Updates About Public Health

According to a statement released by Michigan Department of Health and Human Services (MDHHS) Director, Elizabeth Hertel, the meager budget passed by House Republicans would have dire consequences on Michigan residents. Hertel highlighted that the budget’s $4.95 billion reduction in MDHHS funding would lead to significant staff reductions impacting child protective services workers, benefits specialists, disease specialists, and fraud, waste, and abuse investigators.

The director also reported that the budget cuts would curb certain service programs such as removing $20 million in adult dental coverage, $10 million to hospitals for maternal health care, $7 million for the Office of Community Violence and their gun violence reduction efforts, $6.8 million to state psychiatric hospitals, and $4 million toward addressing homelessness.

Hertel stressed that the eliminated funding would negatively impact behavioral health services by increasing wait times and decreasing the state’s patient capacity capabilities. The cuts would also erase Medicaid coverage for approximately 33% of residents in rural communities, placing an extra burden on local hospitals and resources posed with absorbing the costs of their care.

According to the Citizens Research Council (CRC), approximately 530,000 Michiganders are set to see higher healthcare costs due to the expiration of federal tax credits for health insurance purchased through Patient Protection or the Affordable Care Act (ACA). Congress failed to extend these tax credits when passing the One Big Beautiful Bill Act. Currently, around 350,000 Michigan residents are covered by tax credit supported plans supported by the federal government. After the credits expire, estimates point to a 70% increase in premiums on the marketplace. Additionally, 200,000 Michiganders are set to lose insurance coverage under the ACA.

The CRC warns that these coverage losses could create ripple effects across the state. Residents who forgo coverage will face greater financial and health challenges, while the departure of healthy enrollees from the marketplace will drive up costs for those who remain. Even employer-sponsored plans could see higher premiums as the marketplace shifts. Many will wait to seek healthcare until it requires a visit to the emergency department. However, those delaying care are mostly likely to be unable to afford its cost, thereby causing uncompensated care costs to rise.

The CRC cautioned that the state will have to grapple with the impacts of fewer people having health insurance, higher premiums, and increasing uncompensated care for hospitals. CRC suggested a state tax credit or healthcare incentives, but any move would require more state spending. Given the tight budget climate, lawmakers may resist, but inaction could result in daunting consequences for Michigan residents.

As we prepare for the upcoming cold and flu season, Governor Gretchen Whitmer has taken steps to expand access to the COVID-19 vaccine through instructions in a recently-signed executive directive. Within the directive, Whitmer advised departments to give clear public and provider guidance on COVID-19 vaccine safety, ensure providers promote and administer the vaccines, remove barriers to access, and require coverage by all health plans under the Michigan Department of Health and Human Services (MDHHS) and Department of Insurance and Financial Services (DIFS), including Medicaid and private insurers.

Michigan’s Chief Medical Executive, Dr. Natasha Bagdasarian, also stressed the importance of vaccine accessibility in her Standing Recommendation issued shortly after the executive directive. According to the FDA’s vaccine administration guidelines, the vaccine is approved for individuals over the age of 65 and for those between age 5 and 64 with conditions that place them in a high risk category. Dr. Bagdasarian noted, however, that the FDA did not define which pre-existing conditions qualify an individual as high risk. As such, Dr. Bagdasarian’s recommendation designates that any individual age 6 months or older without contraindications may be eligible to receive the vaccine since any pre-existing or latent condition, including not previously being vaccinated against COVID-19, may qualify someone as high-risk.