Just over 5,000 Michigan residents are expected to lose full Medicaid coverage Thursday, Oct. 1, under new federal eligibility limits for some lawfully present noncitizens. Additional Medicaid changes beginning in 2027 could cause another 200,000 Michiganders to lose coverage, Michigan Public reported, citing MDHHS.
The changes stem from the One Big Beautiful Bill Act passed by congressional Republicans in 2025. Additional provisions take effect Jan. 1, 2027, including new work requirements for some adults enrolled in the Healthy Michigan Plan, the state's Medicaid expansion program.
For Washtenaw County residents who lose coverage, two local resources are available: the Washtenaw Health Plan, a no-premium program for low-income county residents, and patient financial counselors at U-M Health's Ann Arbor campus.
Who loses coverage Oct. 1
Lawfully present noncitizens who had qualified for full Medicaid or the Children's Health Insurance Program are now limited to emergency, pregnancy and some children's coverage, Michigan Medicine reported. Affected groups include refugees, asylees, humanitarian parolees from Iraq, Ukraine and Afghanistan, and immigrant military veterans and their families.
Lawful permanent residents who have met or are exempt from the federal five-year waiting period, along with naturalized citizens, Cuban and Haitian entrants and migrants from the Compact of Free Association states, remain eligible if they meet other requirements.
The federal government is also cutting its share of Emergency Medicaid funding in Michigan from 90% to 65.7%. MDHHS estimates that reduction will cost the state $5.5 million in 2027, Michigan Public reported.
Work requirements arrive in January
Starting Jan. 1, 2027, some adults ages 19 to 64 enrolled in the Healthy Michigan Plan will have to meet new work or community-engagement requirements unless they qualify for an exemption. For existing enrollees, MDHHS says the requirement can be met by completing at least 80 hours of approved activities in at least one month during the review period. The state will begin checking the requirement for renewal dates on or after March 1, 2027.
MDHHS estimates 200,000 Michiganders could lose coverage under the new rules.
Exemptions cover parents of children 13 or younger, caregivers of people with disabilities, pregnant women, people in addiction treatment and disabled veterans, among others. Enrollees will also face income checks every six months instead of once a year.
Samantha Iovan, director of health policy at the U-M-based Center for Health and Research Transformation, said in a Sept. 23 WEMU report that most affected enrollees already work or have qualifying activities.
Local help available
Alena Hill leads U-M Health's patient financial counseling team, which works with MDHHS Medicaid staff embedded in all three of U-M Health's offices.
"The most important thing to do right now is to figure out what form of Medicaid you have … There are a lot of people who are worried, when in fact they will not be affected," Hill said. "But for those who will be affected, knowing now is important because you can use this time to prepare."
Healthy Michigan Plan enrollees can check their coverage type by looking for "HMP-MA" in their MiBridges account.
The Washtenaw Health Plan is not health insurance, but it provides medically necessary health care for qualifying low-income Washtenaw County residents who have no other coverage. It has no monthly premium and covers doctor visits, prescriptions, lab work and limited mental health services. Enrollment is open year-round at 734-544-3030.
Michigan has budgeted $54.3 million to prepare for the overhaul and hired more than 400 workers to help beneficiaries, according to Bridge Michigan. An online tool to help enrollees understand the work rules is expected to launch in October.
Affordable Care Act Marketplace open enrollment for 2027 coverage begins Sunday, Nov. 1, at HealthCare.gov. Residents with Medicaid questions can call 1-800-642-3195.
