As if the numerous job cuts to healthcare and public health workers that have been taking place and the Big Beautiful Bill health budget reductions now being set in stone were not enough, the Trump Administration has been gradually, almost subliminally nipping along the edges of Americans’ more tacit health benefits. The enhanced premium tax credits that continued through the COVID period are set to expire at the end of this year. Subsidized Affordable Care Act (ACA) Marketplace enrollees can expect their out-of-pocket premium payments to rise upwards of 150% (Lo et al., 2025). Those making between 100 and 150% of the Federal Poverty Level (FPL) and currently paying $0 for a benchmark plan can expect to start paying more than $1,100 per year in premium costs. The average person will see a $700 premium rise. In June the Trump administration endeavored to shorten the Health Insurance Marketplace open enrollment period stretching from Nov. 1 to Jan. 15 to an end date of Dec. 31. Those with an income at or below 150% of the FPL will also no longer be able to enroll outside the Annual Open Enrollment Period. States operating their own health insurance exchanges have a degree of timing flexibility, but this measure does not apply to Michigan since it takes part in the federal Health Insurance Marketplace. In addition to their enrollment-related duties, Affordable Care Act Navigators also provide information on Medicaid and employer coverage for low-income populations. Michigan has been in the top half of states receiving federal funding for Navigators. This federal program is undergoing a 90% funding cut.

Gov. Gretchen Whitmer has taken compensatory steps to try to mitigate the effects of these changes. She admits that she cannot shield Michigan from the impacts of the “One Big Beautiful Bill” and the other regressive steps occurring, but assures, “What I can do is whatever it takes to help make  life a little easier for Michiganders, and the work we can do in state government to ensure that people have a little help in these challenges” (Solis, 2025). On August 8, Gov. Whitmer signed Executive Directive 2025-6 to act as a counterbalance to the above federal shifts. Three major features are that the Michigan Department of Insurance and Financial Services (DIFS) must: (1A.) maximize enrollment by educating Michiganders to work with the new administrative requirements and other health policy changes now occurring; (1B.) connect Michiganders with all available resources, including a DIFS live call center and Health Insurance Navigators who will help them assess their options and stay enrolled; and (2.) coordinate with all state departments and agencies in the carrying out of these duties (Office of the Governor, 2025). These actions demonstrate that states have a degree of independence from federal tectonics, and that state policymakers like Governor Whitmer can make a difference in health coverage for people from different walks of life. Michigan public health professionals are in a position to publicize and advance these new, statewide (as opposed to federal) forms of health policy “enhancement.”

References:

Lo, J., Ortaliza, J., McGough, M., Wager, E., Cox, C. (2025, September 19). Premium payments if enhanced tax credits expire. KFF. https://www.kff.org/affordable-care-act/premium-payments-if-enhanced-premium-tax-credits-expire

Office of the Governor, State of Michigan. (2025, August 8). Impact of Federal Affordable Care Act Rollback. Executive Directive No. 2025-6. https://content.govdelivery.com/attachments/MIEOG/2025/08/08/file_attachments/3351371/ED%202025-6%20-%20ACA%20Marketplace%20Changes.pdf

Solis, B. (2025, August 8). Whitmer orders state to help residents maintain affordable insurance in wake of GOP budget bill. Michigan Advance. https://michiganadvance.com/2025/08/08/whitmer-orders-state-to-help-residents-maintain-affordable-insurance-in-wake-of-gop-budget-bill

Updated 09/29/2025