Episode 332- Health Care Should Be A Right, Not A Privilege. With Debbie Stabenow

Health care feels personal until you try to navigate it and realize how many parts are designed to be confusing. From the Mackinac Policy Conference, we sit down with former Michigan U.S. Senator Debbie Stabenow for a fast, candid conversation about what’s working, what’s breaking, and what Michigan communities need next.

We start with the pressure points she’s most concerned about right now: mental health access, Medicaid cuts, and affordability. Stabenow explains why community behavioral health clinics with 24-hour access matter, not just for patients in crisis, but for families, hospitals, and communities trying to keep people out of emergency rooms and jails. We also talk about rural health care in northern Michigan, where hospitals are often the biggest employer and the backbone of local access, yet many are being forced to cut beds, reduce services, or stop delivering babies.

Then we zoom out to the national policy fights. Stabenow reflects on the Affordable Care Act, what she would keep, and what she would change, including her push for a public Medicare option to drive real competition. She shares a stark reminder of why “essential health benefits” matter by revisiting the days when pregnancy could be treated like a pre-existing condition and prenatal coverage was far from guaranteed. We close on prescription drug prices, Medicare Part D, and the long-running impact of blocking Medicare from negotiating prices, plus how PBMs add yet another layer of complexity.

If you care about Michigan health care, rural hospitals, mental health policy, the Affordable Care Act, Medicaid, and prescription drug costs, this one’s for you. Subscribe, share this conversation with a friend, and leave a review so more people can find The Common Bridge.

Transcript

Announcer

This episode of the Common Bridge is part of a special 21-part series of interviews recorded with healthcare leaders from across Michigan during the 2026 Mackinac Policy Conference, in partnership with the Michigan Health and Hospital Association. In these short conversations with his guests, Rich explores regulation, cost pressures, workforce challenges, and the future of healthcare in Michigan and around the country.

Richard Helppie

We're at the Mackinac Policy Conference on behalf of the Michigan Health and Hospital Association and the Common Bridge podcast and Substack page, and we have the honor today of talking with former U.S. Senator from Michigan, Debbie Stabenow. Senator, thank you so much for joining us.

Debbie Stabenow

My pleasure.

Richard Helppie

How have you been enjoying the conference so far?

Debbie Stabenow

Oh, I love this conference. I've been coming up here for a long time — every year, going all the way back to when I was a state legislator chairing the Economic Development Committee. The weather today is beautiful, absolutely phenomenal.

Richard Helppie

We should tell the audience that every day is like this in Michigan.

Debbie Stabenow

Oh, absolutely.

Richard Helppie

Bad weather? Just a rumor.

Debbie Stabenow

Yeah, it's always 70 or 80 degrees — gorgeous.

Richard Helppie

Indeed it is.

Debbie Stabenow

Yeah.

Richard Helppie

So tell us, what have you been up to lately?

Debbie Stabenow

Well, healthcare is my passion, so even though I'm retired, I'm still staying engaged on healthcare access and mental health access. I led major reforms with a Republican colleague of mine, Roy Blunt, to transform community mental health and create what we call community behavioral health clinics — facilities with 24-hour access so folks don't have to sit in the emergency room or in jail to get the help they need. That's been a passion of mine. I've also been deeply concerned about the cuts we're seeing in Medicaid, the cutbacks to ACA affordability tax credits, and the costs going up tremendously for people. So even though I'm retired, I'm still engaged in that, representing the beautiful state of Michigan, which is geographically huge. Now I'm spending a lot of time up in northern Michigan, where our rural hospitals, frankly, have just been slammed. When we see hospitals that can no longer be full-service — cutting back on beds, becoming critical access, or losing the ability to deliver babies or provide other needed services — that's just plain wrong and deeply concerning to me.

Richard Helppie

Critical access hospitals have been kind of a political football that's been kicked around a lot, and they're necessary. Economically, though, they don't pencil out just from caring for people in their communities.

Debbie Stabenow

Right. And actually, when you look at the local hospital — I should tell you, I got interested in healthcare because my mom was director of nursing at a small rural hospital in Michigan when I was growing up, and I saw how hard she worked as a nurse, and how hard the doctors worked. I also saw that the hospital was the biggest employer, and that's true today. Our hospitals up here are the biggest employers, whether it's Henry Ford in Detroit, Munson in Traverse City, or Marquette — they're the largest employers, and they're part of the reason people choose to live in a community, knowing they'll have access to healthcare through the hospital. That's a driver. But the most important thing is simply the care that people need. I'm a fundamental believer that healthcare should be a right, not a privilege, in this country. We can decide how it's structured, but it should be affordable and available.

Richard Helppie

I just want to punctuate and emphasize that point about the people who work inside healthcare. That's what attracted me to healthcare — the passion, the sense of service, the sense of mission. They're doing the best they can, but frankly, from a policy standpoint, we often impede them, if not outright prevent them, from doing their jobs. Now, you were a prime author of the Patient Protection and Affordable Care Act, which was reported to lower everybody's premiums by $2,500 and let people keep their own doctor. That didn't quite work out. If you had to go back and look at that legislation, what parts would you keep, and which parts would you modify?

Debbie Stabenow

Well, first of all, I wanted to see a public Medicare option to keep private insurance companies honest with real competition on price. I think we were close, but we were a couple of votes short of making that happen, which would have been a significant change in terms of competition. On the positive side, I think not allowing insurance companies to drop people with pre-existing conditions is incredibly important. As the author of a number of the essential-care provisions, including women's healthcare, I can tell you we had a big debate in the Finance Committee, where being pregnant was viewed as a pre-existing condition. Prior to the Affordable Care Act, you had to get a rider if you thought you might become pregnant, or you paid a penalty and couldn't get healthcare. About half of the insurance companies in the country didn't offer prenatal and pregnancy care. So one of the things I did was make sure the essential services included women's healthcare. I'll never forget, in the Finance Committee, a colleague of mine from Arizona, Senator Kyl, moved to strike that out. He said, "We shouldn't have to pay for things we don't use — I don't need women's healthcare." And I said, "Yeah, but I bet your mom did." Everybody responded the way you're responding right now, and we defeated it. But it just goes to show — one of the fallacies around healthcare policy is that you can somehow disconnect things. It's all connected, whether it's research, prevention, or primary care. And that's also one of the problems with cutting any piece of it — you just end up increasing emergency room care.

Richard Helppie

That's a strong point. In the many discussions I've had about healthcare policy, no matter where people are coming from on the political spectrum, they understand that employer-sponsored healthcare is a thing of the past. It worked maybe when someone went to work for a company, stayed for 40 years, and retired from there. We have so many tax-supported healthcare programs — Medicare, Medicaid, the VA — and nobody wants to touch that third rail. We'd be a lot more efficient if we just made it one plan, paid for on a sliding scale through your 1040, alongside Medicare Part B, and called it solved.

Debbie Stabenow

But there are so many interests within all of this — private sector interests and others — that healthcare is really complicated. It shouldn't be complicated. As consumers, we don't want it to be complicated. We just want to know it's there when we need it, that we can afford it for ourselves, our kids, and our parents, whether it's the beginning of life or the end of life. But for many reasons — more than we could cover on this podcast — it's complicated, and it's been tough to change.

Richard Helppie

Indeed. Where do you see some of the opportunities for change now that are politically viable?

Debbie Stabenow

Well, right now the problem is you've got two parties — one that just wants to cut everything. The Medicaid cuts have already happened, and there's talk of privatizing Medicare or prioritizing the VA without having a seamless system. So you've got one group that's very negative toward healthcare coverage in general, and then you've got the other side that wants to provide healthcare but argues over what that means. Does that mean Medicare for All? Does that mean a public option as one of the choices? What does that even mean? But the biggest problem is deciding, as a country, that healthcare is something we should design so everyone has the access they need and it's affordable — that it's not a frill. We're still debating, as a country, whether healthcare is a frill, and yet we all know it's not. Nobody individually would think it was, but it shouldn't depend on whether you're wealthy or whether you've had the same long-term job that let you get healthcare through your employer. The politics of healthcare frustrates me so much because it's just a common need, and we should be approaching it from that standpoint.

Richard Helppie

But didn't Medicare Part D work out pretty well?

Debbie Stabenow

It did, except for the provision the pharmaceutical companies got in that prevents Medicare from negotiating price. Every other country negotiates the best price for prescription drugs — we pay more than anybody else in the world. But the pharmaceutical industry is one of the two most powerful lobbies in Washington, and they got language in prohibiting Medicare from negotiating. That was the big problem right there.

Richard Helppie

So was the debate around whether it was the manufacturer, the distributor, or the retail level — or was it just across the board?

Debbie Stabenow

No, they were able to get language in to stop all of it. And then we had PBMs — pharmacy benefit managers — come in as another layer, supposedly to help save on costs, so there's a whole other thing that happened there.

Richard Helppie

Senator, any final thoughts for our wonderful audience?

Debbie Stabenow

I have to say, I think the folks providing our care — the doctors, the nurses, the folks at the hospital, the hospital itself — those are the ones on the front line. They have to deal with all the regulations, all the payment cuts, everything coming at them. And yet they're the ones working hard every day, trying to figure it all out so they can provide care for people in their community. So I just want to give them a big thank you, every day.

Richard Helppie

Well, let me amplify that thank you to the caregivers — the doctors, the nurses, the radiology techs, the laboratory techs, the phlebotomists, the transport staff who wheel you in, the people who shovel the snow. Wait a minute — we don't get that, do we? With our guest, the distinguished Senator Debbie Stabenow, on behalf of the Michigan Health and Hospital Association and the Common Bridge podcast and Substack page, this is your host, Rich Helppie. Thank you for joining us on the Common Bridge, where we continue to seek clarity across divided lines. Subscribe and support the Common Bridge on Substack, YouTube, and wherever you listen to your favorite podcasts. Until next time, we invite you to stay informed, stay engaged, and help build a bridge of common understanding.