Publications

Michigan residents are struggling to afford the basics — and new federal policy changes are poised to make things worse.

The 2025 Cover Michigan Survey, conducted by the Center for Health and Research Transformation (CHRT), finds that despite 94% of Michigan residents having health insurance, nearly one in three skipped necessary medical care in the past year — 40% of whom cited cost or lack of insurance as the primary reason. Beyond healthcare, widespread economic strain is evident: 58% of residents had difficulty making their money last, one in three worried about food running out, and more than a quarter faced transportation barriers to work, childcare, or appointments.

These challenges are not shared equally. Uninsured residents, Medicaid enrollees, Hispanic and Black Michiganders, younger adults, and people with disabilities face the most acute hardships across housing, food, transportation, and financial stability. Notably, economic stress is not limited to those without coverage — insured and employed residents report significant struggles as well.

Looking ahead, federal policy changes under the “One Big Beautiful Bill Act” (Public Law 119-21) could reduce health insurance affordability and access for 300,000 Michigan residents. As coverage gaps grow, the vulnerabilities documented in this survey will only deepen — placing greater strain on households, health systems, and the community organizations already stretched thin.

Read the brief for the full findings and recommendations for how healthcare providers, policymakers, and community organizations can respond.