5 Michigan cities voted to create ‘health action’ boards. Now what?
[November 12, 2026]
By SIMON D. SCHUSTER and ROBIN ERB/Bridge Michigan
Amid growing concerns over medical costs, voters in five Michigan cities
last week approved measures to create new citizen-led boards that will
recommend ways to lower costs and improve healthcare policies.
How the boards will function is not clear, nor is the source of funding
for the successful ballot campaigns. Liberal “dark money” groups spent
nearly $3 million on the initiatives, which were spread across two
toss-up congressional districts represented by Republicans who lost
their reelection bids.
But with healthcare costs top of mind for many, voters agreed to
establish “citizens’ advisory health action” committees by wide margins
in Benton Harbor ( 80% approval ), Lansing ( 66% approval ), East
Lansing ( 69% approval ), Kalamazoo ( 69% approval ) and Portage ( 55%
approval ).
Now, it’s up to local governments in those cities to set up the boards,
prompting fears of additional costs and uncertain outcomes.
“If the voters want it, then we’ll set up a committee and we’ll do it,”
Lansing Mayor Andy Schor told Bridge Michigan ahead of the election,
expressing ambivalence and acknowledging the proposals made a political
point.

The cities will be limited in how much they can impact a sprawling
national healthcare system with mind-numbing complexities, often opaque
financing and Medicaid eligibility changes that are expected to reduce
coverage and cost providers millions of dollars.
But the new committees will be able to advise officials whose policies
could support local health providers in ways that drive down costs, said
Ryan Cohn, a spokesperson for City Action Michigan, the nonprofit
driving the effort.
“Voters sent a clear message,” said Cohn, who works for a Florida-based
public relations firm, Sachs Media. “They want action on healthcare
costs, and they’re done waiting for Congress to deliver it.”
A late-October poll of Michigan voters showed high costs were a top
concern, with health insurance or medical costs the primary driver.
Local amendments, local concerns
The local proposals amended city charters to create seven- or
eight-member committees to:
1. Hold public forums to hear firsthand accounts from community members
about how healthcare costs affect them
2. Hold public forums to learn more about the role of federal and state
policies in determining healthcare costs
3. Track federal and state officials’ votes on healthcare legislation
4. Prepare a “Healthcare Action Plan” for city leaders by Oct. 1 of each
even-numbered year
City councils then must hold public hearings by Oct. 15 of the same year
for public discussion on the action plan. Advisory committee members
will not be paid for their efforts, but must have necessary “research,
analytical and community engagement skills,” according to the new rules.
Some local officials have called the effort misguided.

In October, the Kalamazoo City Commission passed a resolution
unanimously opposing the local ballot measure. In public meetings, Mayor
David Anderson expressed concerns about the ongoing financial burden
organizing and running health advisory committees might impose on
taxpayers.
“Who’s gonna pay for all this work going forward in perpetuity? City
residents,” Anderson said. “The cost of this will end up being a
reduction in resources for something else that we might care a lot
about.”
Kalamazoo Commissioner Chris Praedel criticized the use of dark money to
push the proposal, warning that it was “critically important for the
public to think through how this sets a precedent or how this could
impact things in a very dark, mischievous way.”
It’s unclear how much the initiative will cost cities going forward.
Committee members aren’t paid, although they can be compensated for
costs, according to ballot language.
“I would not envision it would be a lot,” said Alex Little, city manager
in Benton Harbor.
Political impact
The proposals were notable for the way that they intertwined policy and
electoral advocacy — the amendments were only proposed in largely
Democratic cities within battleground congressional districts — and
campaign advertising prominently attacked the Republican incumbents.
Those lawmakers, US Reps. Tom Barrett and Bill Huizenga, were both
unseated in close races in the Nov. 3 election. Democrats Will Lawrence
and Sean McCann will replace them in Congress, respectively.
Critics suggested the petition drives used to put the proposals on local
ballots were designed to collect voter data and spread negative
information about the incumbents.
In an election where Democrats saw sweeping gains, approval rates for
the ballot proposals in the five liberal-leaning cities generally lagged
behind support for major Democratic candidates like Gov.-elect Jocelyn
Benson.
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 Chokwe Pitchford, a Berrien County
commissioner whose nonprofit was paid by City Action Michigan to
build support for the proposals, dismissed concerns that the
initiative could set a precedent where municipal government itself
becomes a platform for political advocacy.
“Everyone has access to these tools, and if the other side wants to
push a ballot proposal about the Second Amendment or about pro-life
policies — if the voters vote for it, that’s democracy,” Pitchford
said in an interview.
The only representative of the City Action Michigan (formerly
Community Action Michigan) that the campaign had not reported paying
as of mid-October, Texas Charter Township trustee Barb Hammond,
declined repeated requests for an interview with Bridge.
What’s next?
Local officials are now attempting to figure out how the new
committees will work and what their responsibilities are.
Municipal advisory boards or committees tend to focus on specific
city operations like parks, libraries or transit systems, said
Little, the Benton Harbor city manager. But “this is more of a study
group to understand price and services for healthcare,” he said.
Benton Harbor faces another challenge, he said: The city’s hospital
closed 40 years ago, and the city — one where the median income is
just above $31,000 and among the lowest in the state — may not have
enough residents with healthcare and financing backgrounds to serve
on the board.
Moreover, he and others said it might seem like local governments
can do little to shape healthcare policy. Benton Harbor’s public
health initiatives are run through the county health department, for
example.
And decisions in a national healthcare system with its “infinite
complexity” are mostly guided by federal and state policy, said
Scott Greer, a University of Michigan professor who researches the
ways in which political systems operate and shape health policy
decisions.
Still, the biennial reports that the committees produce will force
“hyper-local” conversations that otherwise might not happen, Greer
said.

A community might explore how much emergency care is provided to
homeless people, and therefore shift policy to extend more routine
care to the homeless as a way to keep chronic conditions in check,
Greer suggested as an example. That could be a cost saving for the
system as those patients then rely less on expensive emergency room
care.
Benton Harbor, meanwhile, is facing hundreds of thousands of dollars
in extra costs to pay for ambulance services because so many local
patients are uninsured, said Little, the city manager. Perhaps an
advisory committee focused on healthcare can find a solution, he
mused.
Cohn, at City Action Michigan, said the advisory committees can also
offer collective voices that can reach Lansing.
Pitchford, in Berrien County, argued the reports can be tailored to
“the preconditions of your community.”
“You might have an infant mortality crisis, you may have an obesity
crisis, you may have pollution in the water, pollution in the air,”
he said. “How do we gather all of that information, put it into
something that is actionable, and take that to Lansing and to
Washington, (DC) so that citizens can lobby their government on
behalf of the changes to healthcare that they believe in?”
Spokespersons for East Lansing and Portage said city officials now
will review next steps.
The money
Through mid-October, the ballot committee for City Action Michigan
reported receiving $2.8 million in donations, exclusively from
dark-money nonprofits from outside Michigan not required to disclose
their donors.
They include American Opportunity Action, Cityscope, Global Impact
Social Welfare Fund and Global Impact Ventures — all of which have
been known to channel funding to liberal political initiatives while
masking donor identities.
Much of the funding was spent on ads supporting the proposals and to
pay canvassers who collected signatures to get the initiatives onto
local ballots.
City Action Michigan also disclosed giving $100,000 to Pitchford’s
501(c)(4) nonprofit, Berrien Forward.

Pitchford said the money, reported as a grant, was used to pay 17
canvassers to promote the proposals in Benton Harbor and Kalamazoo.
“These were older Black women from churches, young people who were
getting involved with the election process for the first time, who
got trained on knocking doors, and we used that funding to invest in
the election,” he said.
It’s a “fair criticism” to note that neither he nor the voters know
where the money came from, Pitchford acknowledged.
He said he makes “value-based assessments” when groups approach him
to work on their issues. “No funder, no group has ever asked me to
do anything that I don’t believe in,” Pitchford added.
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