Under the Same Sky featuring Jackie Prokop
Jackie Prokop, Associate Principal, HMA, discusses the complexities of designing and deploying work requirements programs.
Lessons learned from the implementation of work requirements in Michigan
In the first episode of our 5-part series focused on Medicaid work requirements, we dove into the urgent challenge facing all 50 states, implementing federally mandated work requirements by January 2027. Host Abner Mason was joined by Jackie Prokop, Associate Principal at Health Management Associates (HMA) and former Director of Medicaid Policy for the state of Michigan, to unpack the complexities of designing and deploying these programs.
Jackie shared firsthand insights from Michigan’s 2020 rollout of work requirements under a Section 1115 waiver, an effort that was halted after about four months due to a change in federal administration. Despite its short lifespan, Michigan’s experience offers valuable lessons for states now racing against time.
Key takeaways include:
Urgency and Scale: With only five quarters to implement, states must act immediately. Millions risk losing coverage if systems aren’t ready.
Operational Overhaul: Work requirements touch every aspect of Medicaid, from IT systems and call centers to member handbooks and contracts.
Policy Clarity: States must define terms like “community engagement” and “medically frail” to guide implementation and avoid confusion.
IT Challenges: Automating data collection and reporting is critical. States must decide whether self-attestation is sufficient or if verification is needed.
Community Engagement: Local organizations and health plans play a vital role in educating members and ensuring fair, accessible compliance pathways.
Fairness and Dignity: Jackie emphasizes designing systems that treat people with respect, especially during life transitions or health crises.
The episode closes with a call to action that states, and health plans should not wait for CMS guidance but proactively collaborate and advocate for practical, humane policies.
This is not just a Medicaid issue, it’s a public health, economic, and equity issue. The success or failure of work requirements will ripple across communities, budgets, and lives.
GroundGame.Health will continue this conversation in upcoming episodes, diving deeper into the challenges ahead and how to best prepare.
Join us for the next conversation in the series on Friday, October 17, at 3:30pm (ET) with special guest Jacey Cooper, President at Precision Health Strategies. Jacey will discuss lessons learned from her experiences with Medicaid and CHIP demonstrations.
