In December 2017, a team of University of Michigan researchers did extensive research on individuals in the Michigan Medicaid expansion, called the Healthy Michigan Plan, population.
- Nearly half the individuals are working (48.8%)
- 5% are students
- Nearly 5% are home taking care of children
- 11% reported being unable to work because of their health
- Over one fourth are out of work, many of them because they are in fair or poor health. Three-quarters of those who were out of work reported having a chronic health condition.
NOTE: This study was the first peer-reviewed study from the formal evaluation of Michigan's expansion, called the Healthy Michigan Plan. The evaluation, funded by a contract with the Michigan Department of Health and Human Services, was required under Michigan's federal waiver.
As Renuka Tipirneni, lead author of the study notes, "'Is it worth the cost to screen and track enrollees when only a small minority isn't working who are potentially able to work?"
2. The Medicaid expansion has helped improve individuals' health.
Health improvements mean it is more likely that they will be able to work--now or in the future.
According to the UM IHPI study, "In all, nearly half of the newly covered Michiganders said their physical health improved in the first year of coverage, and nearly 40 percent said their mental or dental health got better. Those who said their health improved also had the most chance of experiencing an effect on their work life. As a group, they were four times more likely to say that getting Medicaid coverage helped them do a better job at work. And those who felt their health had improved, but were out of work, were three times as likely to say that their coverage helped them look for a job."
3. Work requirements can worsen (or externalize) other problems.
For instance, a person with epilepsy who loses access to seizure medications could have a seizure while driving and have a car accident. The cost, then, is to the individual (who is injured by the car accident and seizure), to the costs to the insurance system, and potentially to other individuals involved in the car accident.
4. Work requirements cost the system more.