After a nearly 24-hour marathon session, state lawmakers passed a state budget in the early hours of July 3. While this was after the July 1 statutory deadline, legislators were eager to get the budget done to allow candidates to get back to their districts to campaign for their respective primary and general elections. 

Budget negotiations were not easy, as the impact of H.R.1, or the federal One Big Beautiful Bill Act, required the state to cut over $1 billion from the Governor’s executive recommendations. The final FY 2027 budget totals $75.2 billion. However, the budget authorizes $86.4 billion in spending after federal Medicaid taxes and federal K-12 appropriations were shifted into boilerplate and not included in the topline.  

Overall, the budget avoids major cuts to Medicaid programs despite not including new tax revenue streams to generate additional dollars as proposed in Governor Whitmer’s Executive Recommendations. The FY 2027 budget also includes $54.3 million to increase staffing capacity and administrative support for SNAP and Medicaid work requirements implementation stemming from H.R.1. 

FY 2027 Budget Highlights

The Health and Human Services budget allocates $30.7 billion Gross ($7.5 billion GF/GP), around a 2.2% increase from FY 26. Highlights include:

• $173.2 million for the Rural Health Transformation Program to align the appropriation with the grant award and designate two FTE positions

• $70.5 million in one-time funding from the Opioid Healing and Recovery Fund

• $351.9 million to maintain direct care worker wages, as well as funding for minimum wage increases and sick leave

• $27.8 million for a new state psychiatric hospital in Southeast Michigan

• RxKids reduced by $20 million in TANF funding that is instead redistributed to different line items and programs

Meanwhile, the legislature also passed nearly 70 non-budget policy bills. This included the following bills of note:

SB 205 – Would expressly allow physician private practice offices and urgent care centers to ask whether new patients are interested in receiving information about bone marrow donation or the organ and tissue donor registry.

SB 415 – Would require MDHHS to provide Medicaid coverage for group prenatal care services. 

SB 501/HB 4101 – Would enter Michigan into the Physical Therapy Licensure Compact (PTLC), which allows physical therapists to practice physical therapy in states that are parties to the compact without having to be licensed in each individual state.

HB 4103/HB 4104 - House Bill 4103 would make Michigan a party to the Occupational Therapy Licensure Compact (OTLC), and House Bill 4104 would make some related changes to the code’s occupational therapy licensure provisions. 

Preserving Physician-Led Care Teams 

Aside from the budget, legislation that aims to dismantle the physician-led care team has been introduced and is beginning to move through the legislative process. Some bills have not yet been considered, but as we prepare for lame duck — the time after the November election – we remain concerned that lawmakers could strike deals at any time to move legislation and send bills to the desk of the Governor for her signature. The following bills are of note:

House Bill 4399 and Senate Bill 268 – this legislation, introduced in both the House and Senate, would expand the scope of nurse practitioners and allow them to care for patients without physician supervision. House Bill 4399 has been sitting in the House Rules Committee and has not yet been taken up for additional consideration due to the grassroots advocacy and education taking place by physician organizations. Senate Bill 268 was referred to the Senate Committee on Regulatory Affairs and has yet to be considered.

House Bill 5522 – similar to the legislation noted above, this bill would expand the scope of physician assistants to grant them the ability to practice independently from the physician-led care team. The bill awaits a hearing in the House Health Policy Committee, where a hearing likely will not be held until after the summer recess.

Next Steps: Take Action During Campaign Season

During an election year where lawmakers and candidates will spend much of summer and early fall campaigning for the August primary and November general election, your voice plays an integral part in educating elected officials on the role family physicians play in the community and how legislation impacts patient safety. Grassroots advocacy offers an opportunity for you to build a relationship with your lawmakers, be a resource, and in turn, protect Michigan patients.

As we enter campaign season and prepare for the lame duck session, MAFP members are encouraged to reach out to their legislators, especially those whom you met on advocacy day, as well as candidates running for the state House and Senate, to advocate for and discuss the importance of primary care investments and the preservation of physician-led care teams. 

To stay up to date on legislative happenings and to use MAFP’s Speak Out tools (located at https://www.mafp.com/how-to-advocate) to communicate with your elected officials. Also be sure to:

• Read MAFP’s Family Medicine Update e-newsletter, delivered to inboxes every other week

• Subscribe to AAFP’s Family Medicine Action Network at aafp.org/advocacy/fight/family-medicine-action-network.html 

• Watch for special advocacy e-alerts asking members to take urgent action