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Opinion | 300K could lose Medicaid without support from community-based organizations
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Access to health care has never been a struggle for me. As a daughter of two college-educated professionals and as a professional myself for nearly 20 years, I have always had health care coverage provided by an employer.
This is quite different from the people I have worked to help every day throughout my career in community health.
I have listened to the stories of people enrolled in Medicaid and how they struggle with understanding their coverage and the processes for accessing needed medications, communicating with providers and making sure their coverage continues without interruption. This is reflected in the experience of a woman I know from Detroit who often finds herself struggling to understand why her Medicaid sometimes “gets cut off.” all while juggling work, raising children, being a caregiver for several family members and managing her own health conditions.
Medicaid provides health care coverage to more than a quarter of Michigan’s population. In July 2025, President Trump signed the One Big Beautiful Bill Act, which created significant changes to Medicaid, including more frequent redetermination of eligibility and work or volunteer requirements.
These changes require people to show proof of work twice a year within the required timelines and in the requested format or risk losing their coverage. It is estimated that these changes will increase the number of uninsured Americans by 7.5 million by the year 2034 due to many people not being able to meet work requirements, missing deadlines for redetermination or simply not understanding how to navigate the processes for showing proof of eligibility. These changes will go into effect on January 1, 2027, and require states to communicate with people effectively about these new expectations.
To help people keep their Medicaid coverage in response to changes from the One Big Beautiful Bill Act, the Michigan Department of Health and Human Services (MDHHS) and the Michigan Legislature should allocate funds for community-based organizations to share information about the changes to Medicaid with people in the communities they serve.
Community-based organizations (CBOs) are driven by community residents and are powerful, influential, trusted entities within specific communities and populations that can connect with people in ways that larger institutions cannot. CBOs often serve as a part of the health care safety net addressing gaps in access to health care by providing resources that traditional health care spaces don’t.
Some states have even integrated CBOs into their Medicaid programs to connect services for clinical and social needs for their populations. CBOs can use these funds to organize targeted engagement efforts to share information with people regarding the Medicaid policy changes, provide support with navigating the new rules and eliminate confusion to make sure coverage is maintained.
Governor Whitmer’s proposed FY2027 budget includes $11.7 million for Medicaid beneficiary support efforts, which the Michigan Legislature should designate for CBOs to do the vital community engagement work to keep people covered by Medicaid.
It is estimated that up to 355,000 Michiganders will lose coverage due to the One Big Beautiful Bill Act. 71% of adults with Medicaid are employed in Michigan, which helps workers manage chronic health conditions without having to leave the workforce due to serious illness.
While MDHHS must make wise decisions on how funds will be invested in response to the changes brought on by the One Big Beautiful Bill Act, it is important to prioritize community engagement to ensure people can maintain their coverage.
Without targeted communication and support for current enrollees, the coming changes to Medicaid will have dire consequences. Our state agencies have the power to make sure these consequences do not happen in the lives of those who need Medicaid for health care coverage.
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