HR1 Impacts on the State of Michigan
HR1, also known as the One Big Beautiful Bill Act, proposes major changes to how states finance and administer Medicaid. For Michigan, these changes could have significant consequences for the state budget, health care providers, and Medicaid beneficiaries.
Nearly 1.7 million Michigan residents were enrolled in Medicaid as of March 2026, including more than 526,000 covered through the Healthy Michigan Plan. The legislation would limit provider taxes and state-directed payments, two important tools Michigan uses to fund and support its Medicaid program. These changes are projected to reduce available Medicaid funding and place additional financial pressure on hospitals and providers serving Medicaid patients.
HR1 would also introduce work requirements for Healthy Michigan Plan enrollees and require eligibility renewals every six months instead of annually. While intended to strengthen program oversight, these changes are expected to increase administrative costs and create new barriers to maintaining coverage.
Together, the funding reductions and administrative requirements could force difficult decisions for state policymakers, including finding new revenue sources, reducing provider payments, or scaling back Medicaid services.
Read the brief to learn exactly how these changes could affect Michiganders.