Michigan: #ACA Medicaid enrollment hits 900K as CMS formally revokes work requirements; #ACA directly covers 11.4% of the population

I last updated my Michigan Medicaid expansion tracking back in January.At the time, I noted that enrollment in this ACA programhas increased dramatically here in Michigan since the COVID-19 pandemic struck, increasing from 673,000 in February 2020 to 853,000 as of January 2021, or nearly 27% in less than one year.

As of April 5th, the Healthy Michigan program (that's the branding of Michigan's ACA Medicaid expansion) notes 897,261 enrollees. That's a net increase of 224,000 Michiganders enrolled in the program since last February, or over 33%.

With this as backdrop, consider the timing of the following events:

January 1st, 2020: Medicaid work requirements, mandated by the GOP-controlled state legislature back in 2018, go into effect; at the time, an estimated 100,000 enrollees were likely to lose their healthcare coverage due to the new requirements...had the requirements stayed in effect.

March 4th, 2020: The DC District Court declares Michigan's Medicaid work requirement provision to be illegal and orders it to be suspended immediately pending a final ruling.

March 11th, 2020: Just one week later, the first cases of COVID-19 in Michigan are officially confirmed and announced. Statewide business & school shutdowns and stay-at-home orders followed within the next few weeks. You know the rest: Over a million Michiganders lost their jobs, or 10% of the popualtion, in a matter of a couple of months.

That's right: If the federal court hadn't happened to put a hold on the work requirements at the exact moment that they did, in addition to those 100,000, hundreds of thousandsmoreMichiganders who had just lost their jobs would have beentold that they had to find employment in order to enroll in a program designed specifically for low-income residents.

The mind boggles.

In any event, this news is obviously welcome:

President Joe Biden rescinded Michigan’s Medicaid work requirements this week, reversing restrictions that had been approved by former President Donald Trump in 2019.

The waiver, which had taken effect on Jan. 1, 2020, but was blocked by a federal judge two months later, had conditioned Medicaid coverage upon work requirements. The law passed by the GOP-led Legislature was signed by former Gov. Rick Snyder, but wasopposedby current Gov. Gretchen Whitmer, Democrats and groups like the Michigan League for Public Policy.

Nine other states besides Michigan had also been granted waivers by the Trump administration. Michigan’s was set to expire at the end of 2023.

The Biden administration cited challenges for residents during the COVID-19 pandemic as reason to drop the work requirements.

I should also note that in addition to this, 267,000 Michiganders enrolled in ACA exchange coverage during the 2021 Open Enrollment Period, of which a good 90% (240,000)paid their first monthly premium based on past ACA data. At the time I noted that around 83% were subsidized, or perhaps 200,000.

However, two important things have changed since then: First, the American Rescue Plan means that more like 95%+ of those 240K are now subsidized (remember, the expanded subsidies are retroactive to January 1st), meaning it's more like 230,000. Second, the ongoing COVID Special Enrollment Period has already resulted in over 12,200 additional Michiganders enrolling in ACA exchange policies since the end of the 2021 OEP...and that's before the expanded subsidies actually went live on HealthCare.Gov starting April 1st.

All told, that's upwards of 252,000 Michiganders currently enrolled in subsidized ACA exchange plans, plus another 897,000 covered by Medicaid expansion, or 11.4% of our entire state population.