In their words: How Michigan governor candidates would fix health care

How eight Michigan gubernatorial candidates say they’d tackle Michigan’s most pressing health care problems
Perry Johnson declined to respond to Bridge’s questions individually
Candidates were asked to limit their responses to 300 words

Bridge Michigan readers have identified health care as one of the most pressing issues in Michigan’s upcoming election, so we reached out to gubernatorial candidates to see what they’d do about it.

The state’s next governor will face a litany of issues, from an overloaded mental health system to rising premiums and a Medicaid funding shortfall.

We asked the candidates six questions on health-related topics and urged them to explain what, if anything they would do to address those problems.

The candidates:

Secretary of State Jocelyn Benson, a Democrat
Former Attorney General Mike Cox, a Republican
Former Detroit Mayor Mike Duggan, an independent
US Rep. John James, a Republican
Businessman Perry Johnson, a Republican
State Senate Minority Leader Aric Nesbitt, a Republican
Pastor Ralph Rebandt, a Republican
Genesee County Sheriff Chris Swanson, a Democrat

A collage of governor candidates. — Michigan governor candidates. Top row: Jocelyn Benson, Mike Cox, Mike Duggan. John James, Bottom row: Aric Nesbitt, Perry Johnson, Ralph Rebandt, Chris Swanson. (Bridge, AP and courtesy photos)

Only Johnson declined to provide full answers to Bridge’s questions. After repeated inquiries, his campaign provided a brief statement that did not directly address any of the health care issues raised by Bridge readers.

“I will audit state government with my MEGA Audit and return the money to the taxpayers with my 4747 income tax elimination plan and property tax reform plan,” Johnson said. “This will help with affordability and healthcare for working families and seniors across our state.”

Related:

As Bridge previously reported, Johnson is exaggerating the income tax savings, and his plan would cost the state about $13 billion in annual revenue.

Read on to see how Michigan’s other gubernatorial candidates would tackle some of the most urgent health issues facing Michigan today.

Cost and affordability

The question: Amid soaring hospital costs and rising drug prices, Michiganders are seeing major increases to their insurance premiums. Plans on the Affordable Care Act marketplace have risen more than 20% over the past year. What specific steps would you take, if any, to tackle the rising cost of health care in Michigan?

Benson (D): As I meet residents across our state I hear countless stories of Michiganders crushed by medical bills and making unthinkable sacrifices to cover the rising cost of healthcare.

We need to address the unchecked escalating cost of medicine in Michigan.

As governor I will establish an Independent Prescription Drug Affordability Board that will hold pharmaceutical companies accountable for price gouging and identify ways to reduce the overall cost of care and increase the fairness and transparency in healthcare decisions — including forcing hospitals to share costs upfront to eliminate surprise billing.

We also need to take on a broken healthcare system that too often puts profits over patients. My plan will take on insurance companies who consistently and unfairly deny doctor-prescribed care, reform the MDHHS to assist patients in appealing decisions and filing complaints when insurers prioritize profits over patients’ health and wellbeing, and empower MDHHS to investigate and penalize insurers with patterns of inappropriate denials.

Finally, we’re going to relieve the burden of medical debt. Under my plan, MDHHS will implement expanded and effective debt forgiveness programs, increase access to financial counseling, and partner with hospitals to limit aggressive collections. Medical debt should not prevent families from being able to put a roof over their heads or put food on the table. “

Cox (R): “Michigan families are paying more every year in premiums and out-of-pocket costs, and small businesses are struggling to keep up. As a business owner, I’ve faced double-digit increases nearly every year. This isn’t sustainable and it isn’t inevitable.

Costs are out of control because our healthcare market has lost real competition. It’s dominated by a handful of large hospital systems and insurers, buried in administrative costs, and keeps patients in the dark on price while saddling them with the bill. As governor, I will focus on three things: restoring competition, expanding lower-cost care options, and giving families real price transparency.

To bring costs down, I would focus on three things: more competition, lower-cost care, and real price transparency.

First, competition. Three hospital systems now control 63% of Michigan’s market, and our insurance market has shrunk from 41 companies to 12. That’s not a market; that’s a cartel. I will use Michigan’s Medicaid buying power, DHHS rulemaking authority, and the governor’s bully pulpit to stop further consolidation and lower the barriers for new insurers to enter Michigan.
Second, lower-cost care. We need to move more procedures out of expensive hospital settings and into ambulatory and outpatient centers where care is equally safe and more affordable. I’ll push Certificate of Need reforms to make that shift happen, and expand scope-of-practice rules and telehealth to address Michigan’s healthcare worker shortage, because fewer workers means higher prices and less access.
Third, transparency. Patients should know what care costs before they receive it. I launched michigandrugprices.com as Attorney General to help families comparison shop for prescriptions, it worked, and I’ll bring it back. I’ll also expand hospital price transparency and limit excessive interest on medical debt so families aren’t blindsided by bills they can’t afford.

Finally, we need to ensure Medicaid dollars reach those who need them most, which means enforcing eligibility standards and supporting work requirements for able-bodied recipients.

Duggan (I): People without health care live sicker, suffer more, and die earlier. Unlike the other candidates for Governor, I ran a health care system that expanded access to care by successfully cutting waste.

Prior to my tenure as CEO of the Detroit Medical Center in 2004, DMC had lost $100 million a year the previous 5 years and was planning to close three critical hospitals, leaving hundreds of thousands of patients without care. Conventional wisdom was that hospitals in Detroit could not survive financially.

Our team didn’t talk about cutting costs – we delivered. In my 9-year tenure at DMC, we operated profitably every year all 9 years in the black and from 11,000 employees to 14,000 employees. We cut wasteful spending, excessive wait times, and inefficient systems and successfully treated more than 1 million patients a year.

There are two major drivers of rising health care costs in Michigan that can be reduced by a Governor who understands health care:

About a quarter of all health care dollars spent go to billing and administrative paperwork, not to care. Each health insurer and provider now operate their own billing systems with multiple incompatible portals and conflicting protocols and practices. A single coordinated process that worked across all plans and providers could dramatically reduce waste without reducing care.
Almost half of all health care costs are spent treating chronic diseases: heart failure, high blood pressure, kidney disease, diabetes, COPD, etc. The failure to coordinate care to keep patients healthy and out of the hospital is the single greatest driver of rising health care costs. At DMC, I led America’s most successful Pioneer ACO that dramatically reduced Medicare costs by partnering with primary care doctors in keeping patients well. The approach of shared risk between doctors and hospitals must be significantly expanded in Michigan.

Michigan and get the care they need without being crushed by the bill.

James (R): When I ran my family business in Detroit, my family and I were on the same health care plan as our employees. I watched premiums climb and choices shrink. That experience is personal, and it is exactly why I reject the idea that more government spending is the answer.

The 20-plus percent premium increases under Obamacare are not a surprise. The law was never sustainable and never lived up to its promises. It distorted the market, reduced access, drove insurers out, and created dependency. Propped up by reckless Democratic spending, it left more Americans underserved, prescription drugs less affordable, and families drowning in medical debt. The numbers don’t lie: Obamacare has been a fiscal disaster and a nightmare for consumers.

The single greatest driver of rising costs is increased utilization, and that starts with sicker Americans. The best way to lower health care costs is to have healthier Michiganders, and secure borders. We need to address the root causes of poor health and stop subsidizing the consequences of failed border policy.

As Governor, I will pursue three concrete, market-based reforms to increase access, improve transparency, and lower costs. First, I will work with the legislature to overhaul Michigan’s Certificate of Need laws, which artificially limit competition and drive up costs, especially in rural communities. Second, I will push for full medical price transparency, building on the Patients Deserve Price Tags Act I introduced in Congress and Senator Jonathan Lindsey’s companion legislation here in Michigan. Third, I will take on Pharmacy Benefit Managers. These middlemen are legally pocketing the difference between what your insurance plan pays for your prescription and what the pharmacy actually receives. You pay more. They profit. As Governor, I will ban that practice and require every dollar of drug rebates to flow back to patients, not corporate middlemen.

Michigan families work too hard to be secretly price gouged on their prescriptions. I also support tort reform and cross-state insurance sales to further drive down costs. Market competition and healthier communities, not government dependency, are how we fix health care in Michigan.

Nesbitt (R): Democrats socialist revision of our healthcare has been a disaster from the start, and Michiganders are paying the price with skyrocketing premiums. We cannot tax and mandate our way to affordable healthcare. The root cause of these 20% hikes is bloated government intervention and a broken system that subsidizes care for illegal immigrants at the expense of hardworking taxpayers. This drains our resources and shifts the financial burden onto Michigan families.

To lower costs, we need aggressive free-market solutions, not more state control. We must root out the massive waste, fraud, and abuse in state health agencies and eliminate hidden taxes on medical services. By increasing price transparency and fostering cross-state competition, aligning with President Trump’s push to put patients first, we can drive prices down. My goal is simple: a thriving, competitive economy where everyone can make it in Michigan and get the care they need without being crushed by the bill.

Rebandt (R): Hospital costs and drug prices keep soaring because government mandates, hidden pricing, and regulatory barriers have shielded providers from real competition while rewarding volume over value. The ACA marketplace premium hikes of more than 20% prove top-down price controls and expansions simply shift costs to families without fixing root causes. Chronic disease — fueled by ultra-processed foods and sedentary lifestyles — drives the majority of spending. The COVID-19 mandates that postponed non-essential care only made things worse by delaying cancer screenings and routine checks.

I will enact full price transparency legislation so patients see real upfront prices (modeled on Texas’s successful All-Payer Claims Database and shoppable-services requirements). I will repeal Michigan’s Certificate of Need (CON) laws that block new private surgical centers — Florida’s broad CON repeal produced new hospitals, no closures, and hospital revenue that outpaced national trends. I will reform pharmacy benefit managers to cut middlemen waste, expand Health Savings Accounts, remove barriers to physician-owned hospitals, and promote Direct Primary Care models that restore the patient-doctor relationship. Most importantly, we will attack root causes with tax incentives for wellness programs, exercise, and “seed-to-table” initiatives: farm-to-school programs, community food co-ops, and local farmers markets to boost natural fiber intake, cut processed foods, and ease the epigenetic burden on our children. Texas-style farm-to-school and nutrition education reforms have proven effective at improving kids’ diets and activity levels.

An ounce of prevention is worth many pounds of expensive reactive care — these market-driven steps will lower premiums and save both dollars and lives downstream

Swanson (D): “Costs for consumers are rising in every sector of our economy and now working families are being attacked with cuts in healthcare coverage and services at the Federal level, leaving fewer healthcare options for those who can afford it the least. As Sheriff, I have fought for our local health providers by advocating for the nurses striking at Henry Ford Genesys as they work to ensure a fair wage and safe patient to nurse ratio. As Governor, I’ll always fight for families and use our budget process to prioritize funding for Medicaid and healthcare services for low-income residents.

A healthcare crisis for a family that is uninsured or underinsured is one of the scariest situations anyone can face. Even in the best of scenarios where the health concern is remedied, it leaves a financial disaster that bankrupts that individual through no fault of their own. This is unacceptable. As Governor I will support programs that help forgive medical debt, advance legislation capping the interest rates associated with this type of debt, and ensure credit scores are not impacted simply because someone suffered injury or illness.”

Social safety net

The question: Michigan has the potential to face a multibillion-dollar Medicaid funding shortfall during your first term, due to changes from the One Big Beautiful Bill Act. Would you secure the funding required to maintain coverage or would you seek to reduce coverage? Please explain how.

Benson (D): The next governor of Michigan will have a moral responsibility to make sure as many people in Michigan can keep and maintain access to care and health insurance. The federal cuts and changes – which leading Republican candidates for governor have voted to support – create significant burdens that I, as the only candidate in this race with experience streamlining the efficiency of state agencies, will be determined and prepared to surmount.

As the current CEO of one of our state’s largest agencies, I know how to fix broken systems. As governor, I will simultaneously work with our congressional delegation to push for a restoration of healthcare cuts at the federal level while also eliminating wasteful and inefficient spending in our state agencies so that it is as seamless as possible for Michiganders to maintain coverage for healthcare.

We’ll also maximize our use of the data we have as a state to make it as easy, simple and seamless as possible for people to keep coverage, while also funding navigators and community health workers at MDHHS to keep people enrolled and provide resources to help people navigate the complex choices they must make in a changing healthcare landscape.

Finally, recognizing that every state is facing this dilemma, I will build partnerships with governors in neighboring states to explore ways to leverage economies of scale to reduce costs and elevate best practices as we work to tackle these problems together.

Cox (R): The best long-term solution to Medicaid dependency is a stronger Michigan economy, which is why my goals start with developing a stronger and more vibrant economy as I lay out at www.mikecox2026.com. My tax and regulatory reforms will ensure more Michigan citizens are able to access insurance through their employer rather than rely on Medicaid.

For those who truly need Medicaid coverage, I would protect and strengthen it by putting a stop to spending it on illegal aliens and able-bodied adults who refuse to work. I will fully embrace the One Big Beautiful Bill’s common-sense reforms. Able-bodied recipients who can work should work, or contribute through volunteering at least 20 hours per week. These aren’t cuts to coverage; they’re a commitment to making sure the program serves the people it was designed for.

Combined with the market reforms I outlined above, including increased competition, lower administrative costs, and Certificate of Need reform, we can deliver more care for fewer dollars. Michigan doesn’t have a Medicaid funding problem; it has a Medicaid efficiency problem. I intend to fix that.

Duggan (I): If you listen to the way Republicans and Democrats attack each other on the health care issue, you would believe the only two choices are cutting coverage or increasing funding. An Independent Governor who actually ran a health care system knows how to preserve the coverage without having to fund the federal shortfall.

In 2027, there will be new federal obstacles to Medicaid enrollment. Strong leadership can overcome those obstacles and protect our residents’ coverage. We would do that in 3 ways:

Simplify the Medicaid enrollment process. At DMC, we encountered numerous uninsured patients who should have been on Medicaid, but couldn’t get enrolled because of the State bureaucracy. DMC hired our own staff at our hospitals and clinics who enrolled thousands of patients. As Governor, we will completely overhaul the Medicaid enrollment process to expand access.
Simplify the reporting for the new work/education/volunteer requirements. In 2027, many current Medicaid patients will lose coverage if they fail to document their work/education/volunteer activities. If the state continues past enrollment processes the human effect will be disastrous. I will create a new IT system where Michigan residents can readily record their work/education/volunteer time on a simple form on their smart phones all connected to a network of eligible activities.
Cut waste in the Medicaid program. The total Medicaid budget now exceeds $30 billion and is not managed in a way to reduce health care costs. A total overhaul of Michigan’s Medicaid delivery system that cuts costs by managing chronic conditions in doctors’ offices and outpatient settings can dramatically reduce the cost of the system and give the State the resources to protect our residents’ access to care.

James (R): Medicaid must protect the people it was designed to serve: Michigan’s poorest and sickest residents, low-income families, senior citizens, and people with disabilities. When the program expands beyond that core mission, it becomes unstable for the very people who depend on it most.

As Governor, I will meet new federal standards expeditiously and permanently, but in a way that is as humane and compassionate as possible. I will implement work requirements and conduct more frequent eligibility verification to eliminate fraud, waste, and abuse.

And make no mistake, the fraud is real and it is happening right here in Michigan. Last year, 13 Michigan residents were charged as part of a nationwide Medicaid sweep involving pharmacists, doctors, and patient recruiters bilking the program out of millions part of an estimated $14.6 billion in losses nationally. Just this month, a Macomb County dentist was charged with racketeering and 131 counts of Medicaid fraud for billing taxpayers for dental crowns that were never provided, leaving real patients told their benefits were exhausted when they needed actual care. That money belongs to Michigan’s most vulnerable, not to fraudsters.

If we are serious about holding Big Insurance, Big Pharma, PBMs, and consolidated hospital systems accountable for what they take from Michigan families, we must be equally serious about the criminals stealing from Michigan’s most vulnerable. Protecting Medicaid means protecting it from all sides.

I support the bipartisan effort to restructure provider taxes. And I will explore preventive care pilot models within Medicaid, because addressing chronic illness early is both compassionate and fiscally sound. A healthier Michigan is a less expensive Michigan. That is not a partisan position. It is common sense.

Nesbitt (R): The multibillion-dollar Medicaid shortfall we are now facing is the direct result of the mismanagement, waste, and fraud Lansing Democrats have allowed to fester in our state. Whitmer’s administration lost $8.5 billion to unemployment fraud and blew a $9 billion surplus on pet projects and corporate welfare. All while state revenue increased by 40%. The money is there. It’s about how we spend it.

My administration will absolutely not raise taxes on hardworking Michigan families to bail out Democrat incompetence. We will secure the necessary funding by aggressively auditing our Medicaid system to root out the money lost to government waste, fraud, and abuse.

Furthermore, we will put an end to Democrat sanctuary policies and ensure that our state’s safety net is strictly reserved for American citizens and legal residents, not illegal immigrants.

For able-bodied adults without dependents, we will implement strict work requirements to transition them from government dependency back into the workforce. By cleaning up the Democrats’ mess, stopping the fraud, and protecting our resources, we can maintain a truly sustainable safety net for our seniors, children, and individuals with disabilities, ensuring everyone has the foundation they need to make it in Michigan.

Rebandt (R): Medicaid expansions ballooned enrollment and costs, trapping able-bodied adults in dependency while fraud and inefficiency drained billions. The One Big Beautiful Bill Act’s work requirements and tighter eligibility are necessary corrections after years of unsustainable growth that crowded out care for the truly vulnerable.

I will implement these federal changes through executive action and supporting legislation rather than backfilling shortfalls with new Michigan taxes. Following Paragon Health Institute and Heritage Foundation recommendations, we will prioritize the elderly, disabled, and children; enforce work or community engagement for able-bodied recipients; strengthen fraud audits; and adopt leaner benefit structures with greater state flexibility. Personal responsibility and self-reliance are the path to sustainable safety-net programs that actually help people move forward.

Swanson (D): Disastrous policies and ill-conceived legislation such as the OBBBA are lining the pockets of C-Suite executives and corporate shareholders who are hoarding record profits. As long as our Federal Government chooses to ignore the health care needs of our residents, Michigan’s elected leaders must act boldly to secure and protect life sustaining medical care and preventative treatment for those we serve.

As Governor I will use every lever and resource to ensure Medicaid services continue for those in need. Roughly 1 in 4 Michiganders rely on Medicaid for their healthcare, including nearly 1 million children across our state. As a society we cannot turn our backs on our most vulnerable. My administration will ensure we value the health and safety of every person in our state, regardless of their economic status or income level. Addressing this looming crisis is crucial for our entire healthcare system. Medicaid cuts that lead to reduced reimbursement rates could shutter hospitals and force medical providers to other states. Whether you are on Medicaid or not, these cuts stand to harm every citizen in Michigan.

Access

The question: Health care services outside of Michigan’s population centers are in decline. State officials report 1.7 million Michiganders live in areas with a primary care shortage, and rural hospitals are facing financial challenges. What actions would you take, if any, to ensure continued access to health care in rural Michigan?

Benson (D): Michigan is facing a critical physician shortage that is contributing to rising costs and growing healthcare deserts across our state. My plan will support healthcare workforce development through an expansion of programs and scholarships for students pursuing medical careers, and create tax and loan forgiveness incentives that make it affordable for doctors, nurses and other healthcare workers to build their lives in Michigan’s highest-need communities.

As Secretary of State, I made it a priority to expand our department services across the state, meeting people where they are and ensuring government shows up when you need it and gets out of the way when you don’t. Just as we’ve launched mobile secretary of state offices to save Michiganders time and money when renewing their licenses and plates, I’ll expand MDHHS to bring care directly to underserved communities. Our programs will include partnering with local healthcare providers to invest in mobile health centers to bring low or no-cost preventative services directly to rural and underserved areas hit hardest by hospital closures and federal funding cuts.

Cox (R): Rural Michigan matters, and for the past four years it has been ignored by a governor more focused on Detroit than on the rest of the state. Whether it was the dangerously slow response to the Ice Storm of 2025, the attempt to shut down Line 5, or the chronic underfunding of rural programs, the Whitmer Administration has turned its back on rural Michigan. Rural healthcare is no different, and I intend to change that.

The numbers tell the story. More than 1.7 million Michiganders live in areas with primary care shortages, nearly 40% of rural counties have no OB/GYN, and rural hospitals across the state are operating at a loss. This is a crisis, and it demands a governor who actually shows up.

As governor I will tackle rural healthcare access on three fronts.

First, I will reduce the regulatory burden that makes it harder for rural hospitals to stay open and fight any further hospital consolidation that inevitably leads to shutting rural facilities down.
Second, I will expand telehealth options so that distance is no longer a barrier to quality care.
Third, I will push scope of practice reforms and immediately recognize out of state medical licenses so qualified providers can get to work in Michigan without unnecessary delay. We cannot afford to turn away good doctors and nurses while families go without care.

Rural Michigan deserves a governor who fights for it. I will be that governor.

Duggan (I): Rural health care is every bit as critical to Michigan’s future as urban health care. We’ve got 1.7 million people living in primary care shortage areas, and parts of the Upper Peninsula don’t even have an OB-GYN. We can improve rural health care through three steps:

Incentivize graduates of Michigan medical schools to remain in Michigan and practice in areas of shortage. Michigan has seven medical schools, graduating 1,200 new doctors each year, more than enough to solve Michigan’s physician shortage. We are paying huge amounts in taxes to operate medical schools and more than 50% of the graduates move out of Michigan after they finish school. We will expand residency training programs, provide support for new physician practices, and offer tuition debt reductions to expand medical practices in rural communities.
We will build on what is already working. Federally Qualified Health Centers are providing quality access to primary care in many rural communities. We will open more FQHC’s in the areas of greatest shortage.
We will use technology to close gaps where doctors are not readily accessible. Telehealth has expanded care in many rural areas, but too many areas lack broadband access. In 2021, Congress adopted the federal Broadband Equity, Access, and Deployment (BEAD) program. In 2023, $1.5 billion was allocated to the State of Michigan to expand broadband to rural areas. It is 2026 and virtually no broadband has been built. My administration will break through the federal/state bureaucracy and prioritize the buildout of broadband in rural areas, prioritizing those areas most in need of telehealth services.

James (R): Michigan has 1.7 million residents living in primary care shortage areas. As Governor I will take immediate executive action to keep Michigan enrolled in the federal Rural Health Transformation Program, which is already delivering $173 million to expand rural health care access, upgrade facilities, recruit providers, and expand telehealth. I supported this program in Congress because I have heard directly from rural communities what lack of access costs families in both health and dollars. Michigan can unlock additional federal funding through this program by strengthening preventative care and chronic illness policies. I will work with rural hospitals on targeted reimbursement models to keep those facilities open. Every Michigan family deserves quality care, regardless of their zip code.

Nesbitt (R): Growing up on a family farm in a small town, I understand the unique challenges facing rural health systems, but this is a statewide crisis. From the Upper Peninsula to Detroit, every citizen deserves the opportunity to make it in Michigan, and that means having access to quality care.

The reason clinics are closing and providers are leaving is because our state taxes too much and regulates too heavily. I will work to make sure we recognize licences and certificates from other states to make it easier for Medical professionals to come to our state. We will also expand telehealth access and cut the regulatory red tape that strangles independent practices.

By lowering the tax burden on medical professionals, getting rid of red tape, and accepting licenses from other states we will incentivize the doctors and nurses we already have to stay, while attracting new ones at the same time.

Rebandt (R): Rural hospitals are closing and primary-care shortages affect 1.7 million Michiganders because CON laws and over-regulation have stifled new clinics and outpatient centers. Central planning has failed to deliver supply where patients live.

I will repeal CON barriers through legislation to unleash private surgical centers, clinics, and physician-owned hospitals. I will expand telemedicine, scope-of-practice reforms for nurse practitioners and physician assistants, and Direct Primary Care via executive action and legislation so qualified providers can serve rural areas efficiently. Following Florida’s successful Rural Health Transformation Program, I will pursue available federal dollars for mobile units, telespecialty services, remote monitoring, and nutrition-focused preventive initiatives rather than propping up failing systems. Competition and innovation restore access faster than new mandates.

Swanson (D): Health care deserts are a troubling reality for many across our state. Most places in the Upper Peninsula and many rural areas throughout Michigan are at a severe disadvantage when it comes to adequate primary health care and emergency services. As Governor I will divide our state into districts and invest in technology and telemedicine to increase levels of healthcare, fight addiction, and address mental health concerns.

Hospital consolidation does not get adequate public scrutiny, and I will ensure Michigan implements an extensive and thorough approval process for any future acquisition or merger. As corporations grow, they consolidate power at the expense of the customers they serve, leading to financial hardship for the public. When this occurs in the healthcare sector, people get priced out of life-saving care and treatment. I will use every available recourse and oversight ability to stop this practice, including implementing potential price caps, rate reviews, and slowing vertical integration of hospitals purchasing physician practices and outpatient facilities.

I will also work with legislative partners to advance bills that strengthen collective bargaining rights and protections. I will appoint Department Directors who will prioritize public unions over privatization of services. History provides massive amounts of empirical data showing that when critical services are privatized, residents receive lower quality service, reduced accountability, and ultimately higher costs.

Mental health

The question: Michigan’s mental health care system is also severely strained. Experts have cited a shortage in providers, long-term treatment facilities and complex bureaucracy that leads families to struggle to secure treatment for their loved ones. How can the state improve the availability of mental health services?

Benson (D): We have a serious mental health crisis in our nation and it is impacting every corner of our state. When it goes unaddressed we see crime increase, education systems fail, and we need data driven solutions to confront it on several fronts. It starts with treating mental healthcare as healthcare, recognizing that when we say Michiganders have a right to affordable, accessible, and fair healthcare, that includes mental healthcare support. Because when all Michiganders have affordable access to mental healthcare, we all benefit.

In too many cases, mental healthcare isn’t as accessible as it should be – whether it’s the cost or geographic challenges to finding care. This is why my healthcare plan will target the high cost of care overall and help drive it down while also investing in mobile clinics to expand access to quality, and affordable care to every corner of our state. In every aspect of this care, we will ensure mental healthcare is provided and included.

We’re facing a shortage of trained medical professionals. As governor I will expand CTE programs, scholarships, and other incentives for students pursuing medical careers and invest in our students and educators to ensure they have the resources they need.

And we know a decline in effective mental health services in schools are failing students and teachers alike. Michigan is among the worst states in the country for student-to-counselor ratios and school mental health professionals. My education plan includes an expanded investment in wrap-around services for both educators and students, with a focus on strengthening our safety net to support Michiganders who are struggling.

Cox (R): For decades Michigan has had a mental health crisis, I saw it every day of my 13-year prosecutorial career, but I also see it in most every family and neighborhood in Michigan.

We are short on providers, short on treatment capacity, and long on bureaucracy. I would focus on three things immediately: expand the workforce by cutting licensing barriers, increase treatment capacity by prioritizing funding for facilities over administration, and improve crisis response so law enforcement and providers are working together.

The priority should be to get people help, not protecting a broken system.

Duggan (I): “When someone in Michigan has a mental health crisis, the first person who shows up is usually a police officer. That officer does what they can, which often means a 24 hour hold somewhere, and then the cycle repeats with no long term solution. Sometimes officers are driving hundreds of miles to find an open bed, or leaving someone in a jail or emergency room because there is nowhere else to go. If you are in a rural community, or you have a child in crisis, it is even harder.

As Governor, I am going to fix it the same way we did in Detroit.

We will cut through the bureaucracy so families can get help without navigating a maze of agencies in the middle of a crisis.
We will treat mental health like physical health by reducing the stigma and getting people care earlier, before it turns into an emergency.
We will integrate mental health into primary care so doctors are identifying and treating issues early.
We will better coordinate with first responders. Police should not be the default response. We will expand crisis teams and build alternatives to jail and emergency rooms.
We will add both short term and long term behavioral health beds. Right now, the shortage of beds is driving the entire crisis.
I will bring together experts to deliver clear recommendations we will actually implement, including accountability standards for mental health programs.

Michigan has passed this problem along for too long. It is time to fix the system and make sure people get help before this crisis results in any more tragedies.

James (R): Michigan’s mental health system is failing too many people. Too many young people are being sent out of state for treatment simply because providers do not exist in their community. Too many veterans and families are navigating a broken system alone. That changes under my administration. I have already acted in Congress, passing key legislation to improve mental health service delivery in underinvested communities and reauthorizing funding for opioid addiction treatment, because the addiction crisis and the mental health crisis are inseparable. As Governor I will incentivize recruitment and training of mental health professionals, with a focused emphasis on rural communities. I will reform Certificate of Need laws that block new providers from entering the market. I will work with providers to modernize licensing pathways so qualified professionals can enter the field faster without sacrificing training quality. Michigan cannot keep losing people to despair while bureaucracy stands in the way of help.

Nesbitt (R): Our mental health system is drowning in complex bureaucracy with limited resources. I’ve visited over a dozen County Jails this last year. They are filled to the brim with people that need serious mental health resources but there is nowhere else to send them. Jails have become our largest treatment facilities. Families are fighting through miles of red tape while the state throws millions at bloated administrative agencies. I will gut this bureaucracy and redirect those funds straight to local, community-based treatment centers, and we are going to bring back state psychiatric hospitals for long term treatment.

We also have to be honest about the root cause of our current addiction and mental health strain: The influx of illicit fentanyl and dangerous drugs pouring into our country is devastating Michigan communities. By working alongside President Trump to support strong border enforcement and cracking down on the cartels pushing this poison into our state, we can alleviate the massive strain on our emergency rooms and mental health facilities. We will audit current mental health spending to eliminate waste and ensure every dollar goes directly toward getting people the help they need to recover and thrive.

Rebandt (R): Provider shortages, long wait times, and duplicative bureaucracy have left families desperate. Despite massive increases in spending and antidepressant prescriptions, mental-health crises — especially among adolescents — are skyrocketing. Over-reliance on drugs alone often fails to address root causes and can create new problems.

Evidence-based solutions that truly work must come first. Rigorous meta-analyses (BMJ 2024, JAMA Psychiatry) show regular exercise is as effective as — or superior to — antidepressants for mild-to-moderate depression, with far better physical-health side benefits. Prevention is even more powerful: strong families, regular church and community participation, and social integration dramatically lower depression, anxiety, and risky behaviors in adolescents (Harvard longitudinal studies confirm this protective effect).

I will streamline licensing and community mental-health bureaucracy through legislation and executive action, integrate mental health into primary care and Direct Primary Care settings, and offer targeted loan-repayment and tax-credit incentives to attract providers. We will incentivize practical, healthy approaches: tax credits for family wellness programs, faith-based and community initiatives, “seed-to-table” nutrition education, daily physical activity, and policies reducing excessive screen time and social-media harms. Evidence from the Cass Review and long-term Swedish studies also shows that rushing minors into gender transitions or surgeries does not reliably reduce depression or suicide risk and may worsen long-term outcomes; protecting children from irreversible interventions while treating underlying mental-health issues is essential. Local innovation and private-sector solutions deliver timely care far better than one-size-fits-all state control.

Swanson (D): I’ve been a law enforcement officer and paramedic my entire career. During those years of service, and now as a Sheriff of a highly populated county, I understand the lack of resources individuals and families face when navigating their own mental health or that of a loved one.

Michigan must reform the way we approach mental health in our communities. Proper funding, improved access, and standardizing assessment tools are critical pathways forward. As Governor I will support and enact measures that promote early intervention by enhancing coordination between law enforcement agencies, courts, and health care providers.

As stated in the answer to the previous question, I will divide our state into regions to increase responsiveness of services. We will offer comprehensive services within the first 72 hours for addiction and mental health concerns so our residents don’t fall into the trap of incarceration or homeless encampments. We are better than that.

Role of government

The question: Government’s role in personal health care decisions has played a central role in policy debates in recent years. Do you think the state should play a greater or lesser role in the provision of health care? Also address whether Michigan should change laws regarding vaccines, abortion or other issues in your response.

Benson (D): Right now, it can feel like – particularly at the federal level – government is showing up everywhere we don’t want it, and nowhere that we actually need it. We see this so clearly in the area of healthcare, where chaotic and confusing decisions seem to be driven more by partisanship and special interests than data and best practices.

Michigan has a chance to flip that model, and ensure government is showing up when you need it and getting out of the way when you don’t. I’ve done that in transforming our department of state and I’m ready to do it throughout all of state government. This means a well run system that ensures every resident has access to affordable and accessible care, while also staying out of healthcare decisions that should remain between a patient and a doctor. To that end, we must also protect Michiganders to ensure they are safe to make their own personal medical decisions, free from intimidation or threats.

I’ll also work with governors in neighboring states to ensure our vaccination policies are following best practices and explore multi-state partnerships as governors in other regions have established to ensure clear and consistent regional guidance on vaccines and other critical public health protections.

Finally, we have a moral responsibility to ensure every Michigan mother has the support she needs, regardless of race or income. That means addressing the black maternal health crisis in our state, where black women are three times more likely to encounter health related complications in pregnancy than white women. We’ll take that on and invest in culturally competent care, Medicaid-covered doula and midwife services, mandatory bias training for maternal healthcare providers, and better access to life-saving prenatal and postpartum care.

Cox (R): As Attorney General, I issued an attorney general opinion that affirmed the autonomy of adults to make vaccine decisions for themselves and their children. As the lawyer for Unlock Michigan who beat the Whitmer Administration’s legal attempts to stop Unlock Michigan, I continued to fight for the idea that adults should be treated as adults regarding vaccines.

Michigan citizens are sick and tired of government bureaucrats interfering with personal health decisions and under my leadership that will come to a stop.

Duggan (I): The current status of the State’s role in health care isn’t about a greater role or a lesser role. I think it’s about taking the right role.

On vaccines, Michigan should educate the public on the benefits of vaccinations and should make access to those vaccinations readily available. But the decision on whether to get vaccinated must be left to the individual.
On abortion, I am pro-choice. I backed the passage of Proposal 3 in 2022. By a clear margin, the people of Michigan have chosen to guarantee the right to reproductive freedom in the Michigan Constitution and as Governor I will defend those reproductive rights.
Patients should have the right to transparent pricing in health care. Patients must be told up front what the treatment is going to cost and what outcomes can be expected and then be allowed to make informed decisions.

On issues like vaccines, abortion, and other personal medical decisions, I believe the same principle applies. These are deeply personal decisions. The role of government is not to impose ideology. It’s to make sure people have access to safe, accurate information and quality care, and then respect the choices they make.

James (R): My guiding principle as Governor is simple: expand health care freedom for every Michigan resident. More choices. More access. Lower costs. Let me start with something most Michigan parents don’t know: under current state law, your child can consent to their own medical treatment without your knowledge or approval. A school counselor, a clinic worker, a provider — making medical decisions for your child while you are kept completely in the dark. That ends on day one. Restoring full parental consent is my number one health care priority. For those who raise abuse concerns: existing law already handles bad actors. We will not strip rights from the overwhelming majority of loving parents to account for a vanishingly small minority. That also means enacting vaccine choice and informed consent, eliminating school and workplace vaccine mandates, banning artificial dyes and ultra-processed foods from school meal programs, and requiring full price transparency for medical procedures and prescription drugs. And it means defending the religious liberty of faith-affiliated health care providers, without apology. Health care decisions belong to patients, families, and their doctors. Not Lansing. That is a principle I will defend every single day as Governor.

Nesbitt (R): The government’s role in healthcare should be minimal. Bureaucrats make terrible doctors. While I recognize the importance of some vaccines, I vehemently oppose the heavy handed COVID-19 vaccine mandates that Democrats forced on our state.

No Michigander should ever be forced by government bureaucrats to choose between a jab and their job. I fundamentally believe in empowering families to make their own healthcare decisions with their doctors. I will defend the core principles of individual liberty. The lockdowns, shutdown and mandates during COVID were wrong. When I’m Governor, I’m going to make sure it never happens again.

On the issue of abortion, I want to focus on the facts. The simple truth is that abortion is legal and bound to our state constitution in Michigan.

However, I am proudly pro-life, and I have a long record of supporting the cause for life. I can’t imagine what it is like to be faced with an unplanned pregnancy. But for “choice” to truly exist, abortion should not be the only answer. Women must have every opportunity to make a courageous, hopeful choice for life.

We need to do everything in our power to ensure women are supported in these circumstances, and that means backing policies like better access to prenatal care and early childhood education. As Governor, my goal is to lift up the culture of life, which starts with building the kind of state where families can easily live, work, raise a family, and make it in Michigan.

Rebandt (R): Government has inserted itself too deeply into personal health decisions, driving up costs and eroding individual liberty. The COVID-19 crisis laid this bare: bureaucratic, “expert-driven” mandates in Michigan proved harmful and anti-freedom. Families were barred from basic outdoor activity — including motorized boating on our lakes — and non-essential medical and dental procedures were postponed in the name of safety. The result? Delayed cancer screenings, routine checks, and dental care that worsened outcomes for countless Michiganders. These top-down dictates revealed leaders who prefer state power and “we know best” over freedom of choice and patient autonomy.

The state’s proper role is enforcing contracts, preventing fraud, and removing barriers — not dictating choices between patients and doctors. On vaccines, I will protect parental rights and informed consent with no state mandates for healthy children or adults. To improve outcomes, I will emphasize incentives for preventive care: tax credits or rebates for wellness programs, exercise challenges, community fitness initiatives, and nutrition education. Michigan should reward families who take responsibility for diet and physical activity. We will harness competition through statewide youth fitness challenges, school-based activity incentives (modeled on Texas’s daily PE and recess protections), and “seed-to-table” farm-to-school grants to counter excessive screen time and social media’s negative influences.

An ounce of prevention is worth many pounds of expensive reactive care — it saves dollars and lives downstream while restoring patient-doctor control.

Swanson (D): As a Sheriff, I’ve always protected people’s individual rights and freedoms. As the Governor of Michigan, I am going to do the exact same thing. I will protect the constitutional right to an abortion and all reproductive health care. I trust women to make the best decision for their own health care needs, and I will safeguard their right to do so.

As for vaccines, my role as Governor is to keep Michigan safe from disease and illness, while at the same time listening to the voice of the people, parents, and medical professionals on policies that make sense.

Aging

The question: Michigan is aging faster than most states, leading to more pressure on health care, transportation and social services. There’s a desire to age in place. Additionally, some nursing homes provide quality care, but others are frequently cited for chronic understaffing and neglect. What policies would you implement to improve quality of life for older Michiganders?

Benson (D): The “Senior Tsunami” is real, with 25% of Michigan’s population qualifying for Medicare – up from 14% just 10 years ago. As Michigan’s population ages, we must ensure the people who have called Michigan home for their entire lives have the support they need from family members – and that their families have the resources they need to provide that support.

At MDHHS, we will build an effective and accessible counseling center for seniors to ensure we are equipping our residents with the information they need to navigate an increasingly complex care system.

These trends underscore the need for long-term care and caregiver support. Recognizing that, my plan expands financial support and compensation for long term caregivers. This includes a $5,000 caregiver tax credit, geared towards alleviating the financial burden of caring for a loved one.

Cox (R): “Having buried both of my parents since I began this campaign, I understand firsthand how important it is to ensure that older Michiganders are treated with dignity. We have to be honest about the root cause: Michigan is aging faster than most states in part because we are failing to attract and keep young people and young families. As governor, my economic reforms will make Michigan competitive again with states like Florida, Texas, and Tennessee that are growing and getting younger. A stronger economy means more workers, more taxpayers, and more resources to support our seniors.

To help seniors age in place, I will expand telehealth, grow our healthcare workforce through licensing reciprocity and community college partnerships, and drive down costs through the market reforms I have outlined. I will also fully eliminate the income tax on pension income so seniors can afford to stay in their homes and communities longer.

On nursing home quality, I have a specific four-point plan.

First, I will change leadership at DHHS and LARA to drive real accountability in how nursing homes are reimbursed and inspected.
Second, I will tie nursing home payments directly to quality of care.
Third, I will allow in-room cameras so families have confidence their loved ones are safe.
Fourth, I will forge state and community college partnerships to train more certified nurse aides and create a certificate program for senior CNAs to serve as mentors and supervisors.

Michigan’s seniors built this state. They deserve a governor who will fight for them.

Duggan (I): People in Michigan want to stay in their homes as they age. Between the cost of living in a senior care facility and the loneliness and fear that can come along with it, who can blame them?

We start with a simple principle: support aging in place.

If someone can safely live at home, we should make that possible. That means expanding programs like PACE (Program for All Inclusive Care for Elderly), which coordinate medical care, home care, and social services in one system. It works, and we should scale it statewide.
We can bring care to people, technology like telehealth and remote monitoring can catch problems early, manage conditions, and keep people out of the hospital. It’s better care and lower cost.
It’s also key to integrate everything with primary care. Seniors with chronic conditions shouldn’t be bouncing between providers. We need accountable care models focused on coordination and long term management, so people stay healthier longer.
And if we’re serious about aging in place, we have to expand home care. That means investing in the workforce, paying caregivers fairly, and making sure families can actually access services when they need them.
On nursing homes. Some provide quality care, but others are understaffed and falling short. That’s unacceptable. If a facility is receiving public dollars, it should meet clear standards for staffing and care. If they don’t, there need to be real consequences.

Support people at home, coordinate their care, use technology to stay ahead of problems, and hold providers accountable. That’s how you improve quality of life for older Michiganders.

James (R): Michigan’s seniors built this state. They deserve dignity, safety, and a government that actually works for them. As Governor I will remove obstacles for seniors to choose their own home care providers. Forced unionization of home caregivers has driven up costs and reduced access. That policy serves political interests, not Michigan families. I will also push to end the misclassification of home caregivers as public employees. On nursing homes: the Whitmer Administration’s COVID era policies were a catastrophic failure. Seniors were left to die alone. Families could not be with their loved ones in their final days. That must never happen again. I will sign legislation – bills that Whitmer refused to act on – that would allow patients in nursing homes to have the option for cameras in their rooms. This will empower families to more closely monitor the care of their loved ones as well as ensure that patients can maintain closer communication with their families. I will require criminal background checks for all caregivers and suspend Medicaid payments to nursing homes with records of chronic abuse and neglect. Through executive action I will direct LARA to tighten licensing and training requirements. And I will push for aggressive criminal prosecution of operators credibly suspected of abuse or neglect. Michigan’s seniors gave everything to this state. They deserve a Governor who gives everything back.

Nesbitt (R): Our seniors spent their lives building this state, and they deserve to retire with dignity in the communities they helped build. My priority is keeping older Michiganders in their own homes rather than pushing them into institutionalized care. Aging in place is the common sense solution. It means significantly lower healthcare costs for families and a vastly better quality of life for our seniors.

Right now, too many seniors are being taxed out of the homes they spent decades paying off. That stops under my watch. To ensure aging in place is an affordable reality, I am going to completely eliminate the state property tax. It’s time to let our seniors keep their hard earned money instead of feeding the Lansing bureaucracy.

By empowering families to care for their loved ones at home, we reduce the massive financial strain on our state systems. But for those who do require residential care, the neglect and understaffing we see in some facilities is unacceptable. We won’t solve this by throwing more blind government funding at a broken system.

I will launch a zero-tolerance audit of state nursing home oversight to root out the bad actors, fraud, and abuse siphoning money away from patient care. We will cut the administrative bloat and ensure every dollar goes toward actual care, ensuring that every generation is respected and has the ability to make it in Michigan.

Rebandt (R): Michigan is aging rapidly, yet nursing-home understaffing and neglect persist despite increased regulations and spending. Current institutional-heavy models have failed to deliver dignity or quality while making it harder for families to help loved ones age in place.

I will enact legislation for tax credits and respite-care incentives to support family caregivers. We will expand home- and community-based services through competition and transparency (following Florida’s Home Care for the Elderly and Community Care for the Elderly expansions), making it easier for high-quality providers to enter the market. Public quality reporting and competitive incentives will hold nursing homes accountable while rewarding better outcomes. Preventive medicine is essential: incentives for exercise, better diets, and chronic-disease management (especially obesity and diabetes) will keep seniors healthier longer. Florida’s focus on home-care expansion and caregiver support proves this model works.

Swanson (D): I have seen the worst of the worst of our elder population being abused and neglected. The state must enforce stringent oversight to ensure those we love have dignity in the final chapters of their lives. My administration will mandate strict staffing ratios for CNA’s and other critical care workers and tie Medicaid reimbursement to increased wages for medical professionals.

One of the greatest challenges in life is navigating the proper way to provide care for loved ones as they age, or family members who may need longterm care due to injury or disability.

Needing long-term care or a nursing home facility should not bankrupt families and drain life savings. I will continue efforts from a state level and work with federal partners to ensure funding is available to provide affordable care for our aging population.

Michigan budgets have systemically undervalued and underpaid individual home care workers, with rates in most areas falling well short of actual costs. These skilled workers in one of our most important professions have been forced to look at other industries to obtain living wages. This has left dangerous healthcare shortages, leading to negative outcomes for patients. I will put forth a budget that significantly increases caregiver pay, putting Michigan at the forefront in prioritizing this critical healthcare sector, and allowing our loved one’s greater flexibility in staying in their own homes as long as possible.