On February 25 and April 10, 2025, Bill Huizenga cast deciding budget votes; on May 22 he supplied one of the 215 ayes that passed the House bill; and on July 3 his yes went to the final law, which puts work rules on the expansion group KFF calls "the primary coverage pathway for people with mental health or substance use disorders," a group that in Michigan included 213,395 adults with a mental illness in 2021.
Opioid use disorder had been diagnosed in 52,290 Michigan Medicaid adults in 2021, 63% of whom qualified through the expansion that the work requirement targets.
Bill Huizenga's Votes on Medicaid Coverage for Mental Health and Addiction Care
- Huizenga Voted for Medicaid Work Rules That Cover Healthy Michigan Adults With a Mental Illness Unless an Exemption Applies, in 2025. When the final H.R. 1 came up on July 3, 2025, Bill Huizenga voted for it and it passed 218 to 214; in May he had been among the votes that moved the House version 215 to 214. The law exempts people "with a substance use disorder", anyone in an addiction treatment and rehabilitation program, and those "with a disabling mental disorder", and in Michigan it lands on the Healthy Michigan Plan, the expansion program covering about 678,000 people. Because only "disabling" mental disorders qualify for that exemption, anyone whose mental health diagnosis falls short of that bar still owes the monthly hours unless another exemption fits, and the Commonwealth Fund cautions that plenty of the people dropped "will remain eligible for Medicaid but who did not successfully complete the paperwork."
- Huizenga Cast Deciding Votes on a Budget Plan That Leaves States Struggling to Keep Their Addiction-Treatment Gains. The House adopted H.Con.Res. 14 by two votes in February 2025 (217-215) and again in April (216-214), each time with Huizenga's yes, so either tally would have tied and failed without him. Among its instructions was an order to the Medicaid committee to "reduce the deficit by not less than $880,000,000,000." KFF cautioned that the law's cuts and "a more tenuous fiscal climate for states may make those gains harder to sustain," meaning the treatment capacity for addiction and mental illness that states expanded with Medicaid dollars; Medicaid pays for "over half (56%) of those receiving medication" for opioid use disorder nationwide.
What Bill Huizenga's Medicaid Votes Mean for Michiganders in Treatment
- 213,395 Healthy Michigan adults had a mental illness and come under the work rule from 2027 unless an exemption applies. Among Michigan adults covered through the Medicaid expansion in 2021, KFF counted 213,395 with a mental illness, 51,149 of them serious, and 89,192 with a substance use disorder. The adults with a mental illness must meet the work requirement from January 1, 2027 unless an exemption applies, while those with a substance use disorder are exempt by statute; under CMS's rule Michigan can still ask people for information, and one missed form is enough to interrupt the counseling or prescriptions that keep a crisis from turning into a hospital stay.
- Most Michigan Medicaid patients on opioid treatment medication get it through the expansion. In 2021, 34,253 Michigan Medicaid adults received medication for opioid use disorder, with 21,234 (62%) enrolled via the expansion; for those patients a lapse in Medicaid means a lapse in the medication that keeps them in recovery.
- The work rule reaches 46,600 expansion enrollees in Huizenga's district. KFF lists 46,600 people covered through the expansion in Michigan's 4th District in 2025, the group the new rule reaches, and statewide the Urban Institute projects between 171,000 and 355,000 Michiganders will lose Medicaid under the work rule and more frequent eligibility checks.
Frequently Asked Questions About Bill Huizenga on Mental health and addiction
What is Bill Huizenga's record on mental health and addiction under Trump?
Bill Huizenga's 2025 votes decided the February and April budget resolutions and the May 22 House vote on the One Big Beautiful Bill Act, and on July 3 he cast a yes for the finished law. It puts Medicaid work rules on expansion adults, the coverage route KFF identifies as primary for people with mental illness or addiction, and exempts by statute people with a substance use disorder and those with a disabling mental disorder. In Michigan, the expansion covered 32,745 adults with opioid use disorder in 2021.
When will Michigan patients in recovery have to start reporting work hours because of Bill Huizenga's vote?
Michigan's rules under the law that passed July 3, 2025 with Bill Huizenga's vote take effect January 1, 2027, and Healthy Michigan members renewing in March 2027 are the first who must submit proof, with coverage ending March 31 for anyone whose paperwork is missing, Bridge Michigan reported. After that, expansion adults go through eligibility checks "once every 6 months", twice the old pace, so a person in treatment has two chances a year to fall off.
Are people in addiction recovery exempt from the Medicaid work rules Bill Huizenga voted for?
Yes: the law Bill Huizenga voted for in July 2025 exempts people with a substance use disorder, listed under a person "who is medically frail or otherwise has special medical needs," and people in a drug addiction or alcohol treatment and rehabilitation program. The Commonwealth Fund cautioned that many people who lose coverage under such rules "will remain eligible for Medicaid" but fail to complete the paperwork, and in Michigan 89,192 expansion adults had a substance use disorder in 2021, KFF found.
Last updated: 2026-10-27