By Joanne Bump
Eroding health care for many Michigan seniors. The U.S. Congress cut $1 trillion from Medicaid, the federal health insurance plan for low-income people, over the next ten years. This reduction was included in The One Big Beautiful Bill Act of 2025, or House of Representatives (HR) bill number 1 of a two-year session, for short. It adds a significant work requirement starting on January 1, 2027.
Under the new federal work requirement, a Medicaid recipient (which could include seniors in nursing homes) must show that they work or volunteer 80 hours a month, every month, and reapply for Medicaid coverage renewal every six months. There are a number of exemptions to the work requirement. However, individuals still need to file the paperwork to qualify for the exemption.
According to the Kaiser Family Foundation (KFF), most adults under the age of 65 are already working. A 2022 Congressional Budget Office report says that most people on Medicaid already have jobs. However, workers will have to go to greater lengths to prove they are employed. Ending Medicaid coverage isn’t going to help these individuals because health insurance enables them to get and keep their employment.
In Michigan, Medicaid health insurance covers more than 2.6 million people or 1 in 4 State residents, usually with lower incomes. It covers three in five nursing home residents, and nearly half the births in the State, plus 300,000 people living with disabilities.
In Michigan, 200,000 residents are estimated to lose Medicaid coverage due to the new federal work requirements, according to the Michigan Executive Budget for Fiscal Year (FY) 2027. This loss includes residents who are eligible, but are not able to submit all their necessary paperwork. Many lack the basic tools to prove their eligibility without a cell phone, internet, or a printer.
For many working in low-wage jobs, proof of employment comes in the form of pay stubs that are hard to track and paperwork provided by an employer, many times, that is lacking high-tech tools. The resources needed to support these workers aren’t there. The enrollee is responsible for showing proof of employment and hours. Many working in the low-wage labor market, for shorter time periods, may have multiple jobs to report on. In addition, HR 1 doesn’t require employers to provide employees their total number of hours worked and earnings.
Loss of Michigan’s Medicaid coverage has already started, as 149,000 less Michigan residents were not covered over the last 16 months, compared to the end of 2024, according to Bridge Michigan 6-4-2026. This is a drop in Medicaid coverage of 5 percent. According to the Michigan Association of Health Plans, which tracks insurance enrollment statistics, it’s unclear how many of this group have acquired coverage through either employers or the federal market place, or are they now uninsured. “We just don’t know what is driving that loss in enrollment,” said Dominick Pallone, Executive Directorof the insurance association.
The Ripple Effect from cuts to Medicaid, will impact us all – says CalMatters 8-7-2026, a nonpartisan and nonprofit news organization in California.
- “The healthcare system is deeply intertwined, and research indicates everyone may see reduced services, lower quality and potentially higher premiums.
- “Low-income patients who rely on public insurance programs like Medicaid … will be hit hardest, but people with commercial insurance will feel the effects too.
- “Many low-income adults will now be subject to work requirements and shorter eligibility periods – conditions that kick mostly eligible people off public assistance programs due to bureaucratic errors.
- “Experts warn ripple effects like these could happen more frequently as hospitals grapple with a coming spike in uninsured patients.”
Medically Frail – On June 1, 2026, the federal administration came out with a new rule, making it harder for those that are “medically frail” to keep Medicaid coverage. Fewer will qualify, despite their serious medical condition and the fact that they may already be in a nursing home. They will now need to prove that their medical condition significantly impairs their ability to work. As a result, state agencies, that are already short staffed, will be required to do time consuming manual work to approve the exemption, rather than relying on computers to verify the persons medical frailty alone. The medically frail aren’t likely to be able to document their inability to work. That means that responsible family members, such are retirees, will need to take on another difficult and time-consuming responsibility to keep their loved ones Medicaid coverage.
HR 1 Cuts to Hospitals – These cuts are projected to cost Michigan’s hospitals $6.5 billion through FY 2032, according to the Michigan Executive Budget Recommendation Presentation for FY 2027. According to CalMatters, hospitals are the starting point for the rippling effect. Legally, they can’t refuse anybody that comes to the emergency room. As more people become uninsured, this uncompensated care has to be paid by someone other than the patient, so many hospitals are already operating at a loss. Without Medicaid insurance coverage, most patients only seek treatment when its most serious and most expensive, according to Jeremy Lapedis, Executive Director of the Washtenaw Health Project, an Ypsilanti-based nonprofit. This leads to medical debt for individuals, and that drives up the cost of health care for everyone.
Michigan’s Sturgis Hospital Closed -They closed on June 19, 2026, after more than a century of service, citing ongoing financial challenges. Sturgis was Michigan’s first rural emergency hospital to close. Experts say that more rural Michigan hospitals are likely to close due to Medicaid cuts and higher costs. When hospitals cut back, they reduce services for everyone, not just those who lost Medicaid. They cut wages, lay off staff, and cut or stop expensive services like the emergency room. If there are not enough paying patients, hospital income goes down and quality may decline. Financially vulnerable hospitals may close entirely, requiring patients to travel further from home to get medical care. Many seniors use emergency services. The loss of health care services may mean that those services are not there when they are needed.
Joanne Bump serves as feature columnist for “Retirement Matters.” Column content is time sensitive and is based on information as of 8/9/26. Sources are primarily from non-profit, and government policy research organizations. Joanne can be contacted by e-mail at joannebump@gmail.com.