Dual-Eligible Exposure in Michigan
County-level view of Michiganders enrolled in both Medicare and Medicaid. Dual-eligible residents are exempt from P.L. 119-21 work requirements. This map shows where they live.
This page combines measured public data with projections from named sources. All projected values are labeled and dated. accessmi.org does not produce original forecasts; we surface the most current publicly available data from CBO, GAO, MDHHS, MLPP, CBPP, USDA, and other named sources.
Dual-eligible residents are exempt from P.L. 119-21 work requirements. This map shows where they live.
Dual-eligible individuals enroll in Medicaid through the aged (65+) or disabled pathway — not through ACA expansion. P.L. 119-21 §71119 work requirements apply exclusively to expansion enrollees ages 19–64. Michigan's approximately 335,000–405,000 dual-eligible residents are categorically exempt from these provisions. This feature shows the geographic distribution of this protected population, providing context for the county-level Medicaid and SNAP coverage-at-risk maps. Full methodology →
Statewide dual-eligible population
~335,000–405,000
Michigan dual-eligible residents enrolled in both Medicare and Medicaid (range from MACPAC 2022, KFF 2024/2025)
Statewide totals across multiple sources and years
Most current public data: MACPAC Data Book December 2025, CY 2022 (MACPAC) / 2024–2025 (KFF).
83
Michigan counties with dual-eligible data (ACS B27010 5-year 2023)
Complete statewide coverage
Most current public data: U.S. Census Bureau ACS B27010 5-year 2023, 2023.
~864
Median Michigan county dual-eligible population (ACS)
Half of Michigan counties have more, half have fewer
Most current public data: U.S. Census Bureau ACS B27010 5-year 2023, 2023.
County breakdown
Proportional allocation from state range | Proportional allocation from state range | ||
|---|---|---|---|
| Wayne | 56,727 | 87,721 | 106,051 |
| Oakland | 19,110 | 29,551 | 35,726 |
| Macomb | 18,598 | 28,760 | 34,769 |
| Genesee | 11,315 | 17,497 | 21,153 |
| Kent | 10,843 | 16,767 | 20,271 |
| Muskegon | 4,968 | 7,682 | 9,288 |
| Ingham | 4,893 | 7,566 | 9,147 |
| Saginaw | 4,631 | 7,161 | 8,658 |
| Washtenaw | 4,532 | 7,008 | 8,473 |
| Calhoun | 4,118 | 6,368 | 7,699 |
| Kalamazoo | 3,796 | 5,870 | 7,097 |
| Berrien | 3,692 | 5,709 | 6,902 |
| Jackson | 3,364 | 5,202 | 6,289 |
| St. Clair | 3,246 | 5,020 | 6,068 |
| Ottawa | 2,803 | 4,335 | 5,240 |
| Bay | 2,795 | 4,322 | 5,225 |
| Monroe | 2,436 | 3,767 | 4,554 |
| Livingston | 1,824 | 2,821 | 3,410 |
| Van Buren | 1,775 | 2,745 | 3,318 |
| Newaygo | 1,767 | 2,732 | 3,303 |
| Allegan | 1,764 | 2,728 | 3,298 |
| Lenawee | 1,756 | 2,715 | 3,283 |
| Tuscola | 1,734 | 2,681 | 3,242 |
| Midland | 1,672 | 2,586 | 3,126 |
| Eaton | 1,639 | 2,535 | 3,064 |
| Grand Traverse | 1,635 | 2,528 | 3,057 |
| Lapeer | 1,584 | 2,449 | 2,961 |
| St. Joseph | 1,544 | 2,388 | 2,887 |
| Montcalm | 1,482 | 2,292 | 2,771 |
| Shiawassee | 1,360 | 2,103 | 2,543 |
| Alpena | 1,256 | 1,942 | 2,348 |
| Ionia | 1,253 | 1,938 | 2,342 |
| Clare | 1,231 | 1,904 | 2,301 |
| Cass | 1,218 | 1,883 | 2,277 |
| Delta | 1,059 | 1,638 | 1,980 |
| Barry | 989 | 1,529 | 1,849 |
| Isabella | 979 | 1,514 | 1,830 |
| Iosco | 967 | 1,495 | 1,808 |
| Mecosta | 917 | 1,418 | 1,714 |
| Marquette | 909 | 1,406 | 1,699 |
| Hillsdale | 875 | 1,353 | 1,636 |
| Gladwin | 864 | 1,336 | 1,615 |
| Wexford | 842 | 1,302 | 1,574 |
| Sanilac | 836 | 1,293 | 1,563 |
| Mason | 819 | 1,266 | 1,531 |
| Osceola | 791 | 1,223 | 1,479 |
| Huron | 780 | 1,206 | 1,458 |
| Chippewa | 779 | 1,205 | 1,456 |
| Branch | 778 | 1,203 | 1,454 |
| Emmet | 713 | 1,103 | 1,333 |
| Manistee | 711 | 1,099 | 1,329 |
| Ogemaw | 695 | 1,075 | 1,299 |
| Oceana | 683 | 1,056 | 1,277 |
| Roscommon | 657 | 1,016 | 1,228 |
| Menominee | 653 | 1,010 | 1,221 |
| Lake | 640 | 990 | 1,196 |
| Cheboygan | 622 | 962 | 1,163 |
| Otsego | 620 | 959 | 1,159 |
| Clinton | 571 | 883 | 1,067 |
| Houghton | 564 | 872 | 1,054 |
| Arenac | 550 | 851 | 1,028 |
| Gratiot | 530 | 820 | 991 |
| Gogebic | 513 | 793 | 959 |
| Dickinson | 479 | 741 | 895 |
| Kalkaska | 479 | 741 | 895 |
| Benzie | 467 | 722 | 873 |
| Montmorency | 437 | 676 | 817 |
| Missaukee | 425 | 657 | 795 |
| Antrim | 423 | 654 | 791 |
| Iron | 401 | 620 | 750 |
| Crawford | 393 | 608 | 735 |
| Presque Isle | 388 | 600 | 725 |
| Charlevoix | 359 | 555 | 671 |
| Mackinac | 324 | 501 | 606 |
| Oscoda | 292 | 452 | 546 |
| Alcona | 255 | 394 | 477 |
| Baraga | 227 | 351 | 424 |
| Leelanau | 203 | 314 | 380 |
| Schoolcraft | 198 | 306 | 370 |
| Alger | 193 | 298 | 361 |
| Ontonagon | 189 | 292 | 353 |
| Luce | 186 | 288 | 348 |
| Keweenaw | 50 | 77 | 93 |
Most current public data: ACS B27010 5-year 2023 × MACPAC/KFF statewide range (335,000–405,000), 2023. ACS dual-eligible count: B27010_046E (ages 35–64) + B27010_062E (ages 65+) per county. Allocated low/high: county ACS share × statewide range endpoints (335,000 / 405,000). ACS statewide total used as denominator: 216,635. Full methodology → | |||
Related coverage-at-risk analyses
- SNAP Coverage at Risk — county-level exposure to P.L. 119-21 ABAWD provisions (methodology)
- Medicaid Coverage at Risk — county-level exposure to P.L. 119-21 work requirement provisions (methodology)