Gizmo Warehouseby Joe Eichenbaum | 17A

Medicaid work requirements · Michigan

Medicaid work requirements in Michigan: who is subject and who loses coverage (2027)

Data snapshot 2026-06-03 · part of These 5 Million People Are About to Lose Their Medicaid — But They Don't Have To

Michigan expanded Medicaid, so the federal work requirement that takes effect January 1, 2027 applies to its expansion adults. About 670,144 of them (11.3% of an expansion pool of 716,393) will have to prove 80 hours a month of work, school, or service, or an exemption, to keep coverage.

This model's bottom-up estimate is that 216,131 people in Michigan lose coverage by 2034: 196,026 of them still eligible but lost to paperwork and reporting failures, and 20,104 not meeting the requirement. Nationally the same model gives 5,461,400, against CBO's 5,200,000.

Whether those eligible people keep coverage depends on the state's ability to renew them automatically (ex parte) from data it already holds. Michigan scores 65 of 100 on this model's ex parte capability index, a mid band; its eligibility system is Bridges / MiBridges.

Key figures

Model v2-2026-06-03. "Strict" counts adults whose ACS record shows them subject with no observable exemption; "permissive" allows the broader exemption reading.
MeasureMichigan
Expansion stateYes
Subject to the requirement via waiverNo
Expansion pool (adults 19 to 64)716,393
Adults subject, strict definition670,144
Adults subject, permissive definition656,741
Share of expansion pool subject11.3%
Projected coverage loss by 2034216,131
Hardship exception statusAdopting
Early implementerNo
Ex parte capability score (0 to 100)65 (mid)

Who is subject in Michigan

Of the 670,143 subject adults, 38% already work 80 or more hours a month and 55% are not working. 34% have a child under 14 at home. Among those not working, 49% report a disability and 16% are caregivers.

ACS PUMS 5-year 2020 to 2024, subject adults only.
CharacteristicShare of subject adults
Age 19-2414%
Age 25-3422%
Age 35-4420%
Age 45-5419%
Age 55-6425%
Not working55%
1 to 19 hours a month1%
20 to 79 hours a month6%
80 or more hours a month (meets the bar)38%
Not working: Disabled49%
Not working: Caregiver16%
Not working: Postpartum0%
Not working: Student3%
Not working: Other32%

Why eligible people lose coverage

Of the 216,131 projected to lose coverage in Michigan, 196,026 meet the requirement or qualify for an exemption but fail to document it. 68,261 of those are working people who cannot prove their hours through data the state can see, and 127,766 qualify for an exemption the state does not detect automatically.

Bottom-up model v8.0-2026-05-30; documentation-failure buckets compound over the 14 six-month renewal cycles through 2034.
GroupProjected to lose coverage
Multiple part-time jobs (aggregation failure)22,273
Variable shifts / on-call work14,157
Self-employed (other)13,260
Cash-paid construction & trades4,747
Full-time students not auto-verified4,419
Volunteering / job training4,078
Seasonal: agriculture, hospitality, food service3,501
Gig / courier (DoorDash, Uber, Lyft, Instacart)1,825
Medically frail without auto-match41,477
Caregivers of a disabled adult31,664
Parent caregivers of children ≤13 without auto-match29,916
Kinship caregivers (non-parent) of children ≤139,744
SUD treatment not flagged in claims data5,349
American Indian / Alaska Native (tribal exemption)4,659
Other categorical exemptions (foster, AYA cancer, SNAP/TANF)3,460
Recent incarceration (data-match gap)1,133
Pregnancy / postpartum data lag363

Can the state renew people automatically?

The ex parte capability index blends the state's observed automatic-renewal rate (67% in CMS eligibility-processing data), the wage, disability, and other data sources it can query, and its history of churn. Michigan's composite score is 65 (mid band). A low score means more eligible people will be dropped for paperwork unless the state changes its process before January 1, 2027.

ComponentScore
Composite65
Observed ex parte67
Core capability79
Data sources69
Historical churn50

How subjects overlap across exemption categories

Each subject adult sits in exactly one cell. Categories: Working ≥ qualifying hours / income; Parent caregiver of child ≤13; Medically frail; Full-time student.
CombinationAdultsShare
None of the four244,07536.4%
Working ≥ qualifying hours / income124,85218.6%
Medically frail102,07915.2%
Working ≥ qualifying hours / income + Parent caregiver of child ≤1395,64514.3%
Parent caregiver of child ≤1341,0266.1%
Full-time student17,9582.7%
Working ≥ qualifying hours / income + Full-time student15,5712.3%
Working ≥ qualifying hours / income + Medically frail10,6411.6%

Counties in Michigan

Subject adults concentrate: Wayne County (107,114), Oakland County (82,576), and Macomb County (55,962) account for 37% of the state's subject population.

All 83 counties in Michigan with subject adults, sorted by count. County figures are model allocations of the state estimate by ACS tract characteristics.
CountyAdults subjectSubject rateProjected lossPoverty rateWorking-age population
Wayne County107,11410.3%34,54620.0%1,040,022
Oakland County82,57610.7%26,6328.0%771,876
Macomb County55,96210.6%18,04910.0%528,548
Kent County41,46310.4%13,37211.0%399,818
Washtenaw County27,56511.8%8,89014.0%233,950
Genesee County25,66111.0%8,27616.0%233,443
Ottawa County21,42912.2%6,9118.0%175,427
Ingham County20,88911.7%6,73717.0%178,348
Kalamazoo County18,56711.6%5,98813.0%159,590
Livingston County13,76611.9%4,4405.0%115,489
Saginaw County12,56811.7%4,05318.0%107,281
Muskegon County11,08510.9%3,57513.0%102,034
St. Clair County11,05711.8%3,56612.0%93,386
Monroe County10,62411.8%3,42611.0%90,398
Jackson County10,38411.0%3,34912.0%94,174
Berrien County10,35312.0%3,33916.0%86,190
Calhoun County8,65511.3%2,79115.0%76,596
Allegan County8,18811.8%2,64110.0%69,533
Eaton County7,35711.6%2,3738.0%63,632
Bay County7,07611.9%2,28215.0%59,256
Lenawee County6,67211.7%2,15211.0%56,828
Grand Traverse County6,54511.8%2,11110.0%55,263
Lapeer County6,13811.7%1,98010.0%52,308
Midland County5,48911.3%1,77010.0%48,379
Clinton County5,42111.6%1,74810.0%46,780
Marquette County5,22813.0%1,68614.0%40,150
Isabella County5,18412.5%1,67224.0%41,616
Van Buren County5,14912.1%1,66114.0%42,555
Shiawassee County4,49411.3%1,44911.0%39,783
Montcalm County4,45710.9%1,43812.0%40,883
Barry County4,37112.0%1,4108.0%36,550
Ionia County4,31710.5%1,39210.0%41,284
St. Joseph County4,17612.2%1,34713.0%34,112
Cass County3,74313.0%1,20713.0%28,852
Tuscola County3,65512.1%1,17912.0%30,220
Houghton County3,61716.4%1,16717.0%21,992
Newaygo County3,54012.4%1,14215.0%28,648
Mecosta County3,30913.8%1,06718.0%24,066
Hillsdale County3,25312.8%1,04915.0%25,400
Branch County2,92811.5%94415.0%25,369
Sanilac County2,85712.9%92115.0%22,171
Delta County2,67013.5%86113.0%19,782
Gratiot County2,59210.3%83614.0%25,243
Emmet County2,48913.1%8038.0%19,059
Huron County2,36314.4%76211.0%16,460
Chippewa County2,36310.6%76216.0%22,234
Wexford County2,31112.3%74513.0%18,872
Clare County2,28413.5%73722.0%16,936
Mason County2,14713.8%69214.0%15,529
Alpena County2,03512.7%65617.0%16,029
Iosco County2,00315.4%64615.0%12,992
Cheboygan County1,99914.1%64512.0%14,136
Oceana County1,97513.3%63714.0%14,878
Roscommon County1,96816.4%63516.0%11,992
Charlevoix County1,95713.8%6319.0%14,202
Antrim County1,89814.7%6129.0%12,889
Leelanau County1,88716.6%6097.0%11,386
Otsego County1,87913.1%60611.0%14,351
Gladwin County1,87313.8%60414.0%13,588
Manistee County1,86313.5%60111.0%13,834
Dickinson County1,81712.7%58610.0%14,264
Menominee County1,76814.0%57011.0%12,627
Osceola County1,65613.0%53416.0%12,702
Ogemaw County1,55714.0%50217.0%11,148
Benzie County1,38514.1%44710.0%9,789
Kalkaska County1,24111.9%40015.0%10,444
Arenac County1,14014.1%36814.0%8,056
Gogebic County1,09714.3%35414.0%7,660
Presque Isle County1,09116.4%35213.0%6,636
Missaukee County1,08613.0%35011.0%8,340
Lake County96013.5%31020.0%7,119
Crawford County94713.0%30614.0%7,284
Iron County93215.8%30115.0%5,877
Alcona County85716.5%27716.0%5,193
Mackinac County83713.9%27016.0%6,026
Montmorency County79916.4%25819.0%4,882
Oscoda County65715.5%21214.0%4,231
Schoolcraft County63514.8%20516.0%4,296
Alger County62312.4%20110.0%5,006
Baraga County52010.8%16812.0%4,820
Ontonagon County51317.6%16514.0%2,908
Luce County42711.4%13818.0%3,738
Keweenaw County16015.4%518.0%1,033

State brief and methodology

Estimates, not counts. The model rakes to CBO's national subject total and allocates by ACS microdata; state agencies hold the administrative data that would replace these figures.

Sources

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