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Opinion: Michigan must fix its auto no-fault crisis before more lives are lost
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Each November, National Care at Home Month reminds us of something simple but profound: healing at home matters. The caregivers, nurses, and home care professionals who make independence possible for thousands of Michiganders deserve recognition. But this year’s theme, “One Voice for Care at Home,” carries a weight we cannot ignore.
Because right now, that one voice needs to be shouting from every corner of Michigan: our auto no-fault system is broken, and people are being harmed.
When lawmakers rushed through the 2019 auto no-fault reforms, they promised Michiganders real relief on premiums while preserving needed protections for crash survivors. The savings never truly came. The protections did not hold. And thousands of catastrophically injured people who did nothing wrong — people who paid into a system they trusted — were left stranded.
Before 2019, Michigan’s model was clear and compassionate. Survivors with catastrophic injuries had access to lifetime medical and home-based care. That promise was part of what people bought with their insurance premiums. But the reform slashed reimbursement rates for home care and post-acute services by 45%. Providers simply could not survive on that. Many shut their doors. Others stopped accepting auto no-fault patients altogether.
The results were as predictable as they were devastating.
Crash survivors who once lived safely at home were pushed into institutions or left with no care at all. Family members quit their jobs to pick up the caregiving themselves. Thousands of trained caregivers lost their livelihoods. And the human toll — isolation, injury, decline, even death — has mounted year after year.
Numbers tell part of the story. The Brain Injury Association of Michigan found that within the first two years of the reforms, nearly 6,900 crash survivors lost care, 42% of service capacity vanished, and more than 4,000 health care workers were pushed out of the field. That is a collapse, not a correction.
And yet, lawmakers did nothing to fix the mess they created.
Only the courts stepped in. The Michigan Supreme Court’s 2023 Andary ruling correctly restored benefits for those injured before June 11, 2019, affirming that the state could not retroactively strip away care that had been paid for. But even that did not resolve the crisis.
Survivors injured after that date are still fighting every day to access their medically necessary care. Many paid for unlimited medical coverage only to be told it no longer exists for them. Meanwhile, Michigan remains one of the most expensive states in the country for auto insurance.
Now, a unanimous Michigan Court of Appeals ruling from October 2025 has offered another measure of clarity. The court determined that insurers have been using the wrong payment formula all along, and that home health care should be reimbursed at 200% of Medicare rates, not at the gutted 55% level imposed after 2019. However, this also highlights an uncomfortable truth: insurers have underpaid for years, and lawmakers have refused to clarify the law.
As Tom Judd of the Michigan Brain Injury Provider Council has said, the law has failed to reduce premiums and has instead emboldened delay-and-deny tactics that leave survivors waiting and suffering.
Court orders alone will not fix this. They never could. To put it plainly: the Legislature created this crisis, and the Legislature needs to fix it.
To put it more generously, lawmakers have a real chance to redeem years of inaction. Restoring reasonable reimbursement rates for home care would have minimal impact on premiums, affecting only a small portion of a policy, but it would mean the difference between life at home and life in an institution for thousands of Michigan residents.
Every day we delay, three more people are catastrophically injured in car crashes. Many will discover that the care they thought they paid for is out of reach. Their families will shoulder the burden. Their futures will narrow. And Michigan’s values of fairness, compassion, and responsibility will erode a little further.
National Care at Home Month is supposed to be a celebration. This year, it must also be a wake-up call.
We urge the Michigan Legislature to act swiftly. Restore sustainable reimbursement rates. Honor the promises made to drivers. Restore dignity to survivors. And finally fix the crisis that has already gone on for far too long.
Lives are at stake today, tomorrow, and every day until this is resolved.
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