MAUW Member Policy Hub

Early On is a statewide system of free early diagnosis and intervention services for developmental delays and disabilities for infants and toddlers. All families in Michigan are eligible for Early On. The system is funded with some state funds and IDEA Part C funds, but primarily through county-based special education millages.

Over the past three fiscal years, Early On Michigan’s state and federal funding ranged between $32 million and $35.2 million, with approximately $18.7 million in Medicaid reimbursements (2023) and additional local funding. Based on FY 2025 state and federal funding ($32m) and estimated Medicaid reimbursements ($18.7M):

• An additional $205 million is needed to cover the cost of current services.

• An additional $280 million is required to fund target service levels.

While exact gaps are difficult to determine based on the lack of available information on county special education millage funds used towards Early On in each area, for the first time we have a “true cost of care” for early intervention services. Read the full report.

State-level data on debt in excess of $250 owed specifically to providers or collection agencies (i.e., excluding debts accumulated using general borrowing tools like credit cards and personal loans, debt owed to family and friends, and any medical debts below $250) shows that the percent of adults with this kind of medical debt in Michigan (9 percent) is above the national average (8 percent), which is similar to Ohio and Wisconsin, but lower than Illinois and Indiana. 

Michigan included $4.5 million in the FY2024 budget for a grant program “to eliminate medical debt to patients with an income below the federal poverty level with a financial need or who face insolvency.” There is some effort to build on this funding in this year’s budget.

RIsk: Low, Competition for resources. This has been a particular priority of Senate DHHS Budget Chair Sylvia Santana and was mentioned in Governor Whitmer’s 2025 State of the State Address.

Landscape: Supported more on the progressive side, not many institutional stakeholders active on this issue, mostly just competition for DHHS funds.

The Citizens Research Council of Michigan published a report following these developments on the current state of medical debt regulation, with policy recommendations.

Provide continued funding to support Medicaid reimbursement for the full continuum of perinatal care, including reimbursements for doulas, birthing centers, group-based prenatal care, & lactation support.

Risk: Low, competition for resources. Though it could become Moderate if/when work requirements return as a policy issue in Michigan.

Landscape: Michigan League for Public Policy leads advocacy efforts for this with Think Babies Michigan.

Support universal school meals by joining & completing the action alerts at the Healthy School Meals For All coalition.

The site includes background on the program, key facts, and ways to get involved. If you’d like to be listed as a coalition partner, please fill out this quick form:
🔗 Partner Sign-Up Form

Please share the school meals story collection form with your networks. Personal stories from families, school staff, and students are making a real impact with legislators.

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Federally, the topic of “Community Eligibility” is the center of school lunch policy. Congress is considering raising the threshold.

See which school districts are currently “Community Eligible”

MAUW is part of the Protect MI Care Coalition supporting Medicaid advocacy with Congress. See the Protect MI Care Launch Toolkit.

Proposals to cut Medicaid by $880 billion over the next decade, as outlined in the House Budget Resolution, would be devastating for Michigan. In 2026 alone, our state would experience:

• $2.2 billion in lost federal funding

• $4.9 billion in lost economic output

• $2.9 billion in reduced state GDP

Cuts of this magnitude would force impossible choices—shrinking access to care, shifting costs onto state budgets and local providers, and threatening coverage for seniors in nursing homes, those receiving cancer care, veterans, people with disabilities who need daily support, and working families who can’t afford private insurance.

Worse still, the damage wouldn’t stop with those who rely on Medicaid. These cuts would destabilize the entire healthcare system. Hospitals, birthing centers, mental health clinics, and nursing homes across Michigan depend on Medicaid to keep their doors open. If that funding disappears, many of these facilities will be forced to shut down, leaving entire communities without essential services. And when a hospital or clinic closes, it doesn’t just close for Medicaid patients but for everyone. Whether someone has Medicaid, private insurance, or Medicare, it won’t matter if there’s nowhere to go for care. These closures would create healthcare deserts across our state, straining the remaining providers and putting all residents at greater risk with fewer options, longer wait times, and reduced access during emergencies.

The Medicaid expansion halved hospitals' uncompensated care costs, and the state government does not have revenue to offset possible federal cuts.

Source: Crains (paywall)

In addition to potential Medicaid cuts, additional cuts have been made to federal funding for public health programming in MI, including lab capacity to prevent infections diseases and substance use services.

Increasing the frequency of mandatory eligibility checks for expansion enrollees to every six months would increase administrative burdens and reduce access to care. Many Medicaid coverage losses at redetermination are due to procedural challenges, not a change in eligibility. Therefore, increased redeterminations would create more opportunities for missing mail, higher burdens of completing paperwork, and a greater chance for losing coverage despite remaining eligible.

Here is a summary of the work requirements proposals in the House and Senate versions of the OBBA:

• The House and Senate both propose a work requirement of 80 hours per month for able-bodied adults who receive benefits. Limits exemptions to parents with children ages 14 and under. Allows state exemption from the new requirements until December 31, 2028.

• The House and Senate both propose requiring states to establish Medicaid community engagement requirements for able bodied adults without dependents.

The Michigan State Budget Office (SBO) released a memo calculating the total cost of the congressional bill under consideration to Michigan at $900 million, including massive cuts to Medicaid and SNAP. Nearly 15% of Michiganders, almost 1.5 million people across every region, receive SNAP benefits. More than 59% are families with children, 39% are families with members who are older adults or are disabled, and 41,000 are veterans, around 10% of our total veteran population. Data also shows that 67% of SNAP recipients are covered by Medicaid, meaning the legislation being moved through Congress could threaten both the health care and food access of nearly 950,000 Michiganders.

SNAP is an effective program that has lifted 232,000 people above the poverty line in Michigan, including 101,000 children. SNAP dollars are spent at approximately 9,800 retail locations across the state, supporting jobs and local economies across the state.  

We know that using SNAP leads to fewer missed days of work, fewer doctor’s visits, better mental health, and healthier birthweight for babies whose moms who have access to food benefits during pregnancy. Seniors who use SNAP are less likely to need hospitalization, less likely to be admitted to a nursing home, and more likely to actually use the medications they are prescribed. 

Most working-age adults who receive SNAP supplement their low wages with SNAP or receive SNAP when they’re temporarily out of work. Many work in low-paid jobs with unpredictable hours. Taking SNAP away will hurt workers who are between jobs, work in industries that don’t provide a consistent number of hours per week, or get lost in the burdensome, red-tape-filled-process of documenting their work hours.  

The current House reconciliation bill would extend SNAP work requirements to households with school-age children, raise the maximum age when work requirements apply from 54 to 64, and limit states’ ability to request work requirement waivers for areas with high unemployment. People subject to the policy would be limited to three months of SNAP benefits within a 36-month period unless they meet the work requirement by working or participating in a qualifying work program.

Roughly 44,000 Michigan SNAP enrollees would lose some benefits, and 86,000 would lose all benefits under work requirement expansions. 28,000 enrollees with children would lose some or all SNAP benefits.

While the House bill would preserve work requirement exemptions for veterans, homeless individuals, and youth who were in foster care, the Senate OBBA proposal omits these exemptions.

Another proposal would aim to save money by rolling back changes made to the “Thrifty Food Plan”, which estimates food costs across US regions to set SNAP monthly benefits. The Thrifty Food Plan was updated under the previous administration to respond to the higher cost of food.

Urban Institute has calculated the gap between a moderately-priced meal in your county and the maximum SNAP benefit after proposed rollbacks to the Thrifty Food Plan. See your county stats here.