By Emily Lawler

Gov. Rick Snyder on Friday signed a bill requiring able-bodied recipients of the state's Healthy Michigan Medicaid program to work or risk losing health care coverage.

The Trump administration opened the door to such a change, approving a handful of state waivers to put Medicaid work requirements in place. Michigan will seek such a waiver under the new law.

The new law affects Michigan's 670,000 Healthy Michigan Plan recipients covered under the state's Medicaid expansion. It requires able-bodied recipients to work but provides exemptions for people including pregnant mothers, people with disabilities, caretakers of disabled dependents, caretakers of children under age 6 and individuals who have a medical condition that results in a work limitation.

The House Fiscal Agency estimates that the net fiscal effect of the bill will be a savings of between $7 million and $22 million, mainly due to a reduced Medicaid caseload.

The bill changed significantly throughout the legislative process. As introduced, it would have required Medicaid recipients to work 30 hours per week. The final version requires an average of 20 hours of work per week, or 80 hours per month. Recipients would need to comply with this for at least nine months per year.

It also requires people with income from 100 to 133 percent of poverty level who are on Medicaid for more tahn 48 months to undergo a health risk assessment and pay a premium of 5 percent.

Snyder billed his signature as a way to make sure the Healthy Michigan program he spearheaded was able to continue.

"Our Healthy Michigan program has improved the lives of hundreds of thousands of Michiganders, and I'm very proud it has been so successful," Snyder said in a statement.

"The original estimates were that 400,000 people without health care would be able to obtain it after the creation of Healthy Michigan, and today more than 670,000 people have coverage. I am committed to ensuring the program stays in place and that Michiganders continue to live healthier lives because of it."

But in fact, the bill contains a new provision that critics say could kill the program. If the federal government does not approve a waiver to let the state charge the 5 percent to people who are from 100 to 133 percent of poverty level and have been on the program for more than 48 months, the Healthy Michigan Medicaid expansion will draw to a close.

Michigan League for Public Policy President and CEO Gilda Jacobs in a statement criticized the new law and its potential to kill the program.

"Worst of all, the law would kill the Healthy Michigan Plan altogether, eliminating lifesaving care for 670,000 Michiganders, if the Trump administration fails to approve these changes now or in the future, or if lawsuits invalidate the waiver. It's just appalling," Jacobs said.

Snyder in his press release said he had met with the federal Centers for Medicare and Medicaid Services and expects the waiver to be approved.

The work requirements are scheduled to begin on Jan. 1, 2020.

(c)2018, Walker, Mich.