It was March 2020, and Robert Gordon was about to kick some 80,000 people off health insurance.
As the Michigan state health director, he had spent the past year, and some $30 million in state tax dollars, trying to avoid that very thing.
Gordon was a Democrat, a veteran of the Obama administration, and he did not want people to lose the Medicaid coverage they had recently gained through the Affordable Care Act.
But Gordon and his boss, Democratic Gov. Gretchen Whitmer, had reluctantly inherited a law passed two years earlier, when Republicans led the state. And that law mandated that Michigan institute a work requirement for Medicaid on Jan. 1, 2020.
Gordon and his team determined that most enrollees were already meeting the law’s requirements, either because they were already working or had an exemption. Thousands more reported their status through the newly built phone and online systems.
But even so, estimates suggested 80,000 to 100,000 Michiganders were going to be booted off the rolls within the year.
“That’s the population of the city of Flint who were on track to lose their insurance,” said Gordon, who led the state health department until 2021. “We’re implementing this about as well as this thing can be implemented, and it is still going to be pretty catastrophic.”
The new tax-and-spending law signed by President Donald Trump in July mandates a vast expansion of Medicaid work requirements to most states.
These systems will lead to 5.3 million more people being uninsured in 2034, according to an estimate from the Congressional Budget Office.
The law applies to 40 states and Washington, D.C., because they expanded Medicaid in recent years to cover more working-age adults.
About 18 million people will be affected once the work mandate is fully implemented nationally, according to the CBO. Unless the …