Health insurance

Nearly all children in Michigan – 97.4% as of 2022 – have some form of health insurance. Children with access to health insurance are more likely to have regular contact with a doctor, receive medical attention for injuries and have better outcomes following hospitalizations compared to uninsured children. Child health insurance rates have increased 6% since the turn of the century, a trend driven largely by the fact that the share of children insured by Medicaid has doubled in that time period.

Child Medicaid enrollment peaked during the pandemic, reaching approximately half of all children thanks to continuous enrollment, which prevented states from disenrolling people during the public health emergency. Medicaid insurance rates have since returned to pre-pandemic levels, covering nearly 1 million children in Michigan as of December 2024.

Children also benefit when their parents have access to health insurance. Improving access to health insurance for parents has benefits for kids through increased financial security, lower rates of infant mortality, higher birth-weight, and improved school and health outcomes for children.¹

Medicaid expansion, which was signed into law by Gov. Rick Snyder in 2013, allowed adults with incomes up to 138% of the federal poverty level – $21,472 for a single adult or $44,367 for a family of four – to access public insurance, a policy change that drastically improved access to Medicaid for parents.

Prenatal care and healthy births

Babies have better outcomes when their mothers have access to health care throughout pregnancy, but nearly 1 in 3 women in Michigan receives less-than-adequate prenatal care, among whom a growing share received late or no prenatal care during their pregnancy. Care is considered “adequate” when it begins in the first trimester and includes one to two additional monthly visits, but about 14% of pregnant people report that they do not begin prenatal care as early as desired.²

Many of these mothers report facing systemic barriers, including a lack of transportation, inability to take time off from work or school, not having child care, and not being able to afford the cost. Hispanic, Black and American Indian moms are most likely to receive less-than-adequate prenatal care, but race and ethnicity is just one factor associated with disparate access. Survey data from Michigan’s 2022 Pregnancy Risk Assessment Monitoring System shows that mothers with less than a high school diploma and mothers insured by Medicaid are disproportionately likely to receive less-than-adequate prenatal care.³

Lack of access to prenatal care contributes to poor birth outcomes in Michigan. One in 10 babies in Michigan is born preterm, and the share of babies born with a low birth-weight has increased 18% over the past 30 years. Black newborns are twice as likely as white newborns to be born with a low birth-weight, a disparity that has persisted despite medical advances, in part because of structural and societal factors within and beyond the health care system. These adverse birth outcomes put newborns at a higher risk for physical and developmental delays that hinder growth and school readiness.

Geography also presents a barrier. In 2024, 18 of Michigan’s 83 counties were considered maternity care deserts, which are defined as counties with zero hospitals or birth centers offering obstetric care and zero obstetric clinicians.⁴

The number of births has been declining nationally for years, with the total number of babies born in Michigan falling below 100,000 for the first time in 2023. The decline in Michigan’s birth rate has largely been concentrated among mothers in their teens and twenties; meanwhile the birth rate among women in their 30s and 40s has been rising. Since 1990, Michigan has seen an 82% decline in births to moms in their teens, but a 134% increase in births to moms ages 40-44.

The decline in births to teen mothers should be celebrated, as teen pregnancy is associated with a large number of negative outcomes for both mothers and their babies. Teen parents are more likely to drop out of high school and more likely to live below the poverty line. The children of teen mothers are more likely to grow up in poverty and have lower earnings into adulthood.

Preventive care

Dental care

Children enrolled in Medicaid have access to dental services, although typically fewer than half of enrolled children see a dentist each year. Preventive dental visits among Medicaid-enrolled children fell in nearly every county from 2018 to 2023. Delayed dental care can cause issues, including tooth decay, to become worse. In Michigan, over 100 avoidable hospitalizations of children every year result from dental problems.⁵

One of the most efficient and cost-effective strategies communities across the country have adopted to improve oral health is water fluoridation, which has been shown to reduce tooth decay by 25% in kids and adults.⁶ In Michigan, over 90% of individuals served by community water systems have fluoridated water.⁷

Immunizations

Vaccinations are a crucial defense for the health of the communities and economy in our state and have saved millions of lives. Herd immunity – ranging from about 80% of a population for polio to as high as 95% of a population for measles – can prevent the spread of infection and save lives.⁸ A rise in vaccine skepticism and misinformation as well as disruptions to routine health visits during the pandemic have all contributed to a decline in vaccinations, threatening the health and safety of our most vulnerable residents, including babies who are not yet old enough to be vaccinated themselves.

Mental health

Three in 10 high school students in Michigan report having poor mental health, with higher rates for girls and LGBTQ+ students.⁹ An increase in children and teens experiencing anxiety and depression during the pandemic points to a need for better access to mental health services.

Although Michigan passed legislation in 2024 requiring insurers to cover mental health and substance use disorders at the same level as physical health services, access is limited by the fact that Michigan has just one mental health provider for every 300 residents. School psychologists play an important role in addressing student mental health needs, but Michigan has just one school psychologist for every 1,354 students, more than double the recommended ratio of one psychologist to 500 students.¹⁰

Social media and cell phone use has also been linked to poor mental health among teens, gaining increased attention since the U.S. surgeon general recommended warning labels and age restrictions to address the harms to young people. As of May 2025, 26 states and the District of Columbia have implemented restrictions or bans on student cell phone use in schools, although Michigan is not one of them.¹¹

Reducing teen
tobacco use

Smoking can have harmful, long-term consequences, but more than 1 in 7 high school students in Michigan report regularly smoking cigarettes or using electronic vapor products.¹² Most e-cigarettes contain nicotine, which is harmful to brain development in youth and young adults, particularly affecting the parts of the brain responsible for attention, memory and impulse control.¹³

Although added flavors are not permitted in regular cigarettes, e-cigarettes often contain sweet, kid-friendly flavors. The 2024 National Youth Tobacco Survey found that among middle and high school students who currently use vaping products, 88% were using flavored e-cigarettes with flavors based on fruits, candy and desserts.¹⁴ As of January 2025, six states and a handful of localities – including several in Illinois, Minnesota and Ohio – restrict the sale of flavored tobacco products.¹⁵