As Congress enters its final days of considering the One Big Beautiful Bill Act (OBBBA), the Michigan Primary Care Association (MPCA) and Michigan’s health centers remain deeply concerned about the damage this legislation will do to the health of our patients and communities. As written, the bill would cut $930 billion from Medicaid nationwide and, according to the Congressional Budget Office, would cause at least 11 million Americans to lose health insurance and significantly harm health centers’ ability to continue providing care.
Informed by the research of national partners, MPCA’s updated estimates show over 78,000 patients- the equivalent of 1 in 8 patients served by Michigan health centers today- will lose their health insurance coverage through Medicaid or the Marketplace because of OBBBA, including the impact of Medicaid work requirements, increasing the frequency of Medicaid redetermination, and the loss of enhanced premium tax credits in the Health Insurance Marketplace. Losing affordable health insurance coverage will have a profound effect on health center patients by reducing their access to care, increasing delayed or forgone healthcare, and intensifying financial strain and the likelihood of medical debt- all leading to poorer health outcomes.
Proposed changes to the health insurance coverage programs will also negatively impact the stability of health center services for everyone, not only those losing coverage. MPCA’s updated estimates show that over $94 million in reimbursement for services will be lost annually because of patients becoming uninsured. Health centers already operate on razor-thin margins, and they will not be able to maintain all current healthcare services given the loss of these resources, forcing centers to scale back critical programs or even close the doors of critical healthcare service delivery sites.
Recent research from the Geiger Gibson Program in Community Health at George Washington University expands upon MPCA’s estimates, demonstrating the ways “insurance reforms for working-age adults and people who need but cannot afford private insurance transformed health centers…” and allowed health centers in Michigan and across much of the country to grow “in scale, scope and capacity” since 2014. However, many of the provisions of the OBBBA effectively “turn back the clock” on the gains we’ve made in increasing coverage and expanding access to essential care in communities. Applied to Michigan, the Geiger Gibson Program’s findings show we could see a 41% reduction in sites, or the loss of 187 health center service delivery sites, and a 31% reduction in patients served, or the loss of care for 207,000 people.
Given how damaging this bill would be for health centers and the patients they serve, MPCA calls on lawmakers to reject the current version of the One Big Beautiful Bill Act.
Contact your member of congress and let them know that you oppose this legislation: https://mpca.quorum.us/campaign/FinalPushtoProtectMedicaidEmail/