Find affordable health plans

Since 2008, we’ve helped more than 16 million people.

(Step 1 of 2)

Michigan health insurance

Nine insurers are offering 2019 plans through the state's exchange and will continue to do so in 2020; short-term plans available with plan terms up to 185 days.

Health insurance in Michigan

Michigan exchange overview

State legislative efforts to preserve or strengthen provisions of the Affordable Care Act

How hard is Michigan fighting to preserve the Affordable Care Act’s provisions? Compare to other state-level efforts.

Michigan has a state-federal partnership exchange. All nine of the insurers that offered plans in Michigan’s exchange in 2019 are continuing to offer coverage for 2020. In addition, there are two insurers that offer individual market coverage in Michigan only outside the exchange.

Open enrollment for 2020 health plans has ended, although residents with qualifying events can still enroll or make changes to their coverage for 2020. The next open enrollment period, for plans effective in 2021, will begin November 1, 2020.

After increasing individual market premiums by an average of just 1.7 percent for 2019, Michigan’s insurers proposed an average premium decrease of about 2.5 percent for 2020.

In 2019, a 40-year-old in Lansing who earns $25,000/year could get a bronze plan in Michigan’s exchange for under $15/month after the premium subsidy was applied.

Premium subsidies are available for people with income up to 400 percent of the poverty level. For 2020 coverage, that amounts to $49,960 for a single individual and $103,000 for a family of four.

In addition to the insurers offering plans in the exchange, two off-exchange-only insurers — Alliance Health and Life, and Health Alliance Plan — are offering plans for 2020. Both proposed keeping their rates unchanged for 2020, after also leaving them unchanged in 2019. Premium subsidies are not available for off-exchange plans, so they’re generally only a good option for people who know they won’t be eligible for a subsidy.

In 2019, enrollment in Michigan’s exchange reached 274,058, which was more than 20 percent lower than it had been in 2016, when enrollment peaked in Michigan’s exchange. Enrollment peaked in 2016 in the majority of the states that use, and has declined since then for a variety of reasons: The Trump administration’s decision to reduce funding for exchange marketing and enrollment assistance, the elimination of the individual mandate penalty, the expansion of short-term plans, and the higher premiums that unsubsidized enrollees had to contend with in 2017 and 2018.

Read more about the Michigan health marketplace.

Michigan and the Affordable Care Act

Michigan was considered a red state following the 2014 elections, and support for the Affordable Care Act has been mixed. But the tide has been turning more recently. Following the 2018 election, Michigan’s state legislature is still GOP-dominated, but the margins are much smaller than they were. And Democrats were elected to serve as governor, secretary of state, and attorney general.

Sens. Carl Levin and Debbie Ann Stabenow, both Democrats, voted in favor of the Affordable Care Act in 2010. Levin retired in January 2015 and was replaced by U.S. Rep. Gary Peters, a Democrat. Peters voted for the ACA in the House in 2010.

Michigan’s delegation to the U.S. House of Representatives split along party lines in the 2010 ACA vote. Eight Democrats voted yes, while seven Republicans voted no. Michigan lost a House seat following the 2010 census. Republicans clinched a 9-5 majority following the 2014 elections, but the House representation from Michigan will be 7-7 following the 2018 election, with Democrats picking up two seats.

At the state level, Republicans control both the House and Senate, although their margins are smaller following the 2018 election. The legislature did not authorize a state-run health insurance exchange, despite former Gov. Rick Snyder’s preference for that approach. Michigan was among the handful of states that implemented a partnership exchange.

Michigan did expand its Medicaid program through the ACA, but it included some unique provisions that required federal approval. And the state has received federal approval for a Medicaid work requirement, after enacting legislation to authorize the work requirement during the 2018 session. Governor Gretchen Whitmer is opposed to Medicaid work requirements, but it’s unclear how much latitude she’ll have to intervene in the process, which can be implemented anytime after the end of 2019.

Medicaid expansion and a pending work requirement

Former Governor Rick Snyder, a Republican, pushed for an alternative approach to Medicaid expansion in Michigan and ultimately gained bi-partisan support for Healthy Michigan. Medicaid expansion in Michigan uses the ACA’s eligibility guidelines (ie, up to 138 percent of the poverty level), but the state obtained approval from the Obama Administration to charge premiums when enrollees’ incomes are above the poverty level.

Medicaid expansion took effect under the ACA on January 1, 2014, but Michigan was a few months behind due to the state’s waiver process. Enrollment began April 1, 2014, and 632,254 people were enrolled in Healthy Michigan as of August 2019 (that was down from June 2018’s enrollment of 676,250).

The state is seeking to reduce Healthy Michigan’s enrollment, however, with a work requirement slated to take effect in 2020. Michigan enacted legislation in 2018 directing the state to seek federal approval for a work requirement.The waiver proposal was submitted to CMS in September 2018, and was granted federal approval in late 2018.

It was still pending CMS approval when Gretchen Whitmer, a Democrat opposed to Medicaid work requirements, won the gubernatorial election in Michigan. Snyder was term-limited and did not run for re-election in 2018. Whitmer was Michigan’s Senate Minority Leader in 2013 when Healthy Michigan passed and was instrumental in ensuring that the state would expand Medicaid.

It’s unclear whether Whitmer will be able to intervene in the Medicaid work requirement waiver process, given that all of the details are in statute. And work requirements in Kentucky, Arkansas, and New Hampshire have been struck down by a federal judge in 2019. It’s possible that decision could be overturned during the appeals process, but for the time being, Medicaid work requirements are in legal limbo.

As of April 2019, 2.3 million Michigans were enrolled in Medicaid/CHIP – a 21 percent increase over the enrollment total at the end of 2013.

Read more about Medicaid expansion in Michigan.

Short-term health insurance in Michigan

Michigan regulations limit short-term health insurance plans to no more than 185 days in duration and prohibit renewal. An applicant can purchase additional short-term plans, but cannot have more than 185 days of short-term coverage from one insurer in any 365-day period.

Read more about short-term health insurance in Michigan.

Other ACA reform provisions

The ACA’s Consumer Operated and Oriented Plan (CO-OP) Program encourages the formation of a new type of medical insurance company. CO-OPs are non-profit, consumer-run plans, and they are intended to increase choice and competition. In 2014, CO-OPs operated in 23 states.

Michigan Consumer’s Mutual CO-OP was founded with a $71.5 million dollar loan. Consumer’s Mutual hoped to enroll 37,000 members during the initial open enrollment period. In February 2014, a company executive told The New York Times that the CO-OP was lagging behind its goals, but didn’t share enrollment numbers.

Within days of 2016 open enrollment beginning in the fall of 2015, Consumers Mutual announced its closure and ceased operations at the end of 2015. As of mid-2019, there were only four CO-OPs remaining, offering plans in five states (Maine, Montana, Idaho, New Mexico, and Wisconsin).

Medicare in Michigan includes state protections for consumers

Michigan Medicare enrollment exceeded 2 million people as of early 2018, and has continued to grow, as is the case nationwide. As of mid-2019, there are about 2.06 million Michigan residents with Medicare coverage.

Based on 2016 data, 82 percent of Michigan Medicare recipients were eligible based on age alone, while the other 18 percent were on Medicare as the result of a disability.

Michigan has a Medigap subsidy program to help offset the cost of Medigap coverage for enrollees with modest income. And the state also protects access to certain Medigap plans for people who are disabled and enrolling in Medicare under the age of 65.

In Michigan, Medicare beneficiaries can enroll in Medicare Advantage plans instead of Original Medicare if they wish to gain additional benefits beyond what traditional coverage offers and don’t mind the limited provider networks and potentially higher out-of-pocket costs (versus Original Medicare plus a Medigap plan and Part D plan; out-of-pocket costs are actually unlimited with Original Medicare alone). Forty percent did so as of September 2018; nationally, 36 percent of all Medicare recipients nationwide choose Medicare Advantage.

About 55 percent of Michigan Medicare recipients are enrolled in Medicare Part D plans, which provide stand-alone prescription drug coverage.

State-based health reform legislation

Here’s a summary of recent Michigan bills related to healthcare reform: