Michigan Gubernatorial Candidate Backs Controversial Healthcare Plan
Michigan Representative John James, now vying for the governor’s seat, has expressed support for a Republican initiative aimed at revising the Affordable Care Act (ACA), commonly known as Obamacare. The proposal suggests replacing parts of the ACA with health savings accounts (HSAs), a move experts caution could result in increased premiums and reduced coverage.
James commended the plan during a November 10 event organized by Americans for Prosperity, a group historically critical of Obamacare. The initiative, introduced by Florida Senator Rick Scott, was the focal point of his praise.
“I talked to my buddy Rick Scott who came to Macomb last week,” James remarked. “He’s actually working on a bill with President Trump saying that he’s going after the insurance companies that are stealing from you … The Republican plan is giving health savings accounts. Thousands of dollars going to you directly rather than going to insurance companies.”
The plan’s implications are significant within the current healthcare framework. Private insurers mitigate medical costs by pooling risk across many individuals, where healthier participants often subsidize the costs for those needing more care. Obamacare supports this model by offering subsidies to lower premium costs, maintaining broad risk pools and stabilizing premiums through government-managed exchanges.
Senator Scott’s proposed legislation, the More Affordable Care Act, seeks to allow eligible ACA participants to opt for government-funded HSAs, functioning like bank accounts for healthcare expenses.
Scott’s office stated, “This bill would use HSA-style Trump Health Freedom Accounts to put health care decisions in the hands of Americans. Under Senator Scott’s proposal, Obamacare will continue, Healthcare.gov and state exchanges will continue, protections for pre-existing conditions remain in place, and families who need a safety net have one that works for them.”
However, Tim Layton, a public policy and economics associate professor at the University of Virginia, challenges this view. He explained to Politico that such changes could drastically reduce ACA enrollments and decrease available insurance options.
“If there were this type of large wholesale shift from subsidies to cash payments, I would expect enrollment to drop significantly, and I would expect insurers to pull out of the markets,” Layton noted.
Similarly, Jonathan Gruber, an economist at MIT, anticipates that healthier individuals would be more inclined to abandon the ACA, thereby shrinking risk pools and causing premiums to rise across the board.
Gruber stated, “As we’ve seen with the ending of subsidies, what happens is a twofold effect on insurance affordability: When subsidies fall, it’s the healthiest to drop insurance—that raises premiums for everyone else. Second of all, among those who are paying those higher premiums, they are getting lower subsidies to pay them with.”
This isn’t James’s first venture into ACA reform. During his unsuccessful 2020 Senate campaign, he criticized the Republican “failure to repeal and replace Obamacare” and vowed to eliminate it.
Scott’s proposal is among several addressing the impending expiration of enhanced ACA subsidies, initially expanded under the 2021 American Rescue Plan. These enhancements, set to expire on December 31, may lead to higher monthly premiums for 22 million Americans.
Democratic lawmakers have introduced bills to prolong these subsidies for three additional years, facing opposition from Republicans like James and Scott. This could result in nearly half a million Michiganders experiencing increased premiums in 2026.
State Senator Kevin Hartel commented at an October 22 hearing, “We’re seeing families that are understanding the impact of this, who are already struggling with increased costs from things like groceries, prescription medicines, and everything they need to pay for on a day-to-day basis. This will just compound those issues and make it harder for them to get by.”
As James campaigns for the Republican nomination for governor in 2026, the primary elections are set for August 4.
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