1115 Medicaid Waivers in Michigan
Michigan’s Healthy Michigan plan has been approved through December 31, 2023, with the state’s request to add a work requirement approved December 21, 2018.
The Healthy Michigan Plan began April 1, 2014 and is approved through December 31, 2023. The state passed legislation to add a work requirement to the waiver and that request was included in the state’s 2018 waiver renewal submission. On December 21, 2018, the state’s waiver was extended and it was granted approval to add a work requirement to the program.
- Healthy Michigan Waiver Amendment (2015)
- Families USA comments on Michigan amendment to the state’s Section 1115 Adult Benefits Waiver Demonstration Program (2013)
- View All Federal Comments for 1115 Medicaid Waivers
The Healthy Michigan Plan covers childless adults in the Medicaid expansion population (19-64) who make less than 138 percent of the federal poverty level, or about $16,000 per year for a single person
- Community engagement (Work Requirement)
- Premium Assistance (Private Option)
- Health Savings Accounts
- Wellness Programs
- Impact on oral health
Community engagement (Work Requirement)
No sooner than January 1, 2020, enrollees 19-62 must comply with a work requirement, engaging in work or specified community service at least 80 hours/month. Enrollee verification required monthly. Enrollees are allowed 3 month of noncompliance in a calendar year. Enrollees who do not meet the requirement will be disenrolled for at least one month and not able to re-enroll until the beginning of the month following one month’s compliance with the requirement.
Premium Assistance (Private Option)
Pursuant to the legislation that created the Healthy Michigan Plan, the state gained approval to add a premium assistance component to the program beginning April 1, 2018. Learn more and get advocacy strategies.
Enrollees with incomes above 100 percent of the federal poverty level pay a premium in the form of a health savings account contribution (MI Health Account, see discussion below) set at 2 percent of income. Non-payment cannot result in disenrollment, but it can create a collectable debt to the state. Enrollees with incomes at or below poverty do not have to pay premiums. Learn more and get advocacy strategies to combat premiums.
Standard state Medicaid cost-sharing applies, however there is a pre-paid cost-sharing feature that connects with individual accounts. Learn more and get advocacy strategies to combat cost sharing.
Health Savings Accounts
All enrollees in Healthy Michigan are given a MI Health Account. MI Health Accounts are established by the state and are funded by enrollee premium and copay contributions. Individuals receive monthly statements of health care expenditures (copays) against an account budget. Health care costs exceeding the individual’s account budget are paid with state Medicaid funds. If a beneficiary becomes ineligible for Medicaid, the account balance will be put into a voucher he or she can use to buy private insurance. Learn more and get advocacy strategies to combat HSAs.
Enrollees can lower their quarterly co-payments and/or monthly premium contributions by participating in certain healthy behaviors. Beginning April 1, 2018 all enrollees above the federal poverty line will be required to work with their physicians on certain health improving strategies. If they do not, they will be moved into marketplace QHP premium assistance. Learn more and get advocacy strategies to combat wellness programs.
- Impact on oral health: Healthy behavior goals can include adherence to a schedule of dental benefits. Adults who are moved to the marketplace for failure to meet wellness goals will probably not receive dental benefits in their marketplace plans.