The health of Michigan children and families is a top priority for the League as the Michigan Legislature works on the 2019-20 state budget. At the center of the political debates in the last year has been the adoption of work requirements for the Healthy Michigan Plan, a decision that the League vigorously opposed. Despite little evidence that work requirements are effective, and substantial proof that they can cause hardship for many Michiganders, the Snyder administration submitted a waiver request to the federal government to impose work requirements, which was approved late in 2018. The implementation of the waiver is left to the Whitmer administration, and the governor has indicated her opposition to work requirements.
There is strong evidence that the social determinants of health—including poverty, poor nutrition, inadequate housing and exposure to toxins—can and do affect health outcomes. At the forefront of current public debates in Michigan are continuing environmental and public health crises, including the ongoing problem of lead contamination in Flint and other areas of the state, and the growing awareness of the threats of per- and polyfluoroalkyl substances (PFAS) in water and soil. PFAS contamination has been described as Michigan’s biggest environmental crisis in 40 years, and the full impact of the contamination is not yet known.
The League also documents, through its Kids Count project, the health of Michigan mothers and babies—prenatally through the earliest years of life—and monitors state spending on maternal and child health services. For the 2020 budget, the League supports investments in proven home visiting services as well as the restoration of funding for state family planning and pregnancy prevention services.
At the forefront of the League’s work is the commitment to advocating for policies and state investments that can reduce the deep disparities in outcomes for Michigan residents based on race, place and income. The disparities in health and wellbeing are both deep and broad. The rate at which infants die before reaching their first birthday has declined overall, but is much higher and actually rising for some babies of color. Women of color face more barriers to adequate prenatal care and are more likely to have babies born too early and too small. And, despite expansions in health insurance coverage through the Healthy Michigan Plan, Latinx and African American residents are more likely to be uninsured and have lower life expectancies.
Medicaid and Healthy Michigan
Healthy Michigan Plan, Medicaid and MIChild funding:
- Governor: The governor recommends continued funding for the successful Healthy Michigan Plan, which has provided healthcare coverage to nearly one million Michiganders since its creation in 2014, with current enrollment at approximately 670,000. In the 2020 budget year, the federal match rate for the Healthy Michigan Plan falls from 93% to its permanent level of 91%, requiring an additional $75.1 million in state General Fund dollars to offset the decline. In addition, the federal match rate for Medicaid and MIChild will fall in 2020, requiring an increase in state funding for the programs of $70.5 million.
- Senate: The Senate agreed with the governor and provided the additional state funding needed to continue the Healthy Michigan, Medicaid and MIChild programs. The Senate also included a placeholder in the budget to ensure later consideration of an increase in Medicaid rates paid to neonatologists.
- House1: The House agreed with the governor and the Senate and provided state funding needed to continue the Healthy Michigan, Medicaid and MIChild programs. The House also included $1.7 million to increase Medicaid rates for neonatal services, and $5.8 million to boost payments for pediatric psychiatry.
Healthy Michigan Plan work requirements:
- Governor: The governor recommended a total of $36.2 million to implement the new Medicaid work requirements, including $10 million for supportive services to help people overcome barriers to meeting the requirements. The governor’s budget includes a reduction of $50 million in spending on the Healthy Michigan Plan in 2020 because of reduced access to healthcare when work requirements take effect on January 1, 2020—with 90% of the reduction being federal funding.
- Senate: The Senate agreed with the governor on a reduction in Healthy Michigan Plan spending of $50 million in 2020 as work requirements are implemented, and also provided $10 million in funding for supportive services related to work requirements.
- House: The House included $26.2 million to administer new work requirements, but did not include the $10 million proposed by the governor for support services for individuals attempting to meet them.
Public/Environmental Health
Environmental health threats:
- Governor: With the ongoing Flint water crisis and per- and polyfluoroalkyl substances (PFAS) contamination, the governor recommended a total of $13.8 million to respond to environmental threats, including: 1) $8.3 million to monitor and respond to the public health threats more effectively, including grants to local public health departments and laboratory capacity to investigate and assess the impact of contamination from a range of environmental toxins; and 2) $5.5 million for the public health response to PFAS, including outreach, local health department services, alternative water sources and water filters.
- Senate: The Senate rejected the $13.8 million recommended by the governor to combat environmental threats, leaving a $100 placeholder and using some of the funds to increase funding for local public health departments.
- House: The House agreed with the governor on $8.3 million for a state response to a range of environmental threats, but provided slightly under $5 million to combat PFAS contamination.
Flint water crisis:
- Governor: The governor provides $8.1 million for residents in Flint, an increase of $3.4 million. Included in her 2020 budget are $5.2 million in ongoing funding for Flint, and $2.9 million in one-time funding. Services funded include $650,000 for child and adolescent health centers, $375,000 for the Children’s Health Access Program (CHAP), $1.5 million for lead poisoning prevention, $490,000 for the Michigan Child Care Collaborative Care program, $500,000 to expand the Nurse Family Partnership program, $1.4 million for nutrition outreach and $260,000 for the “Parents as Teachers” program. In addition, funding is included for the delivery of bottled water and filters to seniors and people with disabilities (for six months of the budget year), $2.2 million for lead abatement in Flint, and $500,000 for a non-emergency medical transportation program in the city.
- Senate: The Senate agreed with the governor on most Flint spending but removed funding for lead abatement contracts, inserting a $100 placeholder for later discussion, and changing budget language to make the funding available statewide.
- House: The House rejected the governor’s recommended increase in funding for the Flint water crisis (retaining current funding of $4.6 million), but provided $3.4 million in one-time state funds for healthcare, food and nutrition, lead abatement and other services in communities statewide that have lead contamination in water, soil or housing. The House also requires the Michigan Department of Health and Human Services (MDHHS) to establish a workgroup to determine the cost of establishing lead elimination as an essential local public health service.
Funding for local public health departments:
- Governor: The governor provided flat funding for local public health services ($45.4 million). Prior to an increase in the current budget year, funding for local health departments for infectious disease control, food and water protection, and other essential public health services has been essentially flat since 2005.
- Senate: The Senate included $6 million to hold all local health departments harmless under a new allocation formula for essential public health services.
- House: The House agreed with the governor and provided flat funding for local public health services.
Birth certificates for individuals who are homeless:
- Governor: The governor provided state funding to waive fees for copies of birth certificates requested by people who are homeless.
- Senate and House: The Senate and House agreed with the governor.
Additional House Initiatives:
- Children’s oral health: The House included $2 million in state funds for a new oral health assessment for children entering kindergarten who do not have dental insurance. HB 4223, which is currently being considered by the Legislature, establishes the mandate for a dental assessment.
- Exercise program for children: The House cut $1 million in state funding for grants for exercise programs in schools.
- Child and adolescent health centers, free health clinics and Centers for Independent Living: The House included $2 million in state funds for a one-time expansion of child and adolescent health centers in underserved areas, $1.5 million for Centers for Independent Living, and $150,000 for a funding increase for free health clinics.
Behavioral Health
Cost of behavioral health services:
- Governor: The governor includes increased funding to cover rising costs in Medicaid and Healthy Michigan Plan mental health and substance use disorder services. Between 2001 and the current budget year, total mental health spending increased 80%, with most services covered by Medicaid.
- Senate: The Senate adopted the governor’s projections on growth in Medicaid mental health and substance use disorder services for the 2020 budget year.
- House: The House included a placeholder to continue discussions of ways to hold Community Mental Health Services Programs (CMHSPs) harmless in the second year of a new funding formula that is being phased in over five years. Currently, six CMHSPs would lose a combined $5.5 million.
Medicaid autism services:
- Governor: The governor included a $15 million increase for Medicaid autism services, bringing total funding to almost $208 million. The governor recommended an increase in payment rates for Medicaid autism services of 5.75%. The governor eliminated one-time funding for autism navigators that can assess the rollout of the Medicaid autism benefit and help families find autism services.
- Senate: The Senate reduced rate increases for autism providers to 3%. The Senate also revised budget language to require the MDHHS to continue to provide all autism services to Medicaid enrollees eligible for the services that were covered on January 1, 2018; and to specify who is qualified to make an autism diagnosis for purposes of Medicaid eligibility, and when a second opinion is required. The Senate assumes that these cost containment efforts will save the state just under $7 million in the 2020 budget year. The Senate included a placeholder for further discussion of the autism navigator program.
- House: The House adopted the 5.75% rate increase for autism services proposed by the governor. The House also included $1 million in state funds for autism navigators.
Medicaid behavioral health integration pilot programs.
- Governor: Former Gov. Snyder launched an effort to integrate behavioral health and other health services, and the appropriateness of that approach has been contested in subsequent budgets. Gov. Whitmer continues the pilot projects in her 2020 budget.
- Senate: The Senate continues funding for the pilot programs and adds budget language expressing that it is the intent of the Legislature that by January of 2021 the MDHHS—in conjunction with the Medicaid Health Plans and CMHSPs—will provide the measures that would trigger full statewide implementation by October 1, 2022. The Senate also adds specific metrics for inclusion in that plan.
- House: The House agrees with the governor on continuation of the behavioral health integration pilot programs.
Maternal and Child Health
Funding for maternal and child health:
- Governor: The governor included a total of $329.7 million for maternal and child health programs, an increase of less than 1% over the current year, with essentially flat funding for major maternal and child health programs, including Family Planning Local Agreements ($8.3 million), local Maternal and Child Health (MCH) services ($7 million), and the pregnancy prevention program. The largest maternal and child health program is the Women, Infants and Children (WIC) food program at an estimated $231.3 million in the 2020 budget year. The bulk of the funding (74%) for maternal and child health is federal.
- Senate: The Senate provided a total of $331.4 million for maternal and child health services, an increase of 1.4%. The Senate agreed with the governor on flat funding for Family Planning Local Agreements, local Maternal and Child Health (MCH) services, and the Pregnancy Prevention Program. The Senate included a small increase in prenatal care outreach and service delivery support funding.
- House: The House cut funding for maternal and child health services by $4.3 million (1.3%) to a total of $322.9 million. The House agreed with the governor on flat funding for Family Planning Local Agreements, local Maternal and Child Health (MCH) services and pregnancy prevention.
Home visiting programs:
- Governor: The governor removed $325,000—approved in a supplemental budget bill in the last days of the Snyder Administration—to support Nurse Family Partnership programs in Kent and Ingham counties.
- Senate: The Senate also removed funding for the Nurse Family Partnership programs in Kent and Ingham counties, but left a placeholder for continued legislative discussions.
- House: The House retained current year funding ($325,000) for the Nurse Family Partnership programs in Kent and Ingham counties.
Additional Senate Initiatives: The Senate included $1 million for the Strong Beginnings program in Grand Rapids, a community partnership that works to improve the health and well-being of African American and Latinx families during pregnancy and early childhood. The Senate also included a $100 placeholder to continue discussions about a regional perinatal system in Michigan.
Endnote
- In addition to the specific provisions of the House budget outlined above, the budget for the Department of Health and Human Services approved by the House assumes: 1) a reduction of lapsed savings based on historical lapses in specific budget areas; and 2) a 3% across-the-board reduction for most budget items to be achieved through administrative efficiencies. A 3% across-the-board reduction could affect the ability of the DHHS to administer and provide services needed by families and children with low incomes.
Jay Cutler joined the League in March 2026 as the Kids Count Senior Data Analyst, where he collects, analyzes, and prepares data for Kids Count in Michigan.
Danielle Taylor-Basemore joined the League as the Development Data and Stewardship Coordinator in June 2025. She brings with her five years of nonprofit experience with a special focus on community engagement, data visualization and strategic programming. Prior to joining the League, Danielle served as the Business District, Safety, and Digital Manager at Jefferson East, Inc.
Scott Preston is a Senior Policy Analyst with the Michigan League for Public Policy, where he leads the organization’s immigration and criminal justice reform portfolios. In the three years prior to joining the League, Scott facilitated the Southeast Michigan Refugee Collaborative and managed a small business economic development program at Global Detroit. His work included launching Michigan’s first Refugee Film Festival and building on a trusted connector model that linked marginalized communities with crucial resources. Scott’s work at the League is informed by his background in journalism and research. He spent four years covering the Syrian refugee crisis in the Middle East for publications such as The Economist, and later worked with unaccompanied refugee minors through Samaritas. Scott holds a master’s degree in international migration and public policy from the London School of Economics and Political Science.
Kate Powers joined the League as the Chief Development Officer in February 2025. Prior to joining the League, Kate held leadership positions at many Michigan nonprofit organizations, most recently serving as the COO and Chief Development Officer of Ele’s Place. Kate has spent the bulk of her career in fundraising, with a short stint in the state Legislature as a legislative aide to members in both chambers. Kate is a graduate of Michigan State University’s James Madison College with a Bachelor of Arts in Social Relations and has a certificate in fundraising management from the Lilly Family School of Philanthropy at Indiana University. Additionally, Kate served on the East Lansing Public Schools Board of Education and is a past President of the Junior League of Lansing. In her free time, she enjoys traveling with her husband and her son and saving outfit of the day and home decor ideas on Pinterest. 
Nicholas Hess joined the League as the Fiscal Policy Analyst in September of 2024. In this role, Nicholas focuses on tax policy, government revenue, and their impact on working families and racial equity, including the effects of the Earned Income Tax Credit (EITC) and Child Tax Credit (CTC). Nicholas values the role that judicious fiscal policy can play in the improvement of people’s lives and the economy, alleviating inequities along the way.
Audrey Matusz joined the League as the Visual Communications Specialist in September 2024. She supports the team with implementing social media strategies and brainstorming creative ways to talk about public policy. She brings with her nearly a decade of experience in producing digital products for evidence-based social justice initiatives. 
Jacob Kaplan 
Donald Stuckey 
Alexandra Stamm 
Amari Fuller
Mikell Frey is a communications professional with a passion for using the art of storytelling to positively impact lives. She strongly believes that positive social change can be inspired by the sharing of data-driven information coupled with the unique perspectives of people from all walks of life across Michigan, especially those who have faced extraordinary barriers. 
Yona Isaacs (she/hers) is an Early Childhood Data Analyst for the Kids Count project. After earning her Bachelor of Science in Biopsychology, Cognition, and Neuroscience at the University of Michigan, she began her career as a research coordinator in pediatric psychiatry using data to understand the impacts of brain activity and genetics on children’s behavior and mental health symptoms. This work prompted an interest in exploring social determinants of health and the role of policy in promoting equitable opportunities for all children, families, and communities. She returned to the University of Michigan to complete her Masters in Social Work focused on Social Policy and Evaluation, during which she interned with the ACLU of Michigan’s policy and legislative team and assisted local nonprofit organizations in creating data and evaluation metrics. She currently serves as a coordinator for the Michigan Center for Youth Justice on a project aiming to increase placement options and enhance cultural competency within the juvenile justice system for LGBTQIA+ youth. Yona is eager to put her data skills to work at the League in support of data-driven policies that advocate for equitable access to healthcare, education, economic security, and opportunity for 0-5 year old children. In her free time, she enjoys tackling DIY house projects and trying new outdoor activities with her dog.
Rachel Richards rejoined the League in December 2020 as the Fiscal Policy Director working on state budget and tax policies. Prior to returning to the League, she served as the Director of Legislative Affairs for the Michigan Department of Treasury, the tax policy analyst and Legislative Director for the Michigan League for Public Policy, and a policy analyst and the Appropriations Coordinator for the Democratic Caucus of the Michigan House of Representatives. She brings with her over a decade of experience in policies focused on economic opportunity, including workforce issues, tax, and state budget.
Simon Marshall-Shah joined the Michigan League for Public Policy as a State Policy Fellow in August 2019. His work focuses on state policy as it relates to the budget, immigration, health care and other League policy priorities. Before joining the League, he worked in Washington, D.C. at the Association for Community Affiliated Plans (ACAP), providing federal policy and advocacy support to nonprofit, Medicaid health plans (Safety Net Health Plans) related to the ACA Marketplaces as well as Quality & Operations.
Renell Weathers, Michigan League for Public Policy (MLPP) Community Engagement Consultant. As community engagement consultant, Renell works with organizations throughout the state in connecting the impact of budget and tax policies to their communities. She is motivated by the belief that all children and adults deserve the opportunity to achieve their dreams regardless of race, ethnicity, religion or economic class.
Emily Jorgensen joined the Michigan League for Public Policy in July 2019. She deeply cares about the well-being of individuals and families and has a great love for Michigan. She is grateful that her position at the League enables her to combine these passions and work to help promote policies that will lead to better opportunities and security for all Michiganders.
Megan Farnsworth joined the League’s staff in December 2022 as Executive Assistant. Megan is driven by work that is personally fulfilling, and feels honored to help support the work of an organization that pushes for more robust programming and opportunities for the residents of our state. She’s excited and motivated to gain overarching knowledge of the policies and agendas that the League supports.
