In March 2020, Robert Gordon, the Michigan state health director, faced the daunting task of removing 80,000 people from health insurance due to a law passed two years earlier mandating a work requirement for Medicaid. Despite spending $30 million in state tax dollars to avoid this outcome, Gordon and his team were unable to prevent a significant number of Michiganders from losing their coverage.
Gordon, a Democrat and veteran of the Obama administration, was committed to implementing the law in a way that minimized the number of people losing insurance due to government errors. However, estimates suggested that tens of thousands of individuals were at risk of losing their Medicaid coverage.
The new tax-and-spending law signed by President Donald Trump in July expanded Medicaid work requirements to most states, potentially leading to 5.3 million more people being uninsured by 2034. This law applies to 40 states and Washington, D.C., with around 18 million people affected once the work mandate is fully implemented nationally.
Republicans argue that work requirements are necessary to weed out “freeloaders,” while Democrats believe it is a cover for cutting a program that has saved thousands of lives. The implementation of work requirements can vary widely by state, with Michigan’s experience highlighting the challenges of preventing large numbers of people from losing coverage.
Despite Michigan’s efforts to implement the work requirement, a federal judge blocked the policy in March 2020, just as the state announced its first cases of COVID-19. Gordon continued to serve as health director until 2021 when he resigned over differences in pandemic restrictions with Governor Whitmer.
Currently, new predictions suggest that 500,000 Michiganders could lose coverage within the first year of federally mandated work requirements. Gordon believes that the current policy is wasteful and confusing, and advocates for a more honest and efficient approach to Medicaid.
As Michigan faces the potential loss of coverage for thousands of residents, the impact of work requirements on healthcare access and outcomes remains a contentious issue.
