Michigan Health Insurance

Health Insurance in Michigan

● Michigan has a state-federal partnership exchange.

● The open registration for 2021 health plans is from 1 November to 15 December 2020; Residents with qualifying events can sign up outside that window.

● Michigan has nine insurers offering plans on its exchange, plus two insurers offering out-of-stock plans. The average increase in the proposed rate is around 1.3% for 2021.

● Nearly 263,000 Michiganders enrolled in the 2020 plans during the last open enrollment period.

● Short-term health plans are available in Michigan with initial plan terms of up to 185 days.

● Michigan's legislature has a GOP majority, but their margin narrowed in the 2018 election, and voters elected a Democratic governor.

● Michigan expanded Medicaid, but implemented a work requirement in 2020. The labor 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 will find information about the many types of health insurance coverage available. You can find the basics of Michigan's health insurance market and the next open enrollment period; a brief overview of Medicaid expansion in Michigan; a quick look at the availability of short-term health insurance in the state; statistics on 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 before the age of 65, people who are self-employed, and people who work for a small employer who does not provide health insurance benefits.

Nine insurers offer coverage for 2020 on the Michigan stock 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 of the exchange.

After increasing individual market premiums by an average of just 1.7% for 2019, Michigan insurers reduced average premiums by about 2.5% for 2020. For 2021, they proposed average rate changes ranging from a 2% decrease to a 6% increase, with a proposed overall average rate increase of around 1.3%.

Premium subsidies are available for people with an income of up to 400% of the poverty level. For 2021 coverage, this equates to $51,040 for a single individual and $104,800 for a family of four. As of December 2020, 86% of Michigan trade participants received premium subsidies, which reduce monthly premium costs to affordable levels. Premium subsidies are not available outside the exchange, so buying a health insurance policy directly from an insurance company (instead of through exchange) is generally just a good option for people who know they won't be eligible for a benefit.

In 2020, enrollment in Michigan's health insurance marketplace reached 262,919, down from about 274,000 the previous year. As in the case of Michigan, enrollment peaked in 2016 in most states that use HealthCare.gov, and has since declined for a number of reasons: the Trump administration's decision to reduce funding for exchange marketing and enrollment assistance, the elimination of the individual mandate sanction, the expansion of short-term plans, and premium increases in 2017 and 2018 that made coverage inaccessible to some enrollees who they are not eligible for premium benefits (most enrollees need subsidies in to make coverage affordable, but benefits are not available to families earning more than 400% of the poverty level).

Michigan Open enrollment period and dates

Open enrollment for 2021 health plans is from November 1, 2020 to December 15, 2020. Outside of that window, Michigan residents can only enroll in major individual market medical policies (on-exchange or off-exchange) if they experience a qualifying event.

The open enrollment period is an opportunity to renew or modify an existing plan for next year or to recently enroll in individual market coverage. It's also a good time to update the financial information on file with the exchange, to ensure premium subsidies are accurate for next year.

The enrollment period open from November 1 to December 15 applies only to individual major medical health plans. It does not apply to health plans provided by an employer or to Medicaid or Medicare. Employers set up their own open enrollment programs, Medicaid enrollment is available year-round, and open Medicare enrollment (for Part D and Medicare Advantage plans) follows a different schedule.

Michigan and Affordable Care Act

Michigan was considered a red state after the 2014 election and support for the Affordable Care Act was mixed. But the tide has turned more recently. After the 2018 election, Michigan's state legislature is still dominated by the GOP, but the margins are much smaller than they were. And Democrats were elected as governor, secretary of state and attorney general.

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. Representative 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 seat in the House following the 2010 census. Republicans won a 9-5 majority after the 2014 election, but the House's representation from 2020 includes seven Democrats, six Republicans and an independent.

At the state level, Republicans control both the House and Senate, though their margins have become smaller since the 2018 election. The legislature did not authorize a state-run health insurance exchange, despite former Governor Rick Snyder's preference for this approach. Michigan has been among the few states that have implemented a partnership exchange, meaning the state oversees some aspects of the exchange, but the HealthCare.gov registration platform and federal government 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 eventually garnered bipartisan support for healthy Michigan. The Medicaid expansion in Michigan uses the ACA's eligibility guidelines (i.e. up to 138% of the poverty level), but the state has obtained approval from the Obama administration to charge premiums for Medicaid plans when enrolleees' incomes are above the poverty level.

Medicaid expansion came under the ACA on January 1, 2014, but Michigan lagged a few months due to the state's waiver process. Enrollment began on April 1, 2014, and 770,280 people were enrolled in healthy Michigan in August 2020. This increase was compared to 645,504 in July 2019, an increase of 16%. The growth in Medicaid coverage is not surprising, as so many people have lost their jobs due to the COVID-19 pandemic.

Before the pandemic, however, the state tried to reduce enrollment in Medicaid plans with a work requirement. Michigan enacted a law in 2018 directing the state to seek federal approval for a work requirements. The waiver proposal was submitted to the CMS in September 2018 and obtained federal approval at the end of 2018.

The work requirement went into effect in January 2020, but was overturned by a federal judge in March 2020, shortly before the outbreak of the COVID-19 pandemic and widespread job losses. The judge's ruling was not surprising, given that job requirements in Kentucky, Arkansas and New Hampshire had already been overturned in 2019.

Short-term health insurance in Michigan

Michigan regulations limit short-term health insurance plans to no more than 185 days in life 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 an insurer over a 365-day period.

Other ACA reform provisions

The ACA's Consumer Operated and Oriented Plan (CO-OP) has created a new type of medical insurance company. CO-PoOs are consumer-managed non-profit plans and aimed to increase choice and competition. In 2014, CO-POs operated in 23 states, including Michigan Consumer CO-OP Mutual.

In the days following the opening of 2016 registrations starting in autumn 2015, Consumers Mutual published a communication announcing the closure and cessation of 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 December 2020, there were only four CO-Po's remaining, offering plans in five states (Maine, Montana, Idaho, New Mexico, and Wisconsin). In 2021, this will fall to three remaining CO-PoPs, as New Mexico's health connections are closing at the end of 2020.

Medicare coverage and enrollment in Michigan

Medicare enrollment in Michigan was more than 2.1 million people as of August 2020. Most are eligible for Medicare because of age, but 17% of Michigan Medicare beneficiaries are under 65 and are eligible for Medicare due to a long-term disability, end-stage kidney disease, or UNAS.

Michigan has a Medigap grant program to help offset the cost of Medigap coverage for low-income enrollees. And the state also protects access to certain Medigap plans for people with disabilities who enroll in Medicare under the age of 65.

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 health insurance-related questions or claims.

● Arab Community Center for Economic & Social Services (ACCESS) - The federally funded Navigator organization that can provide awareness and enrollment assistance to Michigan residents who need help getting health insurance. Navigators can help with Medicaid enrollment and a private health insurance plan through exchange.

● Michigan Medicare/Medicaid Assistance Program (MMAP) - A local service that provides health benefit counseling and assistance to Medicare beneficiaries, including those eligible for both Medicaid and Medicare (in that case, Medicaid funds are used to offset some of the costs a Medicare beneficiary would otherwise have to pay, including Medicare premiums and out-of-pocket medical expenses).

● Medicare Rights Center - A nationwide service (website and call center) that can provide a wide variety of assistance to Medicare beneficiaries who have applications about enrollment, eligibility, benefits, and complaints.