for tax credits on the Marketplace. In early 2017, WIll lost his job. He was looking for a job, but now they were living on Marsha's job at Subway, which was averaging about 28 hours/week. Paying for rent was tough, but at least they now qualified for Medicaid. After about six months of being unemployed, Will had a heart attack and was in the hospital for five days.
Under proposed Medicaid work requirements, Marsha's work was less than 30 hours/week and Will wasn't working at all--they would not have qualified for Medicaid. When Will had his heart attack, what would have happened?
Virginia: Medicaid is Vital to Mental Health
Virginia is a single woman in her 20s. She has a history of depression and anxiety, and had been helped by Community Mental Health. When she started working 33 hours/week, her income was too high for Medicaid, and as a result she lost her relationship with Community Mental Health. Without medications and support, her anxiety got so bad that she couldn't work at all. Then Virginia became eligible for Medicaid--and Community Mental Health--again. Now, with the support of Medicaid and CMH, she is able to work. Virginia now keeps her work hours at about 25 hours/week, in order to stay eligible for Medicaid and--therefore--CMH.
With Medicaid work requirements, Virginia might not be able to keep her hours below 30 hours/week. And if her income goes above 30 hours/week, at $11/hour she won't be eligible for Medicaid--or CMH services.
Maria and Jose: Medicaid Keeps The Family Healthy
Maria and Jose have two children, ages 3 and 5. Jose works two jobs so that Maria can stay home with the kids--childcare costs are so high. Jose is offered (and takes!) insurance from his work, but while it would be affordable for him ($100/month), if he were to add the rest of the family it would cost $600/month. So Maria and the kids are on Medicaid, which is a good thing, because Maria and her youngest child have asthma.
With Medicaid work requirements, Maria wouldn't be eligible for Medicaid unless she were working 30 hours/week. In order to do that, though, they would have to pay for childcare. Without the asthma medication, Maria might end up in the emergency room.
Jasmine and Mark: Medicaid Allowed Them To Take A Chance And Start A Business
In 2015 Jasmine and Mark decided to start their own business in Washtenaw County. Investing their life savings, they quit their jobs and started spending long hours on their business. Without income, they and their two kids got Medicaid. In the first year, they did not turn a profit. In their second year, they started making a little bit of money, but were still Medicaid eligible. By year 3, they were over income for Medicaid and went on the Marketplace.
With Medicaid work requirements, in the first two years of their business, their income did not reflect the work they were putting in. How could they prove they were working? Would they qualify for Medicaid?