Potholes? The Proposed Pilot Program in Michigan To Drug Test Medicaid Applicants Just Hit One

Healthy Michigan Campaign

Healthy Michigan Campaign Launched Gov. Snyder 2013

Michigan’s vital economy centers around the automotive industry which has struggled since the mid 1990’s to rebound. Our struggling economy is apparent in our critical infrastructures–bridges and roads– that are crumbling in disrepair, leading to a loss of $ 1 Billion annually in our Michigan transportation assets.  Many residents have suffered layoffs, hard times, and gaps in healthcare.  Michigan initially focused on concrete ways to repair our economy and added 600,000 residents to the medically insured road with the “Healthy Michigan Campaign in 2013”. By 2015, the war on poverty had shifted to war on the  impoverished themselves with passage of SB 275 and HB 4118.

This bill permits a one yearlong pilot program in 3 Michigan counties to drug test Medicaid applicants and recipients suspected of illicit drug use. If the individual tests positive, they will be required to enter a substance abuse treatment program. If the person refuses drug testing, the benefits would be cut off for six months. If the person tests positive a second time, they will lose benefits for another six months. Michigan has previous legal notoriety for imposing drug testing of welfare recipients in 2000 which was struck down as unconstitutional by the US Court of Appeals in 2003 violating the 4th amendment. Gov. Snyder states that in 2015, new data is needed to identify suspected substance abusers who would benefit from treatment so “we can remove the barriers that are keeping people from getting good jobs, supporting their families and living independently.” No other group that receives State of Michigan support is part of this pilot program.

Drug testing welfare recipients as a condition of Medicaid eligibility is a policy that is scientifically, fiscally, and constitutionally unsound.  Welfare recipients are no more likely to use illegal drugs than the rest of the population. Science and medical experts oppose drug testing of welfare recipients because of limited utility and creation of stigma. Drug testing is expensive. Data gathered by ThinkProgress showed 7 states spent over $1 million dollars and all but one (8.3%) had a positive drug test rate of welfare applicants below 1% with a national drug use rate at 9.4% in the general population. In addition, drug testing suspected substance abusers is ineffective to uncover drug abuse. A 1998 Oklahoma study found a questionnaire was cheaper and more effective than drug testing to detect drug use including alcohol.

In 2015, at least 18 states have introduced proposals that would require drug screening or testing for public assistance applicants or recipients. Fixing our state roads and bridges is more fiscally prudent than drug testing Medicaid recipients to remove barriers; this pilots program lacks, scientific, financial or constitutional merit. It is time to revisit the validity of the 1996 Welfare Reform Act that authorized, but did not require, states to impose mandatory drug testing as a prerequisite to receiving state welfare assistance. Michigan, for one, has hit a damaging pothole that could deter people who desperately need health care, including women and children, from a “Healthy Michigan–Saving lives. Strengthening Our State”.


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5 Responses to “Potholes? The Proposed Pilot Program in Michigan To Drug Test Medicaid Applicants Just Hit One”

  1. ehorinek Says:

    There’s a similar initiative in some states with the Temporary Assistance for Needy Families (TANF) program (or welfare). Studies have shown that, in the states implementing drug testing as a requirement of receiving assistance, only a handful of people in each state test positive for drugs. I’m not sure what the argument for implementing drug tests for Medicaid is, but in the case of TANF, supporters claim that it is a method identifying and getting help to drug addicts (as there is a requirement that to get TANF funds after a positive test, one must successfully complete a drug treatment program to be eligible for assistance). But, who pays for that? What other support is that person given during the program? Same situation with this Medicaid issue: spending a a lot of money to save very little and further alienate people who probably need help the most.

  2. kesper2 Says:

    I’m from Michigan and hadn’t yet heard of this policy. I found myself becoming very emotional and frustrated when reading your post. This is a very interesting topic and a great example of policy that isn’t logically sound. Where is the data correlating the drug use to the problem that Michigan is trying to solve? This policy would have a stronger case is there was proven correlation between drug use and inappropriate use of welfare AND if there was data proving that offering treatment to the welfare population would alter the drug use behavior.

    I appreciate you raising awareness on this issue. I ended up doing some research on my own and saw that only 48 of almost 39,000 tested positive in Missouri. The trends were very similar across other states that had implemented the policy. It appears as though a great deal of money is being spent to identify a very small population. If Michigan’s going to go digging for a needle in a haystack, let’s make sure that that needle is worth it and the action taken on that needle will create some real and permanent good.


    Thanks for the post!

  3. monicacmix Says:

    It’s unfortunate that Michigan and so many other states are focusing on punitive, ineffective legislation that only serves to reinforce existing power structures by blaming vulnerable populations for their low socioeconomic status. The Michigan bill is particularly harsh as it is focused specifically on the Family Independence Program (FIP), a program that provides cash assistance only to families with minors. In other words, by definition, the bill disproportionately affects children. Although an earlier version of the bill had a provision to allow children to continue receiving benefits through a third party even if their parents lost benefits, this provision was stripped from the final bill. In a state that received billions from the federal government for bailout of the automotive industry, the Legislature’s lack of interest in protecting the state’s children can only be described as cruel.

  4. carolinejhsph Says:

    Great blog post – lots of good points and interesting arguments. Certainly sounds like a very expensive pilot program that targets and affects a vulnerable population and impinges on these individuals’ personal dignity and rights. I agree that such a punitive approach does not encourage actually addressing the root cause of the health problems suffered by these individuals.

  5. Sara E. Thiam Says:

    I am also from Michigan, and I also did not know about this policy. I am quite shocked. There are various provisions that already make people who are on Medicaid feel like the government is trying to shape their life decisions – teach them how to be better citizens. I think that much if the time, all people need is social assistance and health care. This program clearly feeds off of this perception that people on Medicaid need social, said moral, correction. I am glad to see that you and others on this post have looked into actual evidence (unlike the proponents, perhaps) to find that drug addiction is not particularly characteristic of Medicaid recipients. Please spread your findings far and wide to combat such discriminatory policies which stigmatize and punish the poor.

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