UPDATE: Michigan: #DanceSpiderDance bill moves to full state Senate. Don't worry, "God's safety net" will save the day.


(sigh) This is so predictable...via Jonathan Oosting of the Detroit News:

...Maitre, 62, spends dozens of hours each week babysitting her grandchildren and providing their working parents with free child care. But none of that time or her community service would count as work under an advancing plan that would require Medicaid recipients to spend 29 hours a week at a job or risk losing their health care coverage.

...The Republican-led Senate Competitiveness Committee approved the legislation a short time later in a 4-1 vote. The lone committee Democrat voted against the plan to reform the government health care program for lower-income residents, which has grown significantly in recent years after the state expanded eligibility under former President Barack Obama’s signature health care law.

It now moves on to the full state Senate, as I expected.

...Sponsoring Sen. Mike Shirkey, R-Clarklake, created exemptions in the Michigan legislation that would waive the work requirement for parents with young children, pregnant women or caretakers for disabled family members. But asked about people like Maitre who could still lose health care, he told reporters the social safety net “by definition, has a lot of holes in it.”

“The best safety net ever invented by God is family,” Shirkey said, “but I’m not sure that government is supposed to supplement that process.”

...which means that if you don't happen to have any family members nearby to help out, it's because God hates you, I guess. Plus, while I agree that the support of a loving family is a great thing, a hug from your sister doesn't do much good if you need dialysis or a hip replacement.

...Those who fail to report or do not meet work requirements on at least two occasions would be disqualified from the Medicaid program for a full year.

...after which time some of them will have died off, thus no longer requiring any type of medical services! Brilliant!

More than 2 million residents are on some form of Medicaid insurance in Michigan, including more than 670,000 enrolled in the Healthy Michigan plan, which expanded eligibility to up to 133 percent of the federal poverty level. Many already work or are in failing health, and Shirkey estimates about 300,000 able-bodied adults would be subject to the work requirements.

“This isn’t being done to save money,” Shirkey said in a Wednesday morning hearing. “It is being done to ensure … that we have the resources necessary to really help those that really need the help the most.”

Wait...the "resources" you're referring to are basically...money. But it's not being done to save money. Which means it's not being done to save resources. And I can't believe he just came right out and admitted that it's not gonna save any money anyway, which makes doing this pretty much pointless. Alternately, it's possible that it will save money...by kicking thousands of people off their healthcare coverage. Got it.

The advancing plan has faced criticism from health care and patient advocacy groups, who argue it would create a bureaucratic system that puts a burden on patients and the state, but is supported by several business and conservative groups who argue it would help employers struggling to fill job openings.

Umm...that logic is completely backwards, guys. Getting a job doesn't make someone healthy; being healthy makes you more likely to be able to get a job.

...Critics credited Shirkey with adding more exemptions to the bill for adults who may face barriers to work, but they pointed to studies showing a majority of work-able Medicaid recipients already work.

Requiring recipients to document work hours or qualifying exemptions each month will likely lead to patients with legitimate needs losing coverage, said Ken Fletcher of the American Lung Association.

...which is, of course, the entire point of this bill: To kick people off of Medicaid, which in turns "saves" the state money and other "resources". Otherwise...what's the point again? Oh, right: To make poor people feel bad about being poor. Got it.

“Battling administrative red tape in order to maintain coverage should not take away from patient or caregiver’s focus on maintaining their or their family’s health,” Fletcher said. “Failing to navigate these burdensome administrative requirements could have serious, even life or death consequences for people with serious or acute chronic diseases.”

...Sen. Rebekah Warren, D-Ann Arbor, said the proposed exemptions do not go far enough, pointing to a provision that would waive the work requirement for one parent in a couple to take care of a child six years of age or younger.

“In reality, caretakers with children under the age of 12 should be exempt,” Warren said. “Kids can’t babysit themselves at seven years old.”

Then again, some Republicans want to bring back child labor as well, so I guess the idea is to kick the kids back into the coal mines (which don't really exist anymore anyway)?

...“I am rifle-shot focused on making sure this doesn’t result in a cumbersome administrative process,” Shirkey said. “It is unnecessary to do so.”

I actually agree with Sen. Shirkey 100% on this point. You know how you could ensure that there isn't a cumbersome administrative process? DON'T ADD AN UNNECESSARY WORK REQUIREMENT TO MEDICAID.

UPDATE: Hold the phone a minute.

The minimum wage in Michigan is $9.25/hour. $9.25 x 29 hours = $268.25. Over 52 weeks a year (remember, you have to put in 29 hours per week...I don't think there's any vacation time allowed?), that totals $13,949 per year.

ACA Medicaid expansion covers people in households earning up to 138% of the Federal Poverty Line.

For one person living alone, that's $16,753/year, so they'd be OK.

For a single parent, 138% FPL would be even higher ($22,714 if they have one child, or $28,676 if they have two). The kids qualify for CHIP and the parent would still indeed qualify for Medicaid expansion.

However, what about a couple with no children? In their case, each of them would have to work at least 29 hours per week for both of them to qualify for Medicaid, right?

So, that's 2 people earning at least $13,949 apiece, for a combined household income of...$27,898. That's 169% of the Federal Poverty Line.

That's right: A couple without any children would have no way of being eligible for Medicaid expansion if they met the 29-hour/week work requirement.

Of course, that's their gross income; obviously their MAGI income may be lower than that, so I suppose it's possible that they could squeak in under the 138% wire...and of course, one or both of these folks could spend part of that 29 hours "volunteering" in some authorized way.

Even so, this sounds like an idea which hasn't been thought through very well, to put it mildly.

Granted, a couple with no kids earning $28,000/year combined wouldn't qualify for Medicaid expansion regardless of the work requirement...but that's also kind of my point: It sets up a pointless, cumbersome administrative oversight system to keep track of the day to day activities of a class of people who they don't even need to keep track of.