Michigan health insurance
- Michigan has a state-federal partnership exchange.
- Open enrollment for 2021 health plans ended December 15, 2020. Residents with qualifying events can enroll outside of open enrollment.
- Michigan has nine insurers offering plans on its exchange, plus two insurers that offer plans only off-exchange. Average proposed rate increase is about 1.3 percent for 2021.
- Nearly 263,000 Michiganders enrolled in 2020 plans during the last open enrollment period.
- Short-term health plans are available in Michigan with initial plan terms up to 185 days.
- Michigan’s legislature has a GOP majority, but their margin shrank in 2018 election and voters elected a Democratic governor.
- Michigan expanded Medicaid, but implemented a work requirement in 2020. The work requirement was soon overturned by a federal judge.
- Medicare covers more than 2.1 million people in Michigan
This page is dedicated to helping consumers quickly find health insurance resources in the state of Michigan. Here, you’ll find information about the many types of health insurance coverage available. You can find the basics of the Michigan health insurance marketplace and upcoming open enrollment period; a brief overview of Medicaid expansion in Michigan; a quick look at short-term health insurance availability in the state; statistics about state-specific Medicare rules; as well as a collection of Michigan health insurance resources for residents.
Michigan’s health insurance marketplace
Michigan has a state-federal partnership exchange, and residents use HealthCare.gov to enroll in individual and family health plans. These plans are used by people who have retired prior to age 65, people who are self-employed, and people who work for a small employer that doesn’t provide health insurance benefits.
Nine insurers offer coverage for 2020 in the Michigan exchange, and all nine will continue to offer policies for 2021. In addition, there are two insurers that offer individual market coverage in Michigan only outside the exchange.
After increasing individual market premiums by an average of just 1.7 percent for 2019, Michigan’s insurers reduced their average premiums by about 2.5 percent for 2020. For 2021, they have proposed average rate changes that range from a decrease of 2 percent to an increase of 6 percent, with an overall average proposed rate increase of about 1.3 percent.
Premium subsidies are available for people with income up to 400 percent of the poverty level. For 2021 coverage, that amounts to $51,040 for a single individual and $104,800 for a family of four. As of 2020, 86 percent of Michigan exchange enrollees were receiving premium subsidies, which reduce monthly premium costs to affordable levels. Premium subsidies are not available outside the exchange, so purchasing a health insurance policy directly from an insurance company (instead of through the exchange) is generally only a good option for people who know they won’t be eligible for a subsidy.
In 2020, enrollment in Michigan’s health insurance marketplace reached 262,919, down from about 274,000 the year before. As was the case in Michigan, enrollment peaked in 2016 in the majority of the states that use HealthCare.gov, 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 premium increases in 2017 and 2018 that made coverage unaffordable for some enrollees who didn’t qualify for premium subsidies (most enrollees need subsidies in order to make coverage affordable, but subsidies are not available to households that earn more than 400 percent of the poverty level).
Read our overview of the Michigan health insurance marketplace – including news updates and exchange history.
Michigan open enrollment period and dates
Open enrollment for 2021 health plans ran from November 1 through December 15, 2020. Outside of that window, Michigan residents can only enroll in individual market major medical policies (on-exchange or off-exchange) if they experience a qualifying event.
The open enrollment period is an opportunity to renew or change an existing plan for the coming year, or to newly enroll in individual market coverage. It’s also a good time to update financial information on file with the exchange, to ensure that premium subsidies are accurate for the coming year.
The November 1 – December 15 open enrollment period only applies to individual major medical health plans. It does not apply to health plans provided by an employer or to Medicaid or Medicare. Employers set their own open enrollment schedules, Medicaid enrollment is available year-round, and Medicare open enrollment (for Part D and Medicare Advantage plans) follows a different schedule.
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 as of 2020 includes seven Democrats, six Republicans, and one Independent.
At the state level, Republicans control both the House and Senate, although their margins became 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, which means the state oversees some aspects of the exchange, but the federal government’s HealthCare.gov enrollment platform and call center are used by Michigan residents.
Medicaid expansion in Michigan
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 for Medicaid plans 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 770,280 people were enrolled in Healthy Michigan as of August 2020. That was up from 645,504 in July 2019 — a 16% increase. The growth in Medicaid coverage is not surprising, given that so many people have lost their jobs as a result of the COVID-19 pandemic.
Before the pandemic, however, the state sought to reduce enrollment in Medicaid plans with a work requirement. 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.
The work requirement took effect in January 2020, but was overturned by a federal judge in March 2020, just prior to the explosion of the COVID-19 pandemic and widespread job losses. The judge’s ruling was not surprising, given that work requirements in Kentucky, Arkansas, and New Hampshire had already been overturned in 2019.
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 health insurance 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 created a new type of medical insurance company. CO-OPs are non-profit, consumer-run plans, and they were intended to increase choice and competition. In 2014, CO-OPs operated in 23 states, including Michigan Consumer’s Mutual CO-OP.
Within days of 2016 open enrollment beginning in the fall of 2015, Consumers Mutual put out a communication announcing its closure and ceased operations at the end of 2015. Consumers Mutual members who had coverage in 2015 had to select policies from other insurers for 2016.
As of 2020, there were only four CO-OPs remaining, offering plans in five states (Maine, Montana, Idaho, New Mexico, and Wisconsin). In 2021, this will fall to three CO-OPs remaining, as New Mexico Health Connections is closing at the end of 2020.
Medicare coverage and enrollment in Michigan
Medicare enrollment in Michigan stood at more than 2.1 million people as of August 2020. Most are eligible for Medicare due to age, but 17 percent of Michigan Medicare beneficiaries are under 65 and eligible for Medicare because of a long-term disability, end-stage renal disease, or ALS.
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.
Learn more about Medicare’s open enrollment period (October 15 – December 7), during which Medicare beneficiaries can compare policy options and make changes to their Medicare Part D prescription coverage or their Medicare Advantage coverage.
Michigan health insurance resources
- Michigan Department of Insurance and Financial Services — Regulates and licenses health insurance companies, brokers, and agents; serves as a resource for Michigan residents with questions or complaints related to health insurance.
- Arab Community Center for Economic & Social Services (ACCESS) — The federally-funded Navigator organization that can provide outreach and enrollment assistance to Michigan residents who need help obtaining health insurance. Navigators can assist with enrollment in Medicaid as well as a private health insurance plan through the exchange.
- Michigan Medicare/Medicaid Assistance Program (MMAP) — A local service that provides health benefits counseling and assistance to Medicare beneficiaries, including those who are eligible for both Medicaid and Medicare (in that case, Medicaid funds are used to offset some of the costs that a Medicare beneficiary would otherwise have to pay, including Medicare premiums and out-of-pocket medical costs).
- Medicare Rights Center — A nationwide service (website and call center) that can provide a wide variety of assistance to Medicare beneficiaries who have questions about enrollment, eligibility, benefits, and claims.
State-based health reform legislation
A summary of recent Michigan bills related to healthcare reform can be found at the bottom of this page.
Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org. Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.