The One Big Beautiful Bill Act, passed on a party-line vote, is estimated to lead to several hundred thousand Michiganders losing health insurance and food assistance, and to bring many rural hospitals to the brink of insolvency.

Dr. Anand Parekh is an adjunct professor of health management and policy at the University of Michigan School of Public Health.

In the short term, mitigating these health consequences will be crucial.  The state will need to build an infrastructure for administrative data matching to ensure eligible Michiganders don’t lose Medicaid or SNAP access as well as support rural hospitals as they access federal and state dollars to stay afloat.

Long-term, the path to make Michigan the healthiest state in America will require much more work.  Indeed, for many years, Michigan has hovered in the slightly below average rankings of the healthiest states, especially on measures relating to mortality, behavioral health, and physical health. Only a bipartisan approach in Lansing will result in durable policy to meet these challenges. Part of this approach requires spending health care dollars more smartly.  Here are three investments which would help Michigan become a healthier state and deserve bipartisan support.

First, Michigan needs to increase its per capita public health funding. The state currently ranks 43rd in the nation in this regard. This is in spite of the fact that out of the 30 years of life expectancy the US gained over the course of the 20th century, 25 of those added years were the result of public health activities. 

Most Michiganders take what local public health departments do for granted — from inspecting restaurants for food safety to immunizing kids, staffing school health programs, keeping infectious diseases at bay, providing cancer screenings, and preventing overdoses, among other things. But red and blue states are increasingly realizing the importance of public health to well-being and economic vitality.

For example, in 2024 and 2025, Indiana’s conservative legislature appropriated $225 million in new public health funding for local health departments, a 1,500% increase. Preliminary estimates of the first 8 months of new funding examining just three services (prenatal care, blood pressure screenings, and falls prevention) found an estimated $94 million in direct and indirect cost savings.

Second, Michigan needs to increase its share of primary care spending relative to total health care spending. Greater use of primary care services has long been associated with better health, better care, and lower costs. Primary care clinicians excel at preventing and managing chronic diseases such as diabetes, hypertension, and chronic respiratory disease.

While Michigan has comparatively average ratios of primary care clinicians and primary care spending, health outcomes data suggest that it’s not nearly enough. Michigan ranks below average in categories such as preventable hospitalizations and prevalence of multiple chronic conditions.

Currently 22 states report or have committed to reporting on primary care spending, including New York, which has legislation pending to increase spending by all payers to a least 12.5% and California which set its first primary care target of 15% of total health spending last year.  Michigan should follow suit urgently.

Third, research demonstrates that states with a higher spending ratio of social services to health care services have better health outcomes on measures such as adult obesity, mentally unhealthy days and mortality rates for heart attacks and Type 2 diabetes. These services fall in various determinants of health including education, employment, housing, and nutrition.

Taking into account the state’s difficult fiscal climate, investments in social services should target geographical regions with the worst county health rankings (urban areas with racial disparities & rural areas which lack social services), target vulnerable populations (the young given the state’s high rates of adverse childhood experiences and the elderly given the state’s aging population), target issues which are likely to worsen given recent federal legislation (e.g., food insecurity), and target evidence-based policies (e.g., deployment of community health workers) which can support Michiganders in health promotion and disease prevention.

Only through an embrace of these areas by both sides of the aisle can Michigan become a healthier state.Moreover, the state’s economic competitiveness and population growth depend on it. In this regard, Lansing need not follow the partisanship of Washington, DC; rather it should be the poster child for bipartisanship.

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