MHA Testifies on Hospital Cost Drivers in House Insurance Committee

The MHA testified before the Michigan House Insurance Committee June 11 on healthcare cost issues affecting hospitals and communities across the state.

Laura Appel, executive vice president, government relations & public policy, MHA and Elizabeth Kutter, senior director, government and political affairs, MHA, testified in front of the House Insurance Committee on hospital cost drivers and their impact on hospitals and patients.

Laura Appel, executive vice president, government relations & public policy, MHA and Elizabeth Kutter, senior director, government and political affairs, MHA, testified in front of the House Insurance Committee on hospital cost drivers and their impact on hospitals and patients. Kutter shared that Michigan’s hospitals are more than healthcare providers, serve as economic anchors, stewards of public health and major contributors to community investment. Additionally, Kutter shared data collected by the MHA that Michigan hospitals contributed more than $4.5 billion last year to funding community impact projects like mobile clinics, transportation and housing support, food pharmacies and behavioral health programs.

The testimony also highlighted that hospital expenses are rising nationwide, increasing 5.1 percent in 2024 and outpacing the overall inflation rate of 2.9 percent. These increases are largely driven by labor, prescription drug and supply costs.

Appel provided a detailed explanation on workforce and talent, prescription drugs and supplies as significant cost drivers for hospitals and patients seeking care. Data shared with the committee showed that healthcare is the largest private sector employer in the state, with hospitals employing 222,000 people who provide $10.7 billion a year in tax revenue, and that labor costs typically represent 56% of total expenses for hospitals. In addition, prescription drugs are constantly increasing for hospitals and of the $449 billion spent annually on prescription drugs in the United States, hospitals account for roughly 25 percent of the total. Appel made it clear that hospitals do not set the price of drugs but are subject to the whims of drug manufacturers. It was also shared that supply chain disruptions and inflation continue to affect hospitals’ ability to deliver care. National data shows that per-patient supply costs increased 18.5 percent from 2019 to 2022.

Lastly, Kutter and Appel provided an overview on hospital pricing and reimbursement from commercial insurance. According to the Rand Hospital Price Transparency Study, Michigan had the third lowest average commercial payments relative to Medicare in 2024 and is one of just five states with hospital payments averaging below 200% of Medicare prices. The presentation concluded with a call for working with the legislature to address administrative burdens that impact healthcare access and affordability, and focusing on solutions that keep Michigan a high-quality, lower-cost healthcare state.

Members with additional questions should contact Elizabeth Kutter at the MHA.

Local TV News Coverage Focus on Nurse Compact & Medicaid Funding

The MHA received news coverage during the week of June 9 that included local TV news stories on the Michigan House of Representatives passing a bill that would have the state join the National Nurse Licensure Compact and how federal funding cuts to Medicaid would impact northern Michigan, while the MHA also responded to a hospital drug pricing study story by the Lansing State Journal.

Adam Carlson, senior vice president, advocacy, MHA, speaks with WILX News 10 about the current nurse shortage.

WILX News 10 aired a story June 12 following the 57-52 vote by the Michigan House to have Michigan join more than 40 other states in the nursing compact. Adam Carlson, senior vice president, advocacy, MHA, was interviewed for the story, discussing the current shortage of nurses in hospitals, despite Michigan outperforming the national average retention rate for nurses.

“14% of Michigan nurses are turning over, which is lower than the national average, so Michigan is already doing an above-average job and doing a better job than most other states,” said Carlson. “It’s about trying to find those new ones and bring those new ones in.”

9&10 News also aired a story June 9 about how proposed Medicaid cuts could result in the loss of OB/GYN services in northern Michigan. MHA Executive Vice President Laura Appel spoke to 9&10 News about how having to travel to access healthcare services can impact long-term health.

“You’re traveling a greater distance for any problems you have, and the further that people have to travel, especially people with limited means, the less likely they are to be able to adhere to the best care plan that we might have for them,” said Appel.

The Lansing State Journal also published an article June 9 on a study released by the Michigan Health Purchasers Coalition (MIHPC) related to hospital drug pricing. The MIHPC published their report despite published studies by KFF that conclude price transparency data should not be used to draw broad conclusions about hospital pricing. Appel was interviewed for the piece, expressing the inability to verify the information from the MIHPC, the flaws associated with how they present inpatient drug prices for drugs predominantly administered in an outpatient setting and the lengths hospitals are going to minimize costs.

“Payers are trying to do what they can to keep costs down,” said Appel. “Hospitals are trying to do what they can to keep costs down. Patients are trying to do what they can to keep their out-of-pocket costs down. Everybody’s trying to pull the boat in the same direction, but there are just outside pressures that make our healthcare system somewhat costly and growing. And hopefully we can keep the growth at a minimum, but it takes a lot of effort.”

Lastly, Gongwer published an article June 13 following a press release issued by Gov. Whitmer on a memo from the Michigan Department of Insurance and Financial Services sharing 120,000 Michiganders could lose healthcare access if the Federal budget reconciliation legislation passed by U.S. House of Representatives is signed into law. MHA CEO Brian Peters is quoted in the press release and story.

“These proposed changes will cut healthcare coverage for countless individuals, making Michigan unhealthier and leading to worse outcomes and higher rates of uncompensated care,” said Peters. “Increasing health care costs and reducing access is a bad deal that Michigan hospitals uniformly oppose.”

Members with any questions regarding media requests should contact John Karasinski at the MHA.

WLUC TV6 Focuses on Shortage of Behavioral Health Beds

Laura Appel

WLUC TV6 in Michigan’s Upper Peninsula published a story May 29 on the shortage of inpatient psychiatric beds in Michigan, placing a heavy focus on the testimony the MHA delivered May 20 before the House Oversight Subcommittee on Public Health and Food Security.

The story references results from the MHA’s emergency department boarding survey and the annual hospital workforce survey, while also mentioning several proposed solutions.

Laura AppelWNEM-TV also aired a segment May 26 discussing the impact of federal Medicaid funding cuts on the state. MHA Executive Vice President Laura Appel appears in the segment sharing the consequences of the current federal budget reconciliation bill.

Appel was also quoted in a Detroit Free Press story reacting to a hospital drug pricing report published by the Michigan Health Purchasers Coalition. The study uses a limited data set that was not published with the findings to make broad claims about pharmaceutical drug prices in hospitals. Appel discussed the complexity of hospital financing and mentioned the many factors not considered in the study that impact drug pricing.

“We’re all paying attention to affordability and trying to make sure that patients get the care they need without being financially burdened, but we don’t think that the place to start is by placing blame on hospitals, which are really, to some extent, price takers from drug manufacturers,” said Appel.

Members with any questions regarding media requests should contact John Karasinski at the MHA.

 

Mental Health Awareness Month Highlights Week of Media Coverage

Lauren LaPine

The MHA received news coverage during the week of May 19 highlighted by stories related to Mental Health Awareness Month and the need to expand state psychiatric bed capacity.

Lauren LaPine, senior director, legislative and public policy, MHA, speaks during a May 21 press conference on Mental Health Awareness Month, addressing long emergency department waits for psychiatric beds among Medicaid patients.

Lauren LaPine, senior director, legislative and public policy, MHA, joined state lawmakers and University of Michigan Health-Sparrow clinicians during a press conference May 21 about Mental Health Awareness Month. LaPine focused her comments on the high number of patients waiting in emergency departments across the state for an inpatient psychiatric bed. Many of these patients are Medicaid beneficiaries and experience further delays awaiting a clinical assessment.

WILX News 10 and WLNS 6 News attended the press event and aired stories during their evening news broadcasts.

“Last year, for over 18 months, we collected data from our hospitals and health systems that told us that on any given day, there are more than 155 patients that are stuck in emergency departments across the state that are looking for behavioral health services,” said LaPine.

Other speakers included:

  • Chandu Vemuri, MD, chief medical officer, University of Michigan Health-Sparrow
  • Dominic Barberio, MD, psychiatrist, University of Michigan Health-Sparrow
  • Rep. Angela Witwer (D-Delta Township)
  • Rep. Matthew Bierlein (R-Vassar)

The MHA also provided comment to several stories related to a hospital drug pricing study released by the Michigan Health Purchasers Coalition. The study uses a limited data set of claims data in an attempt to show pricing variances across hospitals for three prescription drugs. MHA Executive Vice President spoke with Crain’s Grand Rapids and WLNS News 6, explaining the differences between hospital charges and what hospitals actually receive as reimbursement, as well as the myriad of factors that determine hospital financing, including legacy contract agreements, mergers and acquisitions, the presence of group purchasing agreements, patient acuity, and labor and overhead costs.

“There are a lot of drugs out there. Picking and choosing a few of them probably doesn’t tell the whole story about the expensive pharmaceuticals in our health care system,” said Appel to Crain’s. “Everybody in the system is trying to do their best. There’s lots of room for improvement, but I don’t think identifying a few items and saying, ‘look at this’ is a way to get us to solving some of the affordability needs that we have for our system for patients.”

Adam Carlson speaks at a Protect MI Care press conference.
Adam Carlson speaks at a Protect MI Care press conference.

Adam Carlson, senior vice president, advocacy, MHA, also spoke at a Protect MI Care coalition press conference May 21 in Lansing about federal Medicaid cuts. Carlson was quoted in an article by Gongwer discussing how the cuts will impact all Michigan residents.

“It’s going to lead to millions of people losing their health insurance coverage, and these funding cuts to Medicaid, they’ll impact access to care for all Michiganders, not just those with Medicaid as their insurance coverage,” said Carlson. “It’s an important program across all state hospitals, but especially for the 65 rural hospitals that depend on it to keep their doors open.”

Members with any questions regarding media requests should contact John Karasinski at the MHA.

 

Medicaid Cuts and Hospital Economic & Workforce Impact News Coverage

Laura Appel

Laura AppelThe MHA received news coverage during the week of May 12 related to federal Medicaid funding cuts and the release of the hospital economic and workforce impact data.

Crain’s Detroit Business published an article May 13 following the release of draft bill language from the House Energy and Commerce Committee as part of the budget reconciliation process, which calls for imposing federal work requirements and freezing state directed payment programs for healthcare providers.

MHA Executive Vice President Laura Appel spoke with Crain’s, expressing the MHA’s concerns on the draft language.

“We of course remain deeply concerned about things like doing redetermination of folks’ eligibility for the coverage on less than an annual basis and things like work requirements or community benefit requirements for certain folks who currently qualify for coverage,” said Appel. “All of those things are barriers to folks.”

Second Wave Michigan also published a story May 13 about potential Medicaid funding cuts, as part of their MI Mental Health Series. Lauren LaPine, senior director, legislative and public policy, MHA, is quoted in the piece discussing what impact the cuts would have to hospitals.

“A real consequence of Medicaid cuts will be closures of service lines and even hospitals,” said LaPine. “When hospitals have to cut services because Medicaid is cut, those services are lost for all patients and not just those who receive health care coverage through Medicaid. Medicaid is the single largest payer for long-term care, maternity care, and mental health services. It is a cornerstone of our health care system and keeps people healthy at every stage of life.”

The MHA also received news coverage from Gongwer and dBusiness following the release May 12 of the association’s annual Economic Impact of Healthcare report and hospital workforce survey results.

Lastly, MHA CEO Brian Peters provided a quote of support in a press release issued by U.S. Sen. Gary Peters (D-MI) following introduction of the Mapping America’s Pharmaceutical Supply (MAPS) Act.

Members with any questions regarding media requests should contact John Karasinski at the MHA.

Medicaid Remains Focus of Healthcare News Coverage

The MHA was successful in placing several news stories during the week of April 28 related to potential federal Medicaid funding cuts.

The Lansing State Journal published an op-ed from MHA CEO Brian Peters that was shared as part of the MHA’s participation in the Protect MI Care coalition that is urging members of Congress to protect Medicaid. The op-ed expressed the importance of Medicaid to Michigan’s healthcare system and the consequences to access to care for all Michiganders if significant funding cuts are implemented.

“The effects would ripple far beyond those who rely on Medicaid — every hospital, mental health clinic and nursing home that depends on Medicaid funding would feel the impact,” said Peters. “When facilities close, it’s not just Medicaid patients who lose out — it’s everyone in the community, regardless of what kind of insurance they have.”

MHA Executive Vice President Laura Appel also sat down with WILX News 10 on April 30 to discuss the potential funding cuts and appeared in a story published by Bridge on May 1 about the impact to rural providers.

“When we close intensive care for newborns, when we close labor and delivery units, they are closing for everyone,” said Appel to Bridge.

In other news, Crain’s Detroit Business published an article April 30 committee testimony on legislation that would have Michigan join the nurse licensure compact. MHA Chief Nursing Officer Amy Brown testified in support of the legislation and is quoted in the article.

“In addition to recruitment and coordination of care in our state’s border areas, joining the compact would positively benefit telehealth access,” said Brown. “Compact licensure means residents in Michigan can access more telehealth professionals in other compact states, increasing access points for our state’s residents.”

Appel also appeared on 760 WJR’s All Talk With Kevin Dietz on May 1 to discuss the compact.

Members with any questions regarding media requests should contact John Karasinski at the MHA.

MHA CEO Brian Peters Joins 2025 State of Reform Health Policy Panel

MHA CEO Brian Peters pictured with Farah Hanley, managing principal, Health Management Associates and Dominick Pallone, executive director, Michigan Association of Health Plans (MAHP) during the 2025 Michigan State of Reform Conference April 17.

The 2025 Michigan State of Reform Health Policy Conference convened April 17 in East Lansing, MI. The morning session began with a panel moderated by Farah Hanley, managing principal, Health Management Associates, alongside MHA CEO Brian Peters and Dominick Pallone, executive director, Michigan Association of Health Plans (MAHP). Discussion focused on the evolving federal landscape and its impact on healthcare and health policy in Michigan.

Panelists explored the impact of recent federal activity and what it means for Michigan communities, hospitals and the healthcare workforce. Throughout the discussion, Medicaid, the 340B program and tariffs were highlighted. Peters emphasized that the current threats to Medicaid go beyond those enrolled in the program, warning that cuts will have a ripple effect across the entire healthcare system.

“This isn’t just about Medicaid recipients,” said Peters. “It’s about every Michigander’s access to care.”

The MHA continues to work with members of Congress to underscore that slashing Medicaid funding puts hospitals, providers and patient care at risk across the state.

Peters and Pallone also discussed partnership between the MHA and MAHP in response to recent proposals and the role tariffs play in healthcare. Peters noted the impact tariffs have on the healthcare supply chain and limitations when it comes to responding to financial shifts in real time, which puts a significant strain on providers trying to maintain care quality amid mounting costs.

Members with questions regarding current legislative activity may contact Laura Appel at the MHA.

Medicaid & Pediatric Behavioral Health Media Coverage

Laura Appel speaks with 9&10 News.
Laura Appel speaks with 9&10 News.
Laura Appel speaks with 9&10 News.

The MHA received media coverage the week of April 7 on potential Medicaid funding cuts, pediatric behavioral health and healthcare costs.

9&10 News aired a story April 9 on potential federal Medicaid funding cuts. MHA Executive Vice President Laura Appel spoke with 9&10 News, explaining how the cuts would specifically impact rural healthcare. Representatives from McLaren Health Care and Munson Healthcare also appeared in the story.

“In our rural areas, we have small populations, and some of them are also shrinking, which makes it that much harder to sustain certain services because of the fixed costs being spread over so few people,” said Appel. “When we lose a labor and delivery unit, we lose it for that entire population.”

Lauren LaPineSecond Wave Michigan published a story April 8 about how Michigan hospitals are improving pediatric behavioral healthcare. Lauren LaPine, MHA senior director of legislative and public policy, spoke with Second Wave Michigan about the MHA’s behavioral health work, focusing particularly on the $50 million state grant the MHA served as the fiduciary for to expand inpatient pediatric behavioral health capacity in the state. LaPine also highlighted the data the MHA collected regarding emergency department boarding, which shows at least 155 people at any point, including 17 children, are in an emergency department awaiting behavioral health care.

“Our data in Michigan reflects some of the trends that we see nationally in terms of the increasing need for behavioral health services for children and youth,” said LaPine. “So, we are paying really close attention to that need and want to make sure that our member hospitals and health systems are able to address the need when pediatric patients and their families come to the hospital in a behavioral health crisis.”

Lastly, Crain’s published a story April 9 about the role of hospitals regarding rising healthcare costs. MHA CEO Brian Peters is quoted in the story, explaining how the majority of rising costs are due to responding to market trends for labor, as well as rising costs for facilities, drugs and supplies.

“The largest expense for hospitals is labor … A large component to increased healthcare costs for hospitals is making sure healthcare workers are appropriately and competitively compensated so they can provide care to patients when and where they need it,” said Peters.

Members with any questions regarding media requests should contact John Karasinski at the MHA.

U.S. House Advances Budget Resolution, Sets Up Potential Medicaid Cuts

The United States House of Representatives advanced a Senate budget resolution April 10 that calls for a minimum of $1.5 trillion in federal spending reductions. A separate budget resolution previously passed by the House in February had specifically targeted $880 billion in cuts from the Energy and Commerce committee, which has jurisdiction over the Medicaid program.

Leadership and committee chairs from both chambers will now begin writing and seeking support for an omnibus budget bill, which could contain cuts to providers in the Medicaid program. The MHA remains strongly opposed to cuts that will limit access to care for Michigan residents and will work with members to advocate against reductions over the next several weeks.

Members may use the MHA’s Medicaid action alert to contact their congressperson and advocate for protecting Medicaid from funding cuts.

Members with questions may contact Laura Appel at the MHA.

How Could Medicaid Cuts Impact Michigan?

MiCare Champion Cast Header Photo

The MHA released a new episode of the MiCare Champion Cast exploring how proposed reductions to Medicaid could disrupt access to care and harm Michigan hospitals, patients and communities.

Laura Appel, executive vice president of government relations & public policy, MHA, first explored the history and purpose of Medicaid and the Healthy Michigan Plan, which has been hailed a success for improving access to care, reducing the uninsured rate and supporting economic stability for families across the state.

Appel explained the potential impact of recent federal proposals, which include instructions to cut Medicaid by at least $880 billion over 10 years. Changes like block grants, per capita caps and reduced federal matching rates could lead to a staggering $1.73 billion shortfall in the state budget, jeopardizing access to healthcare for millions.

“Cutting funding is cutting care,” said Appel. “Not every hospital is on the financial footing it wishes it were and there are a lot of hospitals across the country that are already in difficult financial straits…this could be the reason that they close all together.”

Michigan hospitals are asking members of Congress to protect the Medicaid program and oppose proposed reductions. Appel noted those interested in helping with this effort and reaching members of Congress are encouraged to visit the MHA Legislative Action Center.

Listeners can also expect to learn more about the impact proposed cuts would have on rural healthcare and Michigan’s economy. The episode is available to stream on Apple PodcastsSpotifySoundCloud and YouTube.