Medicaid work requirements move from statute to paperwork

Medicaid work requirements are moving from statute to paperwork. In Michigan, expansion beneficiaries aged 19-64 — nearly 700,000 people in the Healthy Michigan Plan — must document 80 hours per month of qualifying activities and renew twice a year under rules effective Jan. 1, 2027. Family caregivers of a dependent child 13 years of age and under or a disabled individual are exempt. But advocates warn CMS's interim final rule narrows exemptions further: people with substance use disorders must prove the condition significantly impairs their ability to meet the requirement, those in “stable recovery” — defined as five or more years — are excluded, and use of self-attestation is strikingly limited.