The brand new Trinity Health Livingston just replaced the legacy Trinity Health Medical Center — Howell. A perfectly satisfactory hospital in Howell is sacrificed on the altar of Certificates of Need to gain commercial advantage:

https://www.dbusiness.com/daily-news/trinity-health-livingstons-238m-campus-in-brighton-opens/

Trinity Health Livingston’s $238M Campus in Brighton Opens
Trinity Health Livingston’s transition to a state-of-the-art $238 million campus in Brighton from its legacy campus in Howell has been completed.
By R.J. King - April 23, 2026

Trinity Health Livingston’s transition to a state-of-the-art $238 million campus in Brighton from its legacy campus in Howell has been completed.

The opening of the new hospital in Brighton marks the culmination of years of planning, construction, and collaboration across Trinity Health, its medical staff, first responders, and community partners.

“This marks a new chapter in how health care is delivered in our community for generations to come,” says John O’Malley, president of Trinity Health Livingston and Trinity Health Medical Center — Brighton. “With all the new technology and capabilities at our disposal, this new hospital keeps local care local, ensuring that residents of Livingston County don’t have to travel far to receive high-quality health care.”

The new Trinity Health Livingston is located at 7555 Grand River Road in Brighton, across from 2|42 Church and approximately eight miles from the legacy campus in Howell. The four-story, 174,000-square-foot facility features 56 acuity adaptable beds designed to support patients across a wide range of conditions and acuity levels, including several bariatric rooms to meet specialized patient needs.

The campus also includes 18 Short Stay Unit beds, eight licensed operating rooms, intensive cardiac rehabilitation services, and a hospital-based medical and surgical specialty practice. Advanced medical imaging capabilities include a cardiac capable CT scanner and two fixed MRI machines, expanded MRI services, and a new SPECT/CT system.

Two shelled clinical spaces also have been incorporated to support future growth based on the evolving needs of the Livingston County community. Twenty-four additional beds will be added sometime in 2027.

The investments significantly enhance diagnostic capabilities, enabling earlier detection, shorter scan times, and clearer imaging, ensuring that patients have access to advanced, high-quality care close to home.

Trinity Health Michigan is a leading health care provider and one of the state’s largest employers. With more than 25,000 full-time employees serving 29 counties, Trinity Health Michigan is composed of nine hospitals located in Ann Arbor, Chelsea, Grand Haven, Grand Rapids, Howell, Livonia, Muskegon, Oakland Township, and Shelby Township, and two medical groups.

The health system has 1,459 employed physicians and a medical staff of more than 5,766 providers. With operating revenues of $5.16 billion, Trinity Health Michigan reports it returns $357 million back to their local communities each year.

Together with numerous ambulatory care locations, home health and hospice agencies and 17 senior living communities owned and/or operated by Trinity Health, Trinity Health Michigan provides the full continuum of care for Michigan residents.

For more information, visit trinityhealthmichigan.org.

In Related News, Trinity Health Oakland in Pontiac has received a $1 million planned gift from Paul and Cheryl Robertson of Birmingham to benefit Cardiovascular Services at the hospital.

The gift, secured by the health system’s southeast Michigan Office of Philanthropy, also honors Dr. Kirit Patel, a longstanding physician leader within the hospital, who has served as Paul Robertson’s cardiologist for more than 30 years.

During that time, Patel has performed more than 10 interventional procedures on Robertson, all of which have significantly improved the quality and longevity of his life.

“I can’t tell you how many times Dr. Patel has saved my life,” says Paul Robertson. “He is the smartest doctor I have ever dealt with across all specialties. The hospital’s cardiovascular program has meant so much to me and my family personally that we were inspired to make this part of our legacy.”

The Robertsons are dedicated philanthropists who have supported Trinity Health Oakland over the years in a variety of ways. The new funds will support advanced cardiovascular care at the hospital, including research, equipment, and other initiatives focused on enhancing patient care.

To learn more or to support Trinity Health Oakland’s cardiovascular services program, contact the Trinity Health Michigan Office of Philanthropy at 734-712-4040.

https://www.woodtv.com/news/michigan/fewer-women-are-getting-prenatal-care-michigan-doctors-want-to-know-why/

Fewer women are getting prenatal care. Michigan doctors want to know why
By Katherine Connolly - April 25, 2026

GRAND RAPIDS, Mich. (WOOD) — From the closure of rural hospitals to Medicaid policy changes and physician shortages, prenatal care is becoming more difficult to access across the country, including Michigan, a new federal report shows.

According to statistics from the Centers for Disease Control and Prevention, the percentage of pregnant women across the country forgoing prenatal care until the after the first trimester grew in 36 states between 2021 and 2024. That includes Michigan, where more than 20% of women did not receive early prenatal care. About 6.5% of women — more than 26,000 — reported not receiving prenatal medical care until the third trimester, if at all.

The report doesn’t identify why these women didn’t get care — whether it was an issue of access or whether she simply didn’t know she was pregnant until after the first trimester. News 8 spoke with health care experts across the state to understand the barriers their patients face.

“This kind of decline in prenatal care use is also consistent with other worsening trends in the nation in regard to maternal infant health outcomes,” Dr. Mona Hanna, a pediatrician and the founder and director of Rx Kids, said. “We have some of the worst maternal health outcomes in the world, especially compared to peer countries.”

A 2024 report from the Commonwealth Fund found that the U.S. “continues to have the highest rate of maternal deaths of any high-income nation.” In 2022, the U.S. maternal mortality rate, a measure how many women died during pregnancy or within 42 days of the end of pregnancy, was 22.3 per 100,000. Michigan saw a slightly below-average rate of 19.1. In Canada, that number was 8.4.

Up to 80% of U.S. maternal deaths may have been preventable, the nonprofit reported.

Dangerous birth outcomes, including death, are substantially more common for women of color, studies have repeatedly found — especially for Black mothers, who see deaths at a rate of 49.5 per 100,000, more than double that of the average U.S. population.

Kalamazoo County touts lowest infant mortality rate in Michigan

“Black moms are two to three times as likely to die during pregnancy and postpartum and to have other serious complications. When you control for mom’s prenatal health and a lot of other things, including mom’s own health behavior, that difference is still there. So there are some things that are going on in the health system,” Dr. Jessica E. Johnson, a clinical psychologist who works with high-risk pre- and postnatal women around Flint, said.

While several factors influence those disproportionately negative outcomes, Johnson and Hanna explained, access to high quality, local prenatal care is a critical factor in improving Black maternal health.

Prenatal visits are important for the well-being of both moms and their babies, experts who spoke with News 8 said. Early visits can lead to early detection of pregnancy complications like preeclampsia or gestational diabetes that, if left untreated, can lead to death among expectant and new mothers.

“Starting prenatal care before that 10-week mark is incredibly imperative. We know that that’s been also something that’s been shown to help reduce prematurity and very low birth weight outcomes, as well,” said Dr. Karen Garcia, a newborn hospitalist and the system director for health transformation with Bronson Healthcare in Kalamazoo. “The earlier that we can get people in (and) really start trying to see what it is that we can support physically, mentally, emotionally, the better outcomes that we tend to have.”

Numerous studies have found that infant mortality is strongly tied to prenatal care access. The harder it is to find or get to prenatal care, the more likely it is that mom or baby will suffer complications, including death.

Prenatal visits also allow providers to assess the social needs of families and connect them with community resources, local parenting groups and social services, like WIC food benefits and Medicaid, Garcia said.

“We know that there’s a direct correlation between infant mortality and early or prenatal care,” Berrien County Health Officer Guy Miller said. “The mortality rate we had in 2023 was higher than the state’s average. We lost 20 children that year, and we were way higher than the state average of what they typically see for infant mortality in a community.”

In 2023, Michigan saw an average of more than 6 infant deaths per 1,000 live births. In Berrien County, deaths were more than twice that at a rate of 14.4 per 1,000. Over the same period, nearly 25% of the county’s pregnant woman did not receive prenatal care during the first trimester.

Miller said transportation is one of the greatest challenges facing expecting parents in Berrien County. Much of the county is rural, with limited access to public transportation or rideshare services like Uber. For pregnant women without reliable access to a car a 20- or 30-mile journey to the OB-GYN can become an all-day endeavor, requiring them to take time off work or find child care for their other kids.

“If you don’t have transportation, if you are busy trying to work two jobs to support your family, if you just have all the other complications going on that relate to poverty and trying to hold a family together, that can make (getting prenatal care) more complicated,” Johnson explained.

In six Michigan counties, primarily in the Traverse City-Cadillac area, an average of fewer than 60% of pregnant women received prenatal care during their first trimester between 2021 and 2024. In Kalkaska County, only half of women received care during their first trimester, according to county-level data provided by the March of Dimes.

In rural areas, like Branch County where just over half of pregnant women received early prenatal care between 2021 and 2024, care is becoming increasingly difficult to access as hospitals and clinics close. At least 10 birthing hospitals have closed since 2018, eight of which served primarily rural patients, according to a Michigan Senate Fiscal Agency report. In 2023, the ProMedica Coldwater Regional Hospital shuttered its OB-GYN department amid a pending sale. Sturgis Hospital closed its birthing center in 2018.

“There’s been this consistent decline in people in pregnant people’s ability to get health care access. … We’re seeing that, for example, in a lot of rural communities — the Upper Peninsula of Michigan — lots of places have less access to care because these safety net hospitals can’t stay in business,” Hanna said.

As of 2024, nearly 22% Michigan counties were considered maternity care deserts with zero hospitals or birth centers offering obstetric care, and zero obstetric providers. This is up from 18% the year before, the Senate Fiscal Agency report found.

Grants support maternal health equity in Southwest Michigan

The uncertainty of prenatal care access adds another layer of stress to lives already complicated by the daily realities of poverty. In Berrien County, where the median per capita income was just over $38,000 in 2024, parents-to-be are tasked with balancing daily expenses, saving for a new baby and managing and paying for medical care.

“It’s no wonder those families are having a hard time getting to their provider’s appointments because they’re lacking so many other resources,” Miller said. “If you’re worried about paying rent, you’re worried about keeping the lights on, you’re worried about putting food on the table, going to a doctor’s appointment for yourself might fall quickly to the bottom of that list.”

The experts acknowledged that, from the outside, it can be easy to judge these women, but they encouraged the public to put themselves in these expectant mothers’ shoes.

“I think it’s easy to blame moms for not coming in, but that contributes to the problems that lead them to not come in, which is worrying about feeling understood or respected,” Johnson said. “There are still things that we can do to ensure systems meet the needs of moms where they are.”

Karex's supply of precursor chemicals has become unreliable since the Strait of Hormuz closed and shipments to customers which previously took a month now take close to two months.  It stands to reason that the same issues will affect the supply and pricing of nitrile gloves, which are a very similar product in terms of foreign producers, raw materials, and production processes:

https://www.reuters.com/business/healthcare-pharmaceuticals/worlds-top-condom-maker-karex-raise-prices-sharply-iran-war-strains-supply-chain-2026-04-21/

World's top condom maker Karex to raise prices sharply as Iran war strains supply chain
By Rozanna Latiff - April 21, 2026

KUALA LUMPUR, April 21 (Reuters) - Malaysia's Karex Bhd (KARE.KL), opens new tab, the world's top condom producer, plans to raise prices by 20% to 30% and possibly further if supply chain ​disruptions drag on due to the Iran war, its chief executive said on ‌Tuesday.

Karex is also seeing a surge in condom demand as rising freight costs and shipping delays have left many of its customers with lower stockpiles than usual, CEO Goh Miah Kiat told ​Reuters in an interview.

"The situation is definitely very fragile, prices are expensive... We ​have no choice but to transfer the costs right now to ⁠the customers," Goh said.

Karex produces over 5 billion condoms annually and is a supplier ​to leading brands like Durex and Trojan, as well as state health systems such ​as Britain's NHS and global aid programmes run by the United Nations.

The condom maker joins a growing list of companies, including medical glove makers, bracing for supply chain bottlenecks as the Iran war strains energy ​and petrochemical flows from the Middle East, disrupting procurement of raw materials.

Since the ​conflict began in late February, Karex has seen costs increase for everything from synthetic rubber and nitrile ‌used ⁠in manufacturing condoms to packaging materials and lubricants such as aluminium foils and silicone oil, Goh said.

He said Karex has enough supplies for the next few months and is looking to boost output to meet growing demand, as global stockpiles of condoms ​have dropped significantly following ​deep spending cuts in ⁠foreign aid, particularly by the U.S. Agency for International Development last year.

Demand for condoms has risen about 30% this year, with shipping ​disruptions further exacerbating shortages, he said.

Karex's shipments to destinations such ​as Europe ⁠and the United States are now taking close to two months to arrive, compared to a month previously.

"We're seeing a lot more condoms actually sitting on vessels that have not ⁠arrived ​at their destination but are highly required," Goh said, ​adding that a lot of developing countries do not have enough stock because it takes time for ​the products to reach them.

This is a health care story because Michigan Medicine is twice the size of the political indoctrination operation University by all measures.  Michigan Medicine is the largest health care system in Michigan, based on over $5 billion in reported net patient revenue:

https://www.michigandaily.com/news/news-briefs/university-president-elect-kent-syverud-steps-down-due-to-cancer-diagnosis/

University President-elect Kent Syverud steps down due to cancer diagnosis
By THE MICHIGAN DAILY NEWS STAFF - April 15, 2026

University of Michigan President-elect Kent Syverud announced Wednesday morning that he will no longer take up the position due to a recent brain cancer diagnosis. Syverud’s term was set to begin May 11.

The information was first released in an email to the campus community, which included a letter from Syverud. In the letter, Syverud wrote that he is currently receiving treatment from Michigan Medicine.

“Last week, I wasn’t feeling well, and I sought care at Crouse Hospital in Syracuse,” Syverud wrote. “After further evaluation, I traveled to the University of Michigan to receive additional assessment from their specialists. I want to be straightforward with you: I have been diagnosed with a form of brain cancer.”

While Syverud will not be taking up the presidency, he will still take up a position as a member of the Law School faculty and adviser to the University’s Board of Regents. In his letter, Syverud thanked the Board and the University community.

“While my diagnosis and treatment will prevent me from serving as the 16th President of the University of Michigan, I am deeply moved by the generosity of the Regents, who have invited me to continue contributing as a professor in the Law School and as a special advisor to the Board,” Syverud wrote. “My wife Ruth and I look forward with great anticipation to rejoining this remarkable community.”

In a video message, Board Chair Mark Bernstein (D) said interim University President Domenico Grasso will continue his tenure until a new president is elected.

“Domenico Grasso will continue to serve as president until the next president begins their service, and the Board plans to reengage a search process as soon as possible,” Bernstein said. “We’ll share details about this in the coming days. We have no doubt that outstanding candidates will seek an opportunity to lead our great university.”

https://hoodline.com/2026/04/michigan-bosses-claim-blue-cross-turned-billing-blunders-into-cash-cow/

https://dockets.justia.com/docket/michigan/miwdce/1%3A2026cv00895/119939

Michigan Bosses Claim Blue Cross Turned Billing Blunders Into Cash Cow
By Keith O'Donnell - April 14, 2026

Several Michigan employers, including Wesco Inc., the Frankenmuth Bavarian Inn and Opus Packaging Group, say Blue Cross Blue Shield of Michigan found a way to turn claims-processing mistakes into a money-maker. In federal court filings, the companies accuse the insurer of keeping a slice of recoveries generated by errors, invoice adjustments and later reconciliations instead of fully crediting their health plans. Their lawyers point to a thick trail of contracts and monthly invoices they say map out the transfers they now want refunded.

What the suits say

According to Crain's Detroit, the complaints brought by Wesco, the Frankenmuth Bavarian Inn and Opus Packaging attach exhibits that include an Administrative Services Contract schedule and a "Wesco ASC Refund Summary." The reporting notes that the plaintiffs point to an internal "Shared Savings" ledger and a run of monthly invoices that allegedly track disputed refunds and fee calculations they say tilted in favor of Blue Cross rather than the employer plan sponsors. Those allegations sit at the heart of the ERISA-based claims driving the lawsuits.

How plaintiffs say the money flowed

The employers’ theory lines up with issues the Sixth Circuit tackled in its Tiara Yachts decision, summarized on Justia, where judges held that employers could plausibly allege Blue Cross Blue Shield of Michigan acted as an ERISA fiduciary when it overpaid claims and then recouped funds through a shared-savings program. The appellate court explained that administrators who exercise control over plan assets can face equitable remedies if they profit from the recovery process, a legal path the Michigan plaintiffs are now trying to follow. Their complaints highlight what they call "flip logic" and shared-savings invoices as the key mechanics of how the money allegedly moved.

Blue Cross's court strategy

Blue Cross has pushed back hard. It has filed motions to dismiss asking judges to throw out the claims as mere contract disputes or as time-barred, according to the federal docket on Justia. Those filings also show the case has already bounced between districts and that both sides have loaded the record with exhibits and briefing. For now, the fight is parked at the pleading stage while the courts decide whether the ERISA theories are strong enough to move into discovery.

Why the case matters

Legal observers say the outcome could influence how self-insured employers challenge the bookkeeping and recovery practices of their claims administrators. Analysts at Holland & Knight note that the Sixth Circuit’s Tiara Yachts ruling opened the door for arguments that administrators who control plan funds are acting as ERISA fiduciaries. If courts allow the employers’ claims in this case to proceed on that theory, the plaintiffs could seek recovery and disgorgement of plan assets, and other plan sponsors may be encouraged to bring similar suits.

What to watch next

For now, both sides are still trading motions and exhibits while judges decide whether the complaints can survive early dismissal. Varnum LLP, the firm that handled Tiara Yachts, has flagged the Michigan litigation as a case that could claw back plan assets and trigger tougher scrutiny of administrators’ accounting practices. The next milestones will play out on the docket as the courts rule on the motions, potentially open the door to discovery and, if the case survives, set up appeals down the line.

https://www.beckerspayer.com/payer/aca/states-ranked-by-catastrophic-plan-enrollment-growth-in-2026/

https://www.kff.org/affordable-care-act/state-indicator/marketplace-plan-selections-by-metal-level-2/

States ranked by catastrophic plan enrollment growth in 2026
By Jakob Emerson - Friday, April 10th, 2026

Montana saw the largest increase in catastrophic plan enrollment from 2025 to 2026, while Pennsylvania saw the largest decrease, according to CMS data analyzed by KFF.

Catastrophic plan enrollment grew nearly 25% nationally, from 54,000 to almost 68,000, even as total ACA enrollment fell 5% to 23.1 million in 2026.

States ranked by catastrophic plan enrollment growth in 2026

Montana
2026: 3,238
2025: 296
Change: +994%

Delaware
2026: 1,123
2025: 177
Change: +534%

South Dakota
2026: 1,672
2025: 290
Change: +477%

Michigan
2026: 8,045
2025: 1,657
Change: +386%

Oklahoma
2026: 1,127
2025: 261
Change: +332%

New Hampshire
2026: 1,343
2025: 355
Change: +278%

Arizona
2026: 737
2025: 235
Change: +214%

Iowa
2026: 184
2025: 84
Change: +119%

Kentucky
2026: 999
2025: 464
Change: +115%

North Dakota
2026: 791
2025: 373
Change: +112%

Massachusetts
2026: 889
2025: 432
Change: +106%

Go to the hyperlinks for more states' data

https://www.dailysignal.com/2026/04/08/exclusive-american-medical-association-should-lose-tax-exempt-status-watchdog-group-says/

EXCLUSIVE: American Medical Association Should Lose Tax-Exempt Status, Watchdog Group Says

Tyler O'Neil    |    April 08, 2026

FIRST ON THE DAILY SIGNAL—The IRS should investigate and potentially revoke the tax-exempt status of the American Medical Association’s philanthropic arm, according to a new complaint filed Tuesday.

“Based on the evidence in our complaint, we believe the IRS should revoke the AMA Foundation’s tax-exempt status for operating a racially discriminatory program,” Dr. Kurt Miceli, a psychiatrist and chief medical officer at Do No Harm, told The Daily Signal.

“Racially discriminatory scholarships are unlawful and morally wrong, to say nothing of the negative impact they have on public confidence in our medical system.”

The Daily Signal depends on the support of readers like you. Donate now

Do No Harm, a watchdog group of doctors, nurses, and other medical professionals, aims to expose racial discrimination, transgender ideology, and other politically divisive practices in medicine.

The complaint, first provided to The Daily Signal and addressed to the IRS’ section on Exempt Organizations and Government Entities, asks the IRS to investigate the AMA Foundation over “invidious racial discrimination” in its Physicians of Tomorrow Scholarship program.

The complaint notes that the foundation only extends specific scholarships to Americans of certain races.

“The AMA’s obsession with identity politics is no secret, and it should be held accountable for allowing race to dictate applicants’ eligibility for valuable and lucrative learning opportunities,” Dr. Miceli added. “If the AMA Foundation wants to retain its federal tax advantage, it must open its scholarships to applicants of all races.”

The Dr. Richard Allen Williams & Genita Evangelista Johnson/Association of Black Cardiologists Scholarship pays $5,000 to medical students interested in cardiology, but only if they are “African American/Black.”

The Underrepresented in Medicine Scholarship offers $10,000 to winners, who must be “African American/Black, Latine/Hispanic or Indigenous (American Indian, Native Hawaiian, or Alaska Native).” The Patricia L. Austin Family Physicians of Tomorrow Scholarship also offers $10,000, but winners must be “of Eastern European descent.”

“Each of these racist exclusions is repugnant to our civil rights laws and ‘the congressional intent underlying ,'” the complaint states. It cites Bob Jones University v. United States (1983), in which the Supreme Court ruled that the IRS had rightly revoked the 501(c)(3) status of Bob Jones University because it forbade interracial dating and marriage.

The AMA Foundation’s racially discriminatory scholarships are “sufficient grounds for the IRS to revoke the AMA Foundation’s tax-exempt status under 26 U.S.C. §501(c)(3),” the complaint states. It quotes the Bob Jones Supreme Court finding that “racially discriminatory” institutions “cannot be viewed as conferring a public benefit within the ‘charitable’ concept” of the common law.

The complaint also cites Students for Fair Admissions v. Harvard (2023), in which the Supreme Court found that racial preferences in college admissions—often referred to as “affirmative action”—constituted racial discrimination in violation of the equal protection clause of the 14th Amendment.

If Supreme Court precedent were not enough, President Donald Trump’s “executive orders also leave the with no discretion” on the matter, the complaint claims. “The president has rescinded prior executive orders that agencies had invoked to justify race-based classifications in the name of ‘equity.'”

Trump’s Jan. 20, 2025, order directs federal agencies to terminate “all discriminatory programs,” including those related to “diversity, equity, and inclusion,” as well as policies “allowing or encouraging” third parties “to engage in workforce balancing based on race.”

Do No Harm asks the IRS to open an investigation, unless the AMA Foundation alters its policies.

“If the AMA Foundation wishes to avoid such an investigation and maintain its tax-exempt status, it can simply open each of its scholarships and any similar programs to all races,” the complaint notes.

Do No Harm has previously criticized the American Medical Association, particularly on transgender issues. When the world’s largest organization of plastic surgeons recommended delaying “transgender” surgery until a patient reaches the age of 19, the American Medical Association stated it would follow that guidance—but Do No Harm flagged a specific word in the statement that it said gave the AMA “wiggle room” on the issue.

About a month later, the AMA’s board chair suggested that the association would not change its previous support for “gender-affirming care.” This follow-up statement appeared to confirm Do No Harm’s suspicions.

The Daily Signal has reached out to the IRS and the AMA for comment and will update this article with any response.

https://distilinfo.com/2026/04/10/blue-cross-seeks-13-michigan-rate-hike/

Blue Cross Seeks 13% Michigan Rate Hike

Overview

Blue Cross Blue Shield of Michigan is pushing for a sharp 13% midyear rate increase for small business health plans. The state’s largest health insurer filed updated rate proposals in March 2026, targeting small businesses that renew employee health policies in the third or fourth quarter of the year. Consequently, hundreds of thousands of Michigan workers could soon face higher premiums — even as employers already struggle with tight budgets and rising operating costs.

This move signals that the double-digit health insurance premium increases seen over the past two years show no signs of slowing down.

Why Blue Cross Is Raising Rates Now
Claims Outpacing Premiums

Blue Cross Blue Shield originally planned to request a more modest increase — 10.7% for third-quarter PPO policy renewals and 10.4% for fourth-quarter renewals. However, claims trends through late 2024 and early 2025 came in worse than anticipated. As a result, the insurer revised its projections upward significantly.

“It’s really just a continuation of us seeing our claims, projections and actuals outpace our premium,” said Sandra Fester, vice president of Michigan business for Blue Cross Blue Shield.

Utilization and Drug Costs Accelerating

The rate filing reflects clear cost drivers. Specifically, Blue Cross projects a 10% increase in prescription drug claim costs from 2025 to 2026, along with a 0.2% rise in utilization. Furthermore, outpatient costs are projected to climb 8.9% over the same period, with a 0.5% uptick in utilization. These trends compound on top of already elevated expenses from prior years.

The Financial Pressure Behind the Numbers
A $1.7 Billion Underwriting Loss

The financial case for the rate increase becomes clearer when looking at Blue Cross Blue Shield’s 2024 results. The Detroit-based nonprofit mutual insurer recorded a staggering $1.7 billion underwriting loss last year. Moreover, the company paid out more than $20.7 billion in claims — a jump of over $3 billion compared to 2023. Meanwhile, total premiums and administrative fees collected reached $24.7 billion, leaving the insurer in a difficult position as claims continued to outrun revenue.

Rising Costs Across the Board

Beyond prescription drugs, the insurer faces pressure from rising hospital, outpatient, and specialist care costs. Additionally, labor shortages in healthcare have driven up the cost of medical services industry-wide, contributing to elevated claim amounts per patient encounter. These factors together create a cost environment that makes rate increases nearly unavoidable, according to health insurance analysts.

GLP-1 Drugs Driving Cost Surge
$1.1 Billion Spent in One Year

One of the most significant contributors to Blue Cross Blue Shield’s financial strain is the explosive growth of GLP-1 medications — drugs used to treat diabetes and, increasingly, obesity. In 2024 alone, claims for GLP-1 drugs cost Blue Cross Blue Shield $1.1 billion, representing a 29% increase over the prior year. This figure reflects the surging adoption of medications such as Ozempic and Mounjaro across its member base.

Although Blue Cross Blue Shield has since restricted GLP-1 coverage for weight loss purposes (while retaining coverage for diabetes patients), the financial damage from prior years still ripples through this year’s rate calculations. Therefore, even businesses with relatively healthy workforces are feeling the indirect cost of this trend.

Priority Health Also Seeks Similar Hike
Two Insurers, One Shared Trend

Blue Cross Blue Shield is not alone in seeking steep midyear increases. Priority Health, another major Michigan insurer, has also submitted updated rate proposals to state regulators. Notably, Priority Health is requesting regulatory approval for a nearly 13% average statewide rate increase for small group policies renewing in the third or fourth quarter of 2026. That figure aligns closely with the increase the Michigan Department of Insurance and Financial Services previously approved for Priority Health’s 2025 policy renewals.

Together, Blue Cross Blue Shield and Priority Health control more than 85% of the small group health insurance market in Michigan. Both insurers recorded operating losses in 2024, making their rate increase requests a coordinated — if coincidental — response to the same systemic cost pressures. For small businesses, this means there is little room to shop around for a meaningfully lower alternative.

What Small Businesses Can Expect
Who Is Affected

The proposed rate increases apply only to small group policies renewing in Q3 or Q4 of 2026. Plans that already renewed in the first or second quarter of this year are not affected by this particular filing. Nevertheless, employers who are approaching renewal windows should begin evaluating their options now.

Options for Cost Management

Industry experts suggest several strategies for small businesses facing higher premiums. First, employers can consider shifting to high-deductible health plans paired with health savings accounts (HSAs) to manage premium costs while preserving coverage. Second, businesses may explore network restructuring — narrowing provider networks to achieve lower premiums. Third, some employers are turning to self-insured arrangements, particularly as traditional fully insured small group plans become increasingly expensive.

Kirk Roy, a senior official at Blue Cross Blue Shield, noted that the insurer is working to offer more flexible network and plan options. “It can’t just be about shifting cost to higher co-pays and higher deductibles,” said a company spokesperson. “We really have to do different.”

Looking Ahead
A Persistent Premium Spiral

The 2026 midyear rate proposals from Blue Cross Blue Shield and Priority Health suggest that the era of double-digit health insurance premium inflation is not a short-term anomaly. Rising drug costs, aging workforce demographics, increased utilization of specialty care, and the ongoing expansion of expensive biologics all point to continued premium pressure in the years ahead.

For Michigan small businesses — already grappling with economic uncertainty, hiring challenges, and inflation — the prospect of a 13% health insurance cost increase adds meaningful financial strain. Proactive planning, open enrollment strategy, and engagement with brokers will be essential tools as employers navigate an increasingly costly benefits landscape.

https://www.realclearhealth.com/articles/2026/04/01/hospitals_perverse_incentives_are_inflating_healthcare_costs_1174043.html

Hospitals’ Perverse Incentives Are Inflating Healthcare Costs
Congress Should End Them
By Alexander Ciccone - April 1, 2026

There’s no shortage of politicians in Washington ready to blame insurance companies and drug manufacturers for the crushing cost of health care. Yet the single largest driver of health care costs in recent years isn’t pharmaceutical stock-buy backs or opaque insurance practices–it’s hospital systems.

What makes this so frustrating is that rising prices for hospital services aren’t the result of a functioning free market, but rather of perverse incentives created by the government that reward hospitals for their size instead of the value they provide patients.

Between 2022 and 2024, spending on hospital care alone amounted to an eye-watering $277 billion, representing 40% of the overall growth in national health expenditures. This surge outpaced every other source of medical spending, including physician services and prescription drugs. According to the Centers for Medicare and Medicaid Services, in 2024, hospital prices rose at their sharpest rate since 2007.

As a result of distortive policies that encourage hospitals to merge and consolidate, nearly half of all metropolitan areas across the country had just one or two hospital systems controlling the market for inpatient care in 2022. This lack of competition raises prices. According to the Department of Health and Human Services, hospital-to-hospital mergers in concentrated markets can raise prices anywhere from 6% to 65%. Even when hospitals acquire smaller independent physician practices, prices for identical medical services from those doctors rise on average by 14%.

By 2024, nearly 80% of all doctors across the country were employed by hospitals or other corporate entities. The surge in hospitals buying up independent physician practices is the predictable result of flawed Medicare reimbursement policies that pay hospitals more for the same medical service simply because the care is delivered in a hospital-owned facility. In 2021, the average Medicare reimbursement for drug administration services was 129% to 211% higher in hospitals than in independent doctors’ offices.

The nonpartisan Medicare Payment Advisory Commission has repeatedly urged Congress to enact “site-neutral” payments that would reimburse the same service at the same rate regardless of where it is performed. Bipartisan legislation passed by the House of Representatives in 2023 would have saved taxpayers roughly $4 billion over the next decade solely through its reforms to Medicare’s reimbursement rules.

Federal mandates have also buried the health care system in red tape, forcing hospitals to build sprawling bureaucracies instead of focusing on treating patients. A 2022 study found that administrative spending accounted for a whopping 15% to 30% of total health care expenditures. Much of this stems from complicated billing rules that keep hospitals busy tracking paperwork rather than patient outcomes.

Few problems illustrate the costs of burdensome regulations more clearly than unexpected medical bills. Despite Obamacare’s promise to streamline access to care, the legislation’s convoluted insurance mandates have become so confusing that many patients get hit with surprise bills after unknowingly receiving treatment from an out-of-network doctor even if they are at an in-network hospital.

Between 2010 and 2016, out-of-network billing at in-network hospitals rose from 32.3% to 42.8% for emergency room visits. Public outcry over this spike led to the enactment of the No Surprises Act in 2020. Despite addressing out-of-network charges for emergency room visits, the law contains glaring exemptions. For example, ground ambulances are largely excluded from the law’s protections against balance billing.

It’s not just the federal government reducing competition in hospital markets. State-level certificate of need laws require health care providers to obtain government approval before expanding facilities or offering new services. While these laws aim to reduce waste, in effect they let local bureaucrats shield established hospitals from new competition. A study found that overall health care costs were approximately 11% higher in states with certificate of need laws versus those without them.

Hospitals are not the villains of America’s health care system. They are simply responding to incentives created by Washington. Before drafting their next grand plan to address the crisis of affordable medical care, lawmakers should pause and take a hard look at how current government policies fuel the relentless rise in health spending they claim to oppose. A good place for Congress to start would be ending government incentives that reward hospitals for buying up the competition instead of outperforming it.

https://michiganadvance.com/2026/04/04/repub/its-a-safe-space-mobile-midwifery-clinics-meet-patients-where-they-are/

‘It’s a safe space’: Mobile midwifery clinics meet patients where they are
By Nada Hassanein - April 4, 2026

MIAMI — Midwife Sheila Simms Watson leaned to gently press on the pregnant woman’s belly. Me’Asia Taylor lay on a bed fitted with tie-dyed purple printed sheets in the corner of the RV.

Far from a typical camper, this RV houses a mobile midwifery clinic for prenatal, postpartum and women’s general health care.

“Roll when you’re getting up, and we can help you. You can sit there for a moment, all right, so you’re not lightheaded, not dizzy,” said Watson, whom patients and doulas call “Mama Sheila.”

Calm and slow, led by Watson’s soothing and attentive demeanor, the appointments are unrushed.

Run by the Southern Birth Justice Network, the mobile midwifery clinic brings care to majority-Black and Latino neighborhoods across Miami-Dade County several times a month. The clinic aims to offer a more relaxed setting, where women are comfortable and heard, their cultures are integrated, and they can connect with doulas from diverse backgrounds.

On the half-moon bench inside the RV, Watson, a doula and a midwife in training sit with patients. They take blood pressures and draw blood. They ask the women about their lives: How is their mental health and sleep? Do they have support at home? Do they want to give birth at a hospital or birth center with a midwife?

Taylor said pre-eclampsia, a dangerous pregnancy condition, runs in her family. She wanted to make sure she had space and time to express her concerns about her first pregnancy.

Taylor said she wants a midwife for her delivery. Many women of color have reported feeling marginalized or dismissed in medical settings. “I’ve just seen too many people have bad experiences,” Taylor told Watson.

The U.S. has markedly higher maternal mortality and infant mortality rates compared with other high-income countries, and women and babies of color fare the worst. Black women’s maternal death rates are three times higher than those of white women, and American Indian and Alaska Native women’s rates are twice that of white women. Researchers point to implicit bias, less regular access to prenatal care and higher rates of poverty.

OB-GYN shortages and labor and delivery units closing continue to make getting care harder. Last year, more than two dozen hospital labor and delivery units across the nation closed, including some in South Florida. And pregnant patients living miles away, or feeling uneasy about going to the doctor, may even forgo care.

Midwives can help fill gaps, maternal health equity advocates say, and mobile clinics can meet patients where they are.

“It really helps to disrupt this idea that patients must navigate these complex systems to receive care — and instead, (mobile midwifery) reimagines care as something that should be responsive to the needs of patients and should be community-centered,” said Tufts University professor and maternal health scholar Ndidiamaka Amutah-Onukagha.

But mobile units are not as common for midwifery as they are for other areas of care, such as dentistry or family medicine, the American College of Nurse-Midwives told Stateline. Other prenatal mobile outreach efforts in the state include an OB-GYN-run mobile unit by the University of Florida that serves areas around north-central Alachua County and an operation called The Midwife Bus in Central Florida.

To increase access to care, maternal health advocates are also pushing states to change regulations that restrict midwifery. The American College of Nurse-Midwives recently filed a lawsuit against Mississippi for requiring nurse-midwives to have agreements with physicians in order to practice. This week, Jamarah Amani, a midwife and the executive director of the Southern Birth Justice Network, joined other plaintiffs in filing a lawsuit against Georgia over its restrictions. But supporters of the rules say they are meant to protect patients and foster communication between clinicians.

Offering culturally centered prenatal care that women are more inclined to use can help address inequities in maternal health, Amani said. The group trains doulas, offers telehealth, provides referrals such as to mental health therapists, and advocates for equitable policies across the South.

Most of the mobile clinic’s clients — about 70% — are on Medicaid or uninsured, and the clinic is funded through federal and university grants, as well as donations.

“(Midwifery) presents like a luxury concierge-type of service,” Amani said. “Our goal is to really change that and to bring it back to the community in a very grassroots way.”

Preserving tradition

The Southern Birth Justice Network keeps a small drum on a table at a nearby booth. It represents the heartbeat, and ancestral reverence, Amani said. Drums are a universal language, and the instrument is meant to symbolize culture.

For doulas and many midwives like Amani and Watson, bringing their profession to communities today is the continuation of a significant part of Black American heritage.

Throughout history, Black midwives were venerated in their communities. Many practices were rooted in West African traditions. These midwives were the keepers of Black ancestral records, and delivered many white women’s babies. Enslaved women who were midwives traveled for deliveries. Some routes, long and traversed by foot, were dangerous in the deep rural South. During the Jim Crow era, Black Americans were denied care at hospitals or given inferior care.

“They only had protection if someone would send a carriage for them if they were going to deliver a white woman’s baby. But to care for the Black families, they often had to go in the middle of the night, alone,” Amani said. “We talk about the legacy of Black midwives as health care providers, but also as social pillars, as community leaders, as resistors of oppression.”

In the 20th century, medical institutions began to oppose midwifery, sometimes using racist and sexist campaigns to target the practice. They argued it was unhygienic and lobbied across states to dismantle midwifery. At the same time, while developing the field of obstetrics, doctors conducted gynecological experiments on Black women. The American College of Obstetricians and Gynecologists has acknowledged this history and said it’s committed to fighting racism and inequities.

Dr. Jamila Perritt, an OB-GYN and president and CEO of Physicians for Reproductive Health, said that in order to address structural barriers and close gaps, policies have to prioritize access to care, such as allowing midwives to expand their practices. Throughout the South especially, states still restrict midwives from practicing independently, despite widespread maternal health care deserts. She also pointed to research showing midwifery is associated with fewer C-sections, less preterm labor and better patient satisfaction.

“Expanding access to midwifery care, and expanding collaborations between physicians and midwives, only improves outcomes,” Perritt said.

Cultivating trust

On a recent breezy and brisk Saturday morning, the Southern Birth Justice Network’s midwives and doulas were stationed in the parking lot of the Freedom Lab, a local community center that hosts food and clothing distribution and a free urgent care center.

At the booth by the mobile clinic, under the shade of a royal-purple awning, meditation music, low-key and mellow, reverberated from a small speaker. There was a cooler filled with oranges, water and other snacks for the clinic’s pregnant patients.

“I’m going to keep giving you food. You need to eat enough,” one doula told a patient, handing her an orange and a liter of spring water.

Staff had surveys to help assess a new patient’s needs, and Florida-specific pamphlets on pregnant patients’ rights. The group is working on other state-specific guides for Louisiana, Massachusetts, Tennessee and Texas.

The table also held a portrait of the late midwife Ada “Becky” Sprouse, who started the mobile midwife clinic around 2008. She’d drive it to the city of Homestead, an agricultural hub in Miami-Dade County. There, she offered free midwifery care to migrant farmworkers, many of whom couldn’t afford care throughout their pregnancies.

Sprouse passed the clinic on to Amani, who relaunched the mobile unit and broadened the scope of the Southern Birth Justice Network.

Patients told Stateline trust was one of the main reasons they sought out the clinic. One patient said she spent 2 1/2 hours on public transit that day so that she could see the team.

For now, deliveries take place at hospitals or neighboring birth centers, where some of the group’s midwives also work. But the organization recently bought a building to open its own freestanding birth center, aiming for next year, along with a larger RV.

One patient, Isis Daaga, turned to Amani to deliver her other children after her first birth at a hospital. Despite the pressure she felt and her need to push during labor, Daaga recalled, hospital staff prevented her from delivering.

“They literally held my knees together,” Daaga said. “They were like, ‘the doctor’s not here yet,’ and the nurses were scared to deliver the baby.” In many hospitals, protocol is to wait for the doctor in case an emergency occurs.

By the time the doctor came, Daaga had a severe perineal tear, and she delivered the baby in one push. She had been in labor for 15 hours.

“I was in pain, I was upset,” said Daaga, a mental health therapist who is 35 weeks pregnant.

At the mobile clinic and with the midwives, Daaga said she feels supported.

“They make me feel the way I try to make my clients feel, like, it’s a safe space. You’re not judged here. I have a lot going on,” she said. “If I’m MIA or something, most of them will call and text me and (say), ‘Girl, you need to come in.’”