America’s health insurance is distributed in a patchwork way. There are public health insurers, like Medicaid and Medicare, and then there are private ones. That’s where a lot of citizens and state residents get their health insurance — through their work or through the private market. 

That insurance may become harder to come by for over 200,000 residents. Two health insurance agencies, Health Alliance Plan and Molina Healthcare, will no longer offer coverage through the Affordable Care Act in Michigan. And, Meridian Health Plan will be significantly shrinking its coverage for state residents. 

That’s happening as premium costs are expected to go through the roof because the Republican-controlled Congress did not include an extension of health insurance tax credits in the One Big Beautiful Bill Act. 

Robyn Vincent spoke with Brian Peters, CEO of the Michigan Health & Hospital Association, about what these changes will mean for Michiganders who sign up for healthcare through the Affordable Care Act, and how hospitals will be impacted.

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Seeing a doctor in America comes with numerous costs—the wait for an appointment, the hours on hold with insurance, the pit-in-your-stomach feeling when the bill finally lands and it is a lot more than you expected. 

Now, millions of Americans are bracing for another cost they did not see coming. 

The federal subsidies that have lowered health insurance premiums under the Affordable Care Act are set to expire next year and if they do, premium costs could rise by hundreds of dollars a month. 

Healthcare subsidies have been a key point of contention during the government shutdown. Last night, seven Democrats and one independent joined Republicans in a Senate vote that paves the way for an end to the shutdown—but not an end to the debate on healthcare subsidies. 

Senate Majority Leader John Thune agreed to allow a vote in December on the expiring tax credits. 

Meanwhile, here in Michigan, the uncertainty comes on top of another shakeup: some insurers are leaving the state’s individual marketplace, and thousands of people are suddenly searching for new coverage.

But some doctors are rejecting the traditional insurance model altogether. Their alternative is called direct primary care, a type of subscription-based service where patients pay a flat monthly fee and receive care when needed — no billing codes, no middlemen. 

Dr. Paul Thomas brought this model to Detroit a decade ago with Plum Health. His clinics promise same-day visits, transparent pricing, and time to actually talk with your doctor.

Thomas joined Robyn Vincent to discuss how he believes this model could help heal America’s broken healthcare system.

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Health care in Michigan is about to get more expensive.

According to a recent report from the health policy research group KFF, insurers offering plans through the Affordable Care Act will increase premiums by 15% next year, with some even proposing 20% hikes. Medicaid is set for $1.2 trillion in national cuts, including work mandates and higher fees.

Michigan Attorney General Dana Nessel also announced last week that she joined a multi-state coalition lawsuit challenging a Trump administration rule that would “create significant barriers to obtaining health care coverage under the Affordable Care Act.”

So, what does all this mean for you and your family’s health care costs?

Thomas Buchmueller, a health economist at the University of Michigan, joined The Metro on Tuesday to break down what’s changing, who will feel it first, and what Michigan can do to soften the blow.

Use the media player above to hear the full conversation.

Listen to The Metro weekdays from 10 a.m. to noon ET on 101.9 FM and streaming on-demand.

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