Have an opinion on Michigan’s Medicaid work rules? Weigh in quickly.

Michigan health officials say they want to hear from you about the state’s plan to require Medicaid expansion recipients to work to continue receiving health benefits.

Before the state asks the federal government this fall to approve its controversial plan, which Gov. Rick Snyder signed into law in June, it needs to collect public feedback. The deadline to submit questions or comments is Sunday, Aug. 12, though Michigan Department of Health and Human Services staffers say they’ll continue to take feedback even after the formal comment period ends.

When the Republican-sponsored bill was introduced in the Legislature this spring, it immediately elicited criticism from advocates for low-income Michiganders that the bill would harm some of the state’s most vulnerable residents.

Though they have been imposed as conditions for receiving other forms of welfare assistance, work requirements had not been permitted under Medicaid until the Trump administration this year loosened guidelines, allowing states to apply to adopt them.

Four states — Indiana, Kentucky, Arkansas and New Hampshire — have had waivers to create Medicaid work requirements approved by the federal Centers for Medicare and Medicaid Services. But a federal judge recently blocked Kentucky’s proposal from taking effect and sent it back for more review. That case is being watched across the country.

Michigan held two public hearings last week in Lansing and Detroit. DHHS spokesman Bob Wheaton said about 45 people attended in total; the hour-long meetings were held on weekday afternoons. (The Lansing event was recorded and can be viewed here.)

In all, 245 comments have been submitted thus far, Wheaton said. Department staff will send all written comments to the federal Centers for Medicare and Medicaid Services, which decides the waiver request, and will make them available online once the waiver is submitted by Oct. 1.

People will continue to be able to send in questions or comments after Sunday’s deadline passes, he said.

Sen. Mike Shirkey, a Republican from Clarklake in Jackson County who sponsored the work bill, and business groups maintain the requirements are needed to help fill a talent pipeline for employers having trouble finding workers. Requiring work in exchange for government assistance is a “hand up” rather than a “handout,” its backers say, and will help people move up the economic ladder.

GOP legislators and business groups, including the Michigan Chamber of Commerce, have expressed concern that the state’s Healthy Michigan Plan would negatively impact the state budget, as enrollment exceeded initial expectations.

Critics of the idea, including Democratic lawmakers and advocacy groups like the Michigan League for Public Policy, contend that Medicaid was never designed to be a workforce development program.

These critics say it’s unclear how many of the state’s roughly 660,000 Healthy Michigan Plan recipients could be subject to the work rules — a DHHS official said at a recent public hearing that department staff are still working to identify the number. Critics add that many recipients already work or would run into child care and transportation barriers trying to comply with the work mandate.

An earlier version of the bill included an exemption for people who live in high-unemployment counties, though the provision was pulled after criticism that it would cover mostly white, rural residents and not poor, heavily minority residents living in high-unemployment cities.

If the federal government approves Michigan’s request, the law as signed would require able-bodied adults enrolled in the Healthy Michigan Plan to work for an average of 80 hours per month — roughly 20 hours per week — to keep benefits; other activities allowed under the rules include job training, education, internships, community service and an active job search. Recipients who fail to meet the requirements for more than three months in a year would lose benefits for at least a month until they’re again in compliance.

The new changes also would require Healthy Michigan Plan enrollees earning between 100 percent and 133 percent of the federal poverty level, and who have participated in the program for at least 48 months, to pay 5 percent of their income toward their benefits. That’s up from 2 percent today.

The work law also adds triggers that would end the Healthy Michigan program altogether, depending on whether the federal government signs off on the waiver the state would need to impose the work requirements, prompting concerns that the entire Medicaid expansion population could be at risk of losing benefits.