Payer Roundup—Michigan Medicaid work requirements could be discriminatory; Feds block Iowa plan

Medicaid on paper and a stethoscope
Michigan's proposed work requirements could be unfairly targeting black beneficiaries. (Getty/designer491)

Black Michiganders hit hard by proposed Medicaid work requirements

A Republican-sponsored bill in Michigan to impose Medicare work requirements could include a discriminatory component that seemingly favors white beneficiaries.

According to an analysis by the Washington Post, of the 700,000 people who would be hit with the proposed requirements, 23% would be black and 57% white. However, among those who would qualify for the underemployment exemption, only 1% would be black, versus 85% white. 

“The notion that the legislation was written to the benefit or detriment of one group of recipients is false,” the state's Senate Majority Leader Arlan B. Meekhof, a Republican, told the newspaper in an email. "The bill is in the early stages of the legislative process and will likely see changes and revisions before it makes its way to the governor.”


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Republicans in the state have nearly unilateral power over legislation, as the party holds the governor's mansion and both state legislative chambers. The plan would save the Great Lake state between $25 million and $45 million annually. (The Washington Post)

New Hampshire on the cusp of extended expansion

In New England, another Republican-controlled state is close to extending their expanded Medicaid program for another five years.

RELATED: What CMS' Seema Verma says states should think about before applying for Medicaid waivers

A bill to continue the state's expanded Medicaid coverage was approved by the New Hampshire state Senate 16-6 last year after passage in the House last month, as reported by New Hampshire Public Radio. The bill also includes some new work requirements, following a trend in other states, as well as use 5% of liquor revenues to keep costs down as federal funding decreases. 

Gov. Chris Sununu has said he backs the bill and he is expected to sign it. (New Hampshire Public Radio)

Feds block Iowa's controversial Medicaid plan

CMS has blocked a $1 billion plan from Iowa that would have doubled Medicaid reimbursement for some nursing homes.

RELATED: Researchers estimate Alabama's work requirements would drop 8,700 from Medicaid

Iowa's officials asked the feds to reconsider its decision, according to the Des Moines Register, and the agency has until June 30 to reverse the ruling. State officials argue the nursing homes are in a "precarious financial condition," but critics of the proposal argued it was written almost entirely by industry lobbyists. The proposal would have cost the federal government an additional $200 million each year. (Des Moines Register)