Updated April 14, 2021
Actions taken so far:
At the state level, Gov. Gretchen Whitmer has issued a number of executive orders and directives in response to the COVID-19 crisis, including eliminating cost-sharing for COVID-19 testing and treatment for Medicaid enrollees. Yet, on October 2, the Michigan Supreme Court ruled that the executive orders the Governor issued in response to the COVID-19 crisis, under the Emergency Management Act of 1976 and the Emergency Powers of the Governor Act of 1945 (EPGA) as authority, had no basis under state law. Following the ruling, the Michigan Department of Health and Human Services (MDHHS) has stepped in to issue a number of Epidemic Orders to fill many gaps in policy left by the ruling. Other issues have continued to be addressed federally (see below).
In March, Attorney General Dana Nessel signed on to a letter to the Trump Administration asking them to further clarify whether the use of Medicaid-paid services for COVID-19-related healthcare would be considered in a “public charge” test. In May, MDHHS announced that Emergency Services Only (ESO) Medicaid—available to undocumented immigrants who would be Medicaid-eligible based on income—will cover medically necessary COVID-19 testing and treatment received on or after March 10, 2020 (see below). In early August, MDHHS Services Director Robert Gordon issued an Emergency Order requiring COVID-19 testing for agricultural and food processing employees, which seeks to protect Michigan farmworkers who live in employer-provided migrant housing camps.
At the federal level, most recently, on March 9, 2021 the Biden Administration announced that it will no longer be defending the Trump Administration’s changes to the public charge rule, and the U.S. Department of Justice is no longer defending the rule through legal avenues. In addition, the Supreme Court dismissed the pending appeals and the 7th Circuit dismissed the government’s appeal. Therefore, the final judgment entered in the Northern District of Illinois on Nov 2, 2020–which vacated the public charge rule nationwide–is now in effect, and the Trump Administration’s 2019 public charge rule is permanently blocked across the country.
The federal government will now follow the policy in the 1999 Interim Field Guidance related to public charge. Under this policy, it is safe for immigrants and their families to access health (Medicaid/CHIP, e.g.), nutrition (SNAP, e.g.), and housing (Section 8, e.g.) programs for which they are eligible.
On February 2, 2021, President Biden issued an executive order to remove barriers in the country’s immigration system; one component of the order directs multiple federal agencies to begin the administrative process of reversing the Trump Administration’s changes to the public charge rule. The agencies are tasked with reviewing, within 60 days, the effects of the public charge rule on communities, the U.S. immigration system, and public health. Rulemaking and other guidance from the agencies is forthcoming, but will likely solidify the reversal of the Trump Administration public charge changes through the rulemaking process.
For a complete timeline of public charge-related changes, please see this “Public Charge Timeline” from the Immigrant Legal Resource Center.
Thanks to the March Families First Coronavirus Response Act (FFCRA), testing for COVID-19 is free and available to all U.S. residents. Unfortunately, diagnostics, evaluation services and treatment are not necessarily covered. Yet, in Michigan, nearly all private health insurance companies have agreed to waive cost-sharing—including copays, deductibles and coinsurance—for COVID-19 testing and treatment. And for Medicaid recipients, the FFCRA requires that states cover testing and treatment for enrollees without cost-sharing as a stipulation for receiving an increased amount of federal Medicaid dollars—an arrangement that will last through the declared public health emergency.
Therefore, Michigan immigrants who are privately insured or who are enrolled in Medicaid—including those who are naturalized citizens (just over half of immigrants in Michigan) and qualify for Medicaid and those who are not currently citizens but are enrolled in Medicaid because they meet both the income eligibility standards and have lived in the country as lawful permanent residents (“green card” holders) for 5 years or more—should not be subject to cost-sharing for COVID-19 testing and treatment. Thirty-nine health centers in Michigan, which are—resource and healthcare hubs in many immigrant communities,—will share more than $2.5 million in emergency funding. As of early April, additional federal legislation has been introduced; if passed, it would expand services and resources to immigrant communities, such as ensuring COVID-19 testing, treatment and access to a vaccine regardless of immigration status. In May, the House of Representatives passed the Health and Economic Recovery Omnibus Emergency Solutions Act (or the HEROES Act) which, if enacted, would provide access to free COVID-19 testing and treatment to uninsured individuals, regardless of immigration status.
Further federal action includes a March announcement by U.S. Immigration and Customs Enforcement (ICE) regarding updated guidance on COVID-19, stating that, “ICE will not carry out enforcement operations at or near health care facilities, such as hospitals, doctors’ offices, accredited health clinics, and emergent or urgent care facilities, except in the most extraordinary of circumstances,” which is consistent with the agency’s policy on enforcement at “sensitive locations.”
Our recommendations:
Take up the Immigrant Children’s Health Improvement Act (ICHIA) option to cover eligible pregnant women and children. Federal law prohibits noncitizen lawful permanent residents (LPRs, also known as “green card” holders) who have lived in the U.S. for less than 5 years from enrolling in Medicaid or the Children’s Health Insurance Plan (CHIP). Yet, since 2009, states have had the option through the Children’s Health Insurance Program Reauthorization Act (CHIPRA) to eliminate this 5-year waiting period for LPR pregnant women and children who meet Medicaid and CHIP eligibility requirements. Michigan has waived this requirement for prenatal care, but has stopped there. If Michigan takes up the ICHIA option now, the 6.2% bump in the Federal Matching Assistance Percentage (FMAP) – and any future federal matching increases – can go toward covering these additional groups, as the matching rate is the same for these populations as other non-expansion Medicaid enrollees.
Expand Emergency Services Only (ESO) Medicaid to include COVID-19 testing, evaluation and treatment. UPDATE: On May 11, MDHHS announced that ESO Medicaid will cover medically necessary COVID-19 testing and treatment received on or after March 10, 2020. This includes follow-up services, such as outpatient visits and medications, for individuals who test positive for COVID-19.
In Michigan, ESO Medicaid is available to uninsured residents who would otherwise qualify for Medicaid but do not because of their immigration status (e.g., they have not met the 5-year stipulation or are undocumented). Michigan should define testing, diagnostics and treatment services for suspected COVID-19 as emergency services so that more immigrants can receive necessary healthcare services in our state. Notably, ESO has never been considered as part of a “public charge” determination and it could be a way to get more people in the door for testing and care without fear. A number of states, including New York, Pennsylvania and Washington, have made changes to their Emergency Medicaid policies to include the services related to COVID-19. (See New York and Washington examples.)
Actively engage immigrant communities on the status of U.S. Immigration and Customs Enforcement (ICE) enforcement policies at healthcare facilities, per its updated guidance. The state should engage immigrant communities across Michigan by highlighting these updates, monitoring the experiences of immigrants and direct service providers, and focusing outreach including press or media to ensure all Michiganders seek necessary testing and treatment. Documented drops in coverage and utilization of services at community health centers have been driven by not only concerns about “public charge” but also ICE enforcement actions. It is critical that the trusted entities of our state agencies relay accurate information to affected communities and immigrant residents and encourage testing and treatment of COVID-19.
Why Michigan must act now:
Without additional expansions in both healthcare coverage and treatment services, Michiganders who are immigrants will continue to be left out of the state’s COVID-19 response, leading to reduced testing and treatment within immigrant communities. Inclusive healthcare policy action in Michigan could be potentially life-saving for immigrants in our state.
Michigan must continue to adapt current policies to be inclusive of immigrants in Michigan who are seeking treatment and services. Our disparities are clear: 11.3% of Michigan immigrants are uninsured while only 5% of U.S.-born Michiganders lack health insurance coverage. Among uninsured immigrants in our state, 70.7% are not citizens (i.e., are LPRs or “green card” holders, have other visas, or are undocumented). This is not surprising given the realities for immigrants seeking health coverage on their own (not covered through an employer, for example):
- for “green card” holders, the 5-year waiting period is applicable for those eligible for Medicaid and the ACA Marketplace can be unaffordable for those who are higher-income;
- for undocumented immigrants, only those who are Medicaid-eligible can seek ESO Medicaid services and others must pay for private coverage in full.
Throughout the course of the COVID-19 pandemic, many “green card” holders will lose their jobs and health insurance, driving some to enroll in Medicaid or use ESO services if they are eligible. Yet, there will still be gaps, particularly for undocumented residents with higher incomes who must purchase private health insurance without subsidies or go without it. During this time, we must continue to expand coverage and treatment options given the existing tools and authority we have, while considering new solutions for equitable access to care. Taking action to address long-standing disparities will serve Michiganders now and beyond this public health emergency.
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.
