Medicaid Enrollment Decline In Michigan

MLive and other publications are noting a significant FY 26 decline in Medicaid enrollment in Michigan.  Only Montana and Louisiana had larger enrollment declines than Michigan.  The Georgetown Center for Children and Families (CCF) has been closely monitoring Medicaid/CHIP enrollment and found that more than 2 million fewer children have been enrolled since January 2025; enrollment losses occurring before the Medicaid changes required by the OBBBA came into effect.  But Michigan's child enrollment declines are not severe by nationwide ranking.  At the same time, Michigan's Obamacare (PPACA) enrollment is also declining, again not severe but noticeable.

One major caveat about drawing conclusions from these statistics: Is Michigan's population actually growing as the Census Bureau claims, or is it actually declining?  The Census Bureau has been known to routinely cook their books to promote their political agenda, which is to maximize the number of congressional districts in blue states and minimize them in red states:

https://www.mlive.com/news/2026/06/michigans-medicaid-decline-puzzles-experts-though-they-expect-more-to-lose-coverage.html

https://ccf.georgetown.edu/2026/06/10/which-states-are-seeing-the-largest-declines-in-child-medicaid-chip-enrollment/

https://www.newsweek.com/states-seeing-biggest-obamacare-enrollment-drops-12072590

https://files.gao.gov/reports/GAO-25-107160/index.html

Michigan’s Medicaid decline puzzles experts, though they expect more to lose coverage
By Justin P. Hicks | June 17, 2026

Michigan has seen one of the largest decreases in the nation in Medicaid enrollment in recent years.

As of February, there were nearly 2.03 million Michiganders enrolled in the comprehensive safety-net insurance program for low-income people and families. That was about 235,744 fewer people, or a 10% decline, from the same month in 2020, according to the Centers for Medicare and Medicaid Services (CMS).

Some of the people who lost Medicaid coverage may have secured health insurance through the commercial marketplace instead, explained Dominick Pallone, executive director of the Michigan Association of Health Plans.

Others may have dropped down to a less comprehensive public program because they were no longer eligible or didn’t provide the state with enough information to prove eligibility for full coverage.

However, the health insurance buckets collectively haven’t seen a corresponding increase to explain what has happened to the Michiganders who have lost their Medicaid coverage.

“We’re not exactly sure what’s going on but it’s a concern for us,” Pallone said. “That’s kind of the core question driving us right now to work with our partners at MDHHS and other entities; how do we make our enrollment process a little bit better and how do we prevent as many people (as possible) from falling through the cracks?”

More concerning is how many more residents will lose Medicaid coverage and may wind up uninsured in 2027 when new eligibility and reporting requirements take effect.

“To see a continued loss month over month, that we’re worried about, and we know those numbers will get a lot worse,” Pallone said.

Officials with the Michigan Department of Health and Human Services (MDHHS) say the agency is monitoring Medicaid trends closely, including that enrollment is lower now than it was at the end of 2024 -- long after the post-COVID renewal process concluded.

A spokesperson said the department remains committed to ensuring eligible residents can access and keep the coverage they rely on.

“Ensuring Michigan families have access to affordable health care is a priority,” according to MDHHS. “Identifying and understanding the factors driving this decline is an important area of focus for the department.”

Latest on Medicaid changes

Medicaid is available to pregnant women, children and teenagers, and people with disabilities, with eligibility based on income and family size. As of February, the program supported more than 67 million Americans.

In Michigan, Medicaid, the Children’s Health Insurance Program, and other limited-benefit joint federal-state programs provide health insurance for roughly one in every four residents, or as many as 2.7 million people.

Last summer, President Donald Trump signed the One Big Beautiful Bill Act, which included cuts to Medicaid by way of new work requirements and more frequent eligibility checks for Medicaid expansion recipients.

The administration has said it wanted to “root out fraud, waste and abuse in Medicaid.” According to CMS, the program’s latest improper payment rate was about 6%, and 77% of those payments were the result of insufficient documentation.

“These payments typically involve situations where a state or provider missed an administrative step and do not necessarily indicate fraud or abuse,” CMS said in its online fact check.

Starting in January 2027, Medicaid expansion recipients who are able-bodied will be required to work at least 80 hours per month in order to continue to receive benefits.

Exceptions will be in place for people 65 and older, parents with children younger than 14, pregnant women, and those who are medically frail -- a definition the government rolled out on June 1.

Health plans wanted the medical frailty definition to be looser than what was announced, Pallone said. They also wanted enrollees to be able to self-attest their hours of work, community service or work program, though the government denied that option.

“You need to have some kind of third party validating that they’ve met those required hours,” Pallone said. “The problem is going to be in Michigan, that data is going to be in very different places. We’ve got a lot of work ahead of us to operationalize all of this.”

People who fail to verify their hours will get a notice of noncompliance and 30 days to demonstrate compliance before they are disenrolled from Medicaid.

Industry leaders and research groups have said the Medicaid changes will cause millions of Americans to lose coverage, including up to 200,000 residents in Michigan.

Among the residents in danger of losing coverage are those who are meeting or exempt from work requirements but have difficulty submitting the necessary paperwork, said Matthew Buettgens, senior fellow at the Urban Institute.

“The benefits of having coverage are pretty broad across a number of different areas of life,” Buettgens said in a statement. “So, interruptions in that coverage could disrupt both health and financial security.”

Michigan’s shrinking enrollment

During the COVID-19 pandemic, the federal government paused Medicaid disenrollment for three years, which kept more people covered through the public health emergency. That was followed by an unwind period, when enrollment declined as expected beginning spring 2023 and concluding fall 2024.

U.S. Medicaid enrollment climbed from 64.5 million in February 2020 to 86.6 million in February 2023. That total fell 22% over the next three years to almost 67.7 million.

KFF, the San Francisco-based research nonprofit, recommends using February 2020 as a baseline month since it was before the start of the COVID-19 pandemic and the continuous enrollment provision. In the six years since then, U.S. Medicaid enrollment increased 5% with 30 states seeing higher enrollment.

Among the 20 states that reported a decline, only Montana and Louisiana had larger dips than Michigan.

While Michigan’s comprehensive Medicaid enrollment dropped 10% over six years, its Children’s Health Insurance Program (CHIP) enrollment increased 149%. Together, the combination had an enrollment decline of 6% -- the sixth largest dip during that period.

However you look at the numbers, Pallone said his association is concerned that the number of residents currently enrolled in Medicaid is lower than the number of eligible people, meaning more folks are likely left uninsured or underinsured.

Michigan’s uninsured rate was 5.2% in 2024, according to data published by the University of Michigan’s nonprofit health policy center. That rate was up from 4.6% the year prior.

The population going without health insurance was in the double-digits before the Affordable Care Act expanded Medicaid eligibility. Michigan’s rate was more than halved between 2010 and 2015 and hasn’t surpassed 6% for almost a decade.

Medicaid expansion has also been associated with increased use of primary care, reduced use of emergency care, better health, higher employment, and less financial stress for both patients and hospitals, according to research published this month by U-M.

What should Michiganders do to prevent coverage loss?

The No. 1 guidance Pallone has for Medicaid recipients is to keep an eye out for correspondence from their health plan and the state about redetermination. That includes calls, texts, emails and letters.

When the state doesn’t hear back from enrollees, they’re forced to make determinations based solely on what they can prove. That may mean you’re dropped down to a lesser plan and you don’t realize it until you’re seeking care and get denied coverage.

“We’ve heard from folks in the program that the communication from there can be a little confusing,” Pallone said. “Maybe you missed something for your redetermination for Healthy Michigan and then you get something in the mail that says, Congrats, you’re enrolled in Plan First (a Medicaid category with limited benefits).”

Along those lines, enrollees need to make sure their contact information and mailing address are up to date on the state’s MI Bridges website. They can also do so in an MDHHS branch office, or by calling the help desk at 844-799-9876.

“I’ve heard from people that believe it’s a foregone conclusion they’re going to lose coverage,” Pallone said. “My response to them is when the department sends something to you for redetermination, fill it out. Let someone tell you whether you’re in or you’re out of the program.”

Residents who lose Medicaid coverage will qualify for a special enrollment period through the Healthcare Marketplace. For more information, visit healthcare.gov/medicaid-to-marketplace.