That’s Washtenaw County commissioner Andy LaBarre’s emailed estimation of Michigan Republicans’ plan to privatize the state’s community mental health system. Senate majority leader Mike Shirkey’s bill would shift funding from the state’s ten regional plans to commercial health insurers, a change supporters say would make it easier for people to access care.

LaBarre predicts the opposite. In a follow-up phone call, he says the bill is “subverting not just local control but local expertise and local knowledge away from the mental health care system and is seeking to adopt this ever-present quest for quasi-corporate efficiency in the government.” If passed by the legislature’s Republican majority, he fears “a lessening of the quality of services” and a worsening of “the fundamental labor challenges of the mental health care system, which is you don’t have enough qualified people because we can’t pay them enough because the state and the feds have systemically underfunded” mental health care. 

“That is one of the scariest bills in this legislature in terms of mental health that I’ve seen,” says Trish Cortes, the county’s director of community mental health. “That would absolutely unravel the safety net that community mental health systems have worked over decades to weave in our local communities. 

“All the things that community mental health does in our local courts, in our housing and homeless, infrastructure in our schools, with law enforcement in our jails—and the list goes on and on and on—all of that is at risk to be completely unraveled.”

“That is one of the scariest bills in this legislature in terms of mental health that I’ve seen,” says Trish Cortes, the county’s director of community mental health. Photo by J. Adrian Wylie /

Cortes believes the Shirkey bill “is really all about a money grab” by private health insurers who want “to get their hands on … the publicly funded mental health budget.” While it “is being painted as an improvement to integrated health,” she says, “I do not believe that integrated physical and mental health happens at the payer level. That happens at the individual and provider level.”

State senator Jeff Irwin says that the Republican proposals “are getting a lot of attention, both because of the financial interest in privatization but also because we have real problems in our mental health system. We’ve been cutting holes in the social safety net, and people have been falling through for years and years and years.

 “I don’t think Shirkey’s bill is the solution. What Shirkey’s bill really focuses on is on the finance side rather than the service side. Rather than focusing on integrating the service at the level of the patient, it’s focused on integrating the payment system at the level of the insurance companies.”

If it passes in its current form, Irwin predicts Shirkey’s bill will be “dangerous to people with severe mental illness. It’s going to leave many of them without service. And it’s also gonna be putting a lot more pressure on their families … What I’m most worried about is taking someone who is severely and persistently mentally ill and asking them and their family to navigate [private insurance] and try to get the service that they need.”

“I worry with privatization that access to services is going to plummet,” says Ann Arbor state rep Felicia Brabec, a practicing psychologist. Instead, Brabec supports a series of house bills by Republican rep Mary Whiteford. These would also create a new statewide payment organization, but it couldn’t be for-profit, and care would still be provided through the CMH system. 

If approved, Whiteford’s bills would “allow us to work with folks who are in the mild to moderate category, not just severe and acute,” Brabec says. They would provide “a much clearer front door for folks seeking services” regardless of whether they have health insurance. The bills were reported out of committee with bipartisan support in March, and Brabec says she’s “optimistic” about their chances of passing the House. 

Irwin thinks the chances that Shirkey’s privatization bill will pass in its current form are “zero,” but the chances that something will pass are pretty high. “What can pass in this environment with divided government is gonna be a very negotiated solution,” he says. “Hopefully what we get is a solution that preserves the value of our locally accountable CMH operations.” 

Governor Gretchen Whitmer would need to sign off on any plan. Whitmer previously vetoed a provision Republicans inserted in the 2019 state budget that would have privatized part of the public mental health system. 

“Without major modifications, I expect her to veto [privatization],” emails Irwin. “If the bills are significantly altered in a way that preserves case management and local accountability, there will be much more support.”