Updates About Public Health

A recent brief issued by the Senate Fiscal Agency showed that 21.7% (or 18 out of the 83) Michigan counties are considered a maternity desert. This designations is assigned for counties that do not have a single hospital or birth center offering obstetric care and contain no obstetric providers. This number is up from 18% (15 out of 83 counties) in 2023.

Michigan’s maternity desert counties include Keweenaw, Ontonagon, Baraga, Iron, Alger and Luce in the Upper Peninsula. Lower Peninsula counties include Cheboygan, Presque Isle, Antrim, Oscoda, Alcona, Missaukee, Lake, Gladwin Arenac, Ionia, Cass, and Sanilac. The three counties with the longest birth commutes—Luce, Schoolcraft, and Ontonagon—are all located within the Upper Peninsula.

Recently, Aspirus Health announced they were ending OBGYN services at their Ironwood location. The move was met with sharp criticism from Republican lawmakers who represent the Upper Peninsula. Sen. Ed McBroom (R-Vulcan), pointed out that despite the U.P. being bigger than six U.S. states, it only has six locations equipped to handle births.

Other data in the brief shows that the state was experiencing a steady birth rate beginning in the 1950’s. That is until 2023 when, for the first time ever, the birth rate fell below 10 births per 1,000 people. The rate in 2024 was 9.65 births for every 1,000 people.

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.