LANSING, MI - Michigan residents have until Sunday, Aug. 12, to weigh in on Medicaid work requirements as the Department of Health and Human Services pursues a federal waiver for their implementation.
More than 670,000 Michiganders are part of the Healthy Michigan plan, the state's extension of Medicaid under the Affordable Care Act that makes health coverage available to those making between 100 and 133 percent of the federal poverty level.
The new law, signed in June, requires able-bodied Healthy Michigan recipients to work or participate in qualifying activities like getting an education for an average of 20 hours of work per week, or 80 hours per month, with some exceptions.
Sarah Fraser, 33, of Troy, relies on Healthy Michigan, the state's Medicaid expansion, to stop her Multiple Sclerosis from progressing. What's standing between her and the potential progression of her disease - effects that could include things like becoming wheelchair-bound or losing control of bodily functions - is a single pill. It costs $75 per pill, and she takes two per day.
"Thankfully it's working. I'm the healthiest, really, that I've ever been," Fraser said.
But with the new Medicaid work requirements, she fears her health will be put at risk. She left the workforce when she had her son, and later divorced her husband. She goes to Oakland Community College part-time while raising her son, something she's hoping will set them up for an economically successful future.
She's held some part-time jobs while attending school. But when the semester changes her employers haven't been willing to accommodate her new schedule.
She doesn't want to make just enough to make her ineligible for Healthy Michigan. She's done that, and it means she can't afford health insurance. And she doesn't know if she can piece together enough school and work to come up with 80 hours. But most of all, she knows she can't lose the Healthy Michigan plan that gives her access to those two pills per day.
"If they take away my Medicaid, I could be looking at disease progression pretty quickly," Fraser said.
It's stories like this that the Michigan League for Public Policy, a group that advocated against the work requirements in the legislature, has been collecting.
And they're not the only ones; the Michigan Department of Health and Human Services is collecting feedback on the policy from Michiganders as they pursue a waiver from the federal government that the state needs to be able to implement the policy.
Department spokesperson Lynn Sutfin said the state is collecting comments as it requests a waiver from the federal government and comes up with the "operational details" about how the law will work.
"As an example, the law states that individuals who are medically frail are exempt from the workforce engagement requirements. However, the law does not define medical frailty; this is left to the Department. Public comments around this issue could guide potential changes to the proposed waiver on this topic or others," Sutfin said.
The department is collecting public comments here and has already received 245 comments, Sutfin said.
Emily Schwarzkopf, policy analyst for the MLPP, said the public comment period helps inform people about the law's real-world impacts.
"We think that the waiver process is really important in terms of allowing people to kind of talk about the impact that this would have and what this would mean to individuals," Schwarzkopf said.
The federal government recently opened the door to such a change, approving a handful of state waivers to put Medicaid work requirements in place.
The state is accepting public comment on the matter through Aug. 12.
Fraser said it was important to her, as somebody potentially affected by the policy, to make her voice heard. She's disappointed by the Republican-led legislature that put this in place.
"They're making decisions for us regular people without any knowledge of what it's like to be us," she said.