Healthcare (Insurance)

in committee · Michigan · House May 20, 2025

HB 4496: Insurance: health insurers; coverage for the dispensing of a 12-month supply of birth control; require. Amends 1956 PA 218 (MCL 500.100 - 500.8302) by adding sec. 3406jj.

HB 4496 amends Michigan's insurance code to require health insurance policies to cover a 12-month supply of prescription contraceptives. It mandates that insurers provide coverage for these contraceptives, which are on the health plan's formulary, to be dispensed all at once unless otherwise requested or instructed by a prescriber. The bill also requires coverage for necessary outpatient services related to prescribing or dispensing contraceptives, if other prescription drugs are covered by the policy. While standard cost-sharing like copayments and deductibles can apply, insurers are prohibited from imposing utilization controls that limit the supply to less than 12 months. This measure applies to health insurance policies beginning December 31, 2025.

Topics ✓ HealthcareSupports HealthcareMandates insurers to cover 12-month contraceptive supply, expanding access to reproductive healthcare services and aligning with coverage expansion indicators.95% confidence

Sub-Topics Insurance

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passed · Michigan · Senate Apr 17, 2025

SB 32: Insurance: health insurers; provision of information on medical malpractice insurance relating to perinatal care services to the department of health and human services; require on request. Amends sec. 2434 of 1956 PA 218 (MCL 500.2434). TIE BAR WITH: SB 29'25

Senate Bill 32 amends Michigan's insurance code to require insurers offering medical malpractice policies to annually provide specific information. These insurers must submit data about their policies related to perinatal care services to the Department in a manner it determines. Within 60 days, the Department must then forward this information to the Department of Health and Human Services. This data sharing is intended to support a study required under the public health code. The bill will not take effect unless Senate Bill No. 29 also becomes law.

Topics ✓ HealthcareSupports HealthcareBill requires insurers to submit perinatal malpractice data to support public health study under public health code, advancing healthcare policy development.90% confidence

Sub-Topics Insurance Public Health Women's Health

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in committee · Michigan · Senate Sep 17, 2025

SB 552: Insurance: health insurers; coverage for a nonopioid analgesic drug for pain treatment; require. Amends 1956 PA 218 (MCL 500.100 - 500.8302) by adding sec. 3406ll.

SB 552 requires Michigan health insurers to cover non-opioid pain medications prescribed for pain treatment, directly affecting insurers and policyholders. The bill mandates that insurers include such drugs on preferred drug lists within 90 days of FDA approval, prohibits discouraging coverage relative to opioids (e.g., labeling non-opioid drugs as "nonpreferred" when opioids are preferred), and prevents overly restrictive prior authorization for non-opioid options. It does not require insurers to cover specific drugs but ensures equal treatment compared to opioid alternatives in formularies. The law applies to all health insurance policies covering prescription drugs in Michigan.

Topics ✓ HealthcareSupports HealthcareMandates insurer coverage of non-opioid pain meds, prohibits discouraging alternatives to opioids, improving patient access to safer pain management options.95% confidence

Sub-Topics Insurance Prescription Drugs Substance Abuse

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passed both · Michigan · House Sep 18, 2025

HB 4713: Insurance: health insurers; definition of health care insurer; include automobile insurers providing personal injury protection coverage. Amends sec. 2 of 1984 PA 323 (MCL 752.1002).

This bill amends Michigan's Health Care False Claim Act to expand the definition of "health care insurer" to include automobile insurers providing personal injury protection (PIP) coverage. PIP coverage pays for medical expenses after car accidents, and this change brings auto insurers into the same legal framework as health insurers for false claim enforcement. Previously, the law applied only to health insurers and self-insured entities, but now false claims related to PIP benefits will be subject to the same standards. This directly affects auto insurance companies operating in Michigan that offer PIP coverage.

Topics ✓ HealthcareSupports HealthcareExpands Health Care False Claim Act to include auto insurers for PIP medical coverage, strengthening enforcement against false claims for accident-related healthcare expenses, thus protecting healthcare resources.90% confidence

Sub-Topics Insurance

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passed · Michigan · Senate Jul 1, 2025

SB 400: Insurance: health insurers; prior authorization for certain opioid use disorder and alcohol use disorder medications; prohibit. Amends 1956 PA 218 (MCL 500.100 - 500.8302) by adding sec. 3406ww.

SB 400 prohibits Michigan health insurers from requiring prior authorization for medications treating opioid use disorder or alcohol use disorder. This directly affects health insurance companies and patients seeking these specific treatments, removing a common administrative barrier. The bill amends Michigan’s Insurance Code to explicitly ban prior authorization requirements for these medications, using the existing definition of "prior authorization" from Section 2212e. The law ensures faster access to evidence-based treatment without insurer delays.

Topics ✓ HealthcareSupports HealthcareRemoves prior authorization barriers for opioid/alcohol use disorder medications, improving patient access to essential treatments without administrative delays.95% confidence

Sub-Topics Insurance Substance Abuse

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passed · Michigan · Senate Jul 1, 2025

SB 402: Human services: medical services; coverage for street medicine services; require. Amends sec. 109 of 1939 PA 280 (MCL 400.109).

SB 402 requires health insurance plans to cover street medicine services, which provide medical care directly to homeless individuals in non-clinical settings like streets or shelters. The bill amends state law (MCL 400.109) to mandate this coverage, directly affecting homeless residents and healthcare providers offering street-based care. This policy change ensures that street medicine services can be billed through insurance, improving access to healthcare for vulnerable populations who might otherwise avoid traditional clinics. The requirement applies to all health insurers covered under the amended statute.

Topics ✓ HealthcareSupports HealthcareMandates insurance coverage for street medicine services, expanding healthcare access for homeless individuals by requiring insurers to cover non-clinical care.95% confidence

Sub-Topics Insurance Mental Health

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passed both · Michigan · House Jul 1, 2026

HB 4703: Insurance: health insurers; coverage for group prenatal care services; require. Amends 1956 PA 218 (MCL 500.100 - 500.8302) by adding sec. 3406ss.

HB 4703 requires health insurers in Michigan to cover group prenatal care services for policyholders. This directly affects health insurers offering coverage in the state and pregnant individuals seeking prenatal care. The bill defines "group prenatal care services" as evidence-based, group-based visits that include health assessments, social support, education, and peer interaction in a family-centered setting. Insurers must now provide this coverage for group prenatal care under their health insurance policies.

Topics ✓ HealthcareSupports HealthcareMandates insurers to cover evidence-based group prenatal care, expanding access to maternal health services and strengthening coverage requirements.95% confidence

Sub-Topics Insurance Women's Health

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passed · Michigan · Senate Oct 23, 2025

SR 81: A resolution urging the Congress and the President of the United States to permanently extend the Affordable Care Act Enhanced Premium Tax Credit to help ensure that all individuals and families have equitable access to healthcare.

This resolution urges Congress and the President to permanently extend the Affordable Care Act's Enhanced Premium Tax Credit, which helps low- and middle-income individuals and families afford health insurance premiums through the federal marketplace. It directly affects approximately 21.8 million Americans (including 484,000 Michigan residents) who currently benefit from the credit, which caps premium costs as a percentage of household income. The resolution emphasizes that without permanent extension, millions could face higher costs, risking coverage losses and reduced access to care - particularly for working families, seniors not yet on Medicare, and those with chronic conditions. As a procedural resolution (not a law), it does not change policy but formally requests federal action to maintain this existing affordability mechanism.

Topics ✓ Budget & TaxesSupports Budget & TaxesExtends tax credit providing relief to low/middle-income households, directly aligning with tax relief indicators for Budget & Taxes.95% confidence ✓ HealthcareSupports HealthcareBill explicitly urges permanent extension of ACA tax credit, ensuring affordability for 21.8M Americans and expanding healthcare access through subsidized premiums.95% confidence

Sub-Topics Insurance Medicare

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in committee · Michigan · House Nov 5, 2025

HB 5205: Insurance: health insurers; coverage for examinations and medications related to breast cancer; provide for. Amends sec. 3406d of 1956 PA 218 (MCL 500.3406d).

HB 5205 requires Michigan health insurers to cover specific breast cancer-related services without cost-sharing. It mandates coverage for diagnostic exams, screening mammograms (every 5 years for ages 35-39, annually for 40+), outpatient treatment, and rehabilitation services like reconstructive surgery. The law prohibits deductibles, copays, or dollar limits on these services, aligning coverage terms with general medical care. This directly affects Michigan health insurance policyholders, particularly women needing breast cancer screening or treatment.

Topics ✓ HealthcareSupports HealthcareMandates no-cost coverage for breast cancer services including screenings, treatment, and rehab, removing financial barriers and aligning with patient access protections.95% confidence

Sub-Topics Insurance

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in committee · Michigan · House Nov 12, 2025

HB 5226: Insurance: insurers; coverage for certain pediatric autoimmune neuropsychiatric disorders; require. Amends 1956 PA 218 (MCL 500.100 - 500.8302) by adding sec. 3406pp.

HB 5226 requires health insurance policies sold or renewed in Michigan to cover treatment for pediatric autoimmune neuropsychiatric disorders linked to strep infections (PANS) and pediatric acute-onset neuropsychiatric syndrome (PANS), including intravenous immunoglobulin therapy. This applies to all health insurance policies delivered, issued, or renewed in Michigan or covering Michigan residents, starting 90 days after the law takes effect. The bill directly affects children diagnosed with these specific conditions by mandating insurance coverage for their treatment. It amends Michigan's insurance code to ensure these therapies are included in standard coverage without additional patient cost.

Topics ✓ HealthcareSupports HealthcareMandates insurance coverage for pediatric neuropsychiatric disorders, expanding health benefits and improving patient access to required treatments.95% confidence

Sub-Topics Children's Health Insurance

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