Michigan Gubernatorial Candidate John James Supports GOP Health Plan
John James, a Republican candidate for Michigan governor, has endorsed a party initiative to reduce the Affordable Care Act (ACA) and introduce health savings accounts (HSAs) as a replacement. This proposal has raised concerns among experts who fear it may lead to increased premiums and reduced coverage.
During a November 10 event facilitated by Americans for Prosperity, a known opponent of the ACA, James commended a bill proposed by Florida Senator Rick Scott. “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.”
To grasp the potential effects of Scott’s bill, it’s crucial to understand the current structure of Obamacare and the health insurance system.
Under the existing framework, private insurers distribute medical costs across a broad demographic, a practice known as pooling risk. Healthy individuals generally pay premiums that help subsidize the care of those who are sick or require extensive treatment.
The ACA promotes the purchase of private insurance by offering subsidies to lower premium costs, thereby maintaining wide risk pools and steady premiums. These insurance plans are available through government-run exchanges.
Scott’s proposed More Affordable Care Act suggests that some individuals eligible for Obamacare could opt for a government-funded HSA. These accounts could be used for insurance plans or certain out-of-pocket medical expenses.
According to a statement from Scott’s office, “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 professor at the University of Virginia, criticized Scott’s perspective. In an interview with Politico, Layton argued that this plan might cause a sharp decline in Obamacare enrollments and reduced insurance options for remaining participants.
Similarly, Jonathan Gruber, an economist at MIT, suggested that healthier individuals would most likely abandon Obamacare, which would diminish risk pools and lead to premium increases for the rest. Gruber noted, “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.”
James has previously expressed intentions to dismantle Obamacare, as evidenced by his 2020 U.S. Senate campaign, where he decried the Republican “failure to repeal and replace Obamacare” and pledged to “remove this monstrosity.”
Scott’s bill is part of broader efforts to tackle the impending expiration of enhanced ACA subsidies, initially introduced under the 2021 American Rescue Plan by President Joe Biden. These enhancements are set to expire on December 31, potentially raising premiums for 22 million Americans.
Democrats in the House and Senate have proposed extending these subsidies for three more years, a measure opposed by Republicans like James and Scott.
In Michigan, nearly half a million residents could face premium hikes in 2026. State Senator Kevin Hartel highlighted these concerns during an October 22 hearing, stating, “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.”
James is among several candidates vying for the Republican nomination for Michigan governor in 2026, with primary elections set for August 4.
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