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Michigan Requests CMS Approval of Medicaid Expansion Plan, Will Offer Supported Employment and Community Living Services to Previously Uninsured Individuals

December 19, 2013

On November 8, 2013, the State of Michigan submitted a request to the Centers for Medicare and Medicaid Services (CMS) for approval of its Healthy Michigan Plan, which will extend Medicaid coverage to all individuals aged 19 to 64 with incomes below 133% of the federal poverty level (FPL), including low-income workers with disabilities who had not previously been eligible for Medicaid. This expansion of Medicaid eligibility was authorized by the Affordable Care Act. Michigan seeks to implement the Healthy Michigan Plan as a research and demonstration project under Section 1115 of the Medicaid Act.

As authorized by the Affordable Care Act, most Healthy Michigan Plan participants will be enrolled in an alternative managed care plan and not in the traditional Medicaid State Plan. Nevertheless, individuals with significant disabilities in this population may be classified as “medically frail” and given the option to enroll in traditional Medicaid.

The Healthy Michigan Plan promises to include numerous services that could help low-income people with disabilities remain employed, including supported employment services, assistive technology, housing assistance and fiscal intermediary services. These services are already available to existing Medicaid beneficiaries through a Medicaid waiver program aimed at people with mental health disabilities and substance abuse disorders; Michigan plans to work with CMS to determine the best way to ensure that these services are also available to individuals enrolled in the Healthy Michigan Plan. Because Michigan’s proposal continues to classify these services as “mental health services and substance use disorder services,” it is unclear whether these services will be available to Healthy Michigan Plan participants with diagnoses of intellectual or developmental disabilities as well as those with diagnoses of mental health and substance use disorders.

For the full Healthy Michigan Plan proposal, see http://www.michigan.gov/documents/mdch/Healthy_Michigan_Waiver_Amendment_for_Web_439514_7.pdf