Bridge Listens: How Michigan's next governor would fix health care

Bridge asked Michigan gubernatorial candidates about how they’d tackle the state’s most pressing health care issues
Topics including affordability, Medicaid funding, mental health and aging
The candidates responded directly to questions and concerns raised by Bridge readers

Calling it a stress test might be underselling it. Health care in Michigan is under strain. From a mental health system severely lacking capacity to rapidly rising costs, Michigan’s next governor is going to have their work cut out for them if they want to take action on pressing issues many residents are facing.

How candidates intend to tackle those health care issues was ranked as one of the most pressing issues in Bridge Listens, our informal election-year reader survey.

So Bridge Michigan reached out to leading gubernatorial candidates across the political spectrum with a series of questions about pressing health care matters, including steps they’d take to lower costs or protect Medicaid coverage amid looming federal spending cuts.

Listen up

Join Bridge reporters for a free, online discussion about the state of health care in Michigan on Wednesday, April 29 at 7 p.m. Register here. Can’t make it? Listen and look for us on WJR Detroit earlier in the day. Bridge reporters Eli Newman and Simon Schuster will join All Talk with Kevin Dietz, tentatively scheduled for 10:18 am on Wednesday, April 29

We asked:

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

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 health care for working families and seniors across our state.”

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

Related:

Read on to see how Michigan’s other gubernatorial candidates would tackle some of the most urgent health issues facing Michigan today. To read their answers in full, click here.

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?

Candidates across the political spectrum said they’d push for medical price transparency. Cox, James, Nesbitt, Rebandt and Benson all told Bridge they want to require hospitals or other providers to be up front about the full costs to the patient for a given procedure at the time of care.

Outside of that, candidates split to some extent by party, with Democrats calling for more cost control regulations, and Republicans generally advocating for more competition as a solution to bring prices down.

Three GOP candidates — James, Cox and Rebandt — said deregulating Michigan’s Certificate of Need process, the state regulatory approval required when new medical facilities are opened or one is sold, could broaden health availability.

James and Rebandt said they would try to take on pharmacy benefit managers, casting them as wasteful middlemen. Gov. Gretchen Whitmer in 2022 signed a law to require the licensure of pharmacy benefit managers as part of a package she said would help lower prescription drug costs.

As for Democrats, Benson said she would create an independent prescription drug affordability board to “hold pharmaceutical companies accountable for price gouging and identify ways to reduce the overall cost of care.” Similar proposals have stalled in the state Legislature, including recent legislation from Senate Democrats that could empower state government to cap prices.

Swanson and Benson both said they would work to expand medical debt forgiveness, where governments buy residents’ medical debt at a fraction of what they owe to lift the financial burden. Senate Democrats this year moved to cap interest on medical debt and limit collections, but the Republican-led House has not taken up the legislation.

Duggan, the independent who worked as CEO of the Detroit Medical Center from 2004 to 2012, said one way to cut costs would be to create “a single coordinated process” for billing and online administrative portals “that worked across all plans and providers” in Michigan as a way to cut costs.

He also said “the approach of shared risk between doctors and hospitals must be significantly expanded in Michigan” to help keep patients with chronic conditions healthy and out of hospitals.

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.

No candidate told Bridge how they would close a Medicaid shortfall. Whitmer has proposed nearly $800 million in new “sin” taxes, but the GOP-led House has already publicly rejected the idea.

Democrats promised to protect Medicaid despite funding challenges.

Swanson said he would use “every lever and resource to ensure Medicaid services continue” for those in need. “As a society we cannot turn our backs on our most vulnerable,” he said.

Benson said she would push to fund “navigators and community health workers at MDHHS to keep people enrolled” and work with governors in neighboring states to pool resources.

Among Republicans, James, Nesbitt and Rebandt all claimed rising Medicaid costs are at least partly due to fraud. Preliminary data shows Michigan had an improper payment rate of 3.3% in 2025, lower than the national rate of 6.12%. Many of those errors were attributed to insufficient documentation, not confirmed fraud.

Only Rebandt suggested he would pare back benefits in any way, saying the state should “adopt leaner benefit structures.”

Duggan, the independent, also alleged wasteful spending on Medicaid, arguing the program is “not managed in a way to reduce health care costs.” But he asserted he could both cut costs and preserve coverage.

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 and Duggan both told Bridge they would advocate for loan forgiveness and repayment incentives for doctors who work in rural areas, similar to a proposal introduced last year in Lansing that failed to gain traction.

Benson, a Democrat, said she would also extend a strategy she employed at the Department of State by bringing services directly to constituents and “underserved” communities.

“Our programs will include partnering with local health care 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,” she said.

Fellow Democrat Swanson said he would “ensure Michigan implements an extensive and thorough approval process for any future acquisition or merger.”

James, a Republican, said he would work with rural hospitals on targeted reimbursement models to keep those facilities open.

Duggan, the independent, said he would like to see more telehealth options for rural Michiganders, as did Cox, a Republican. Cox said he would also “immediately recognize out-of-state medical licenses” to boost the number of doctors. Michigan is already part of the Interstate Medical Licensure Compact, which includes 39 states.

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?

Among Republicans, Nesbitt has called for the most dramatic and likely costly intervention — building more state psychiatric hospitals for long-term care.

James was the only candidate to mention the opioid crisis in relation to mental health, calling the two issues “inseparable” and promising to “incentivize recruitment and training of mental health professionals.”

Cox said he’d address “licensing barriers” to grow the ranks of mental health professionals in Michigan. He also said he’d push to ensure mental health professionals and law enforcement officials are working together to improve crisis response.

Among Democrats, Swanson offered a blanket guarantee of “comprehensive services within the first 72 hours for addiction and mental health concerns,” but didn’t provide further details about how those would be delivered.

Benson tied education funding into her answers, saying more funding for wraparound services in schools can help head off youth mental health issues before they spiral.

Duggan suggested more school services too, and he said he’d also like to increase the number of psychiatric beds in the state and better integrate mental health into primary care services.

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.

This is where the candidates were most starkly divided along partisan lines.

Democrats and Duggan all said they would promote vaccinations to limit preventable diseases. But none said they are interested in expanded mandates.

Black maternal health has been a focus for Benson, and she said she’d institute mandatory bias training for health care providers and move to have Medicaid cover doula and midwife services.

Every Republican candidate save Johnson — who didn’t directly reply to the question — said they would move to relax vaccine requirements. Several called the COVID-19 pandemic evidence of government overreach.

James suggested he would enact “vaccine choice,” though he didn’t explain what that meant, and said all school and workplace “vaccine mandates” would be ended under his administration. Michigan allows parents to send their unvaccinated children to public school, but forces them to jump through some bureaucratic hoops first by applying for a waiver.

Nesbitt was the only GOP candidate to mention abortion, acknowledging reproductive rights were added to the Michigan Constitution through a 2022 ballot proposal but affirming that he is personally opposed to the practice.

“For ‘choice’ to truly exist, abortion should not be the only answer,” Nesbitt said. “Women must have every opportunity to make a courageous, hopeful choice for life.”

Rebandt said that instead of encouraging vaccines, his administration would push to offer tax credits for healthy behaviors, like exercise programs and education on nutrition.

Most candidates argued personal health care decisions should stay between a patient and their doctor, but James promoted his “parental bill of rights,” which would force doctors to share all information about a minor with their parents.

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?

Republicans Nesbitt and Cox, along with independent Duggan, said they’d prioritize initiatives that allow seniors to age in place.

“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,” Duggan said. “It’s better care and lower cost.”

James, a Republican, said he’d try to clamp down on problematic nursing homes by tightening licensing and training requirements for the industry.

“I will push for aggressive criminal prosecution of operators credibly suspected of abuse or neglect,” he added.

Duggan too said there needs to be “real consequences” for nursing homes that fall short of acceptable standards.

Among Democrats, Benson proposed easing the financial burden of caring for a loved one by reviving Whitmer’s proposal to provide a $5,000 tax credit for caregivers.

Benson also said she would “build an effective and accessible counseling center” in the Michigan Department of Health and Human Services to help guide residents through late-in-life decisions.

Swanson said he’d require “strict staffing ratios for (certified nurses assistants) and other critical care workers,” promising to “put forth a budget that significantly increases caregiver pay,” while calling for “stringent oversight” of elder care facilities.

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Bridge Listens: How Michigan’s next governor would fix health care