Health Care and Child Care Costs in Michigan: How these expenses affect child support calculations under the law in Michigan

I. INTRODUCTION

In Michigan, the calculation of child support involves more than simply determining how much one parent pays the other each month. Under the state’s guidelines, the governing statute, and an evolving body of case law, child support must reflect the costs of a child’s health care and child care in addition to basic needs. These supplementary costs — health insurance premiums, uninsured medical expenses, daycare or before-/after-school care — play a critical role in ensuring the child’s welfare is protected, while balancing parental financial responsibilities. This blog explores how health care and child care costs are treated under Michigan law, how they are integrated into child support orders, and how the courts interpret and apply the relevant rules. By analyzing statutory provisions, administrative guidelines, and key Michigan appellate decisions, this guide aims to clarify how these expenses affect child support in practice.

Under MCL 552.605(2), “The court shall order child support in an amount determined by application of the child support formula developed by the state friend of the court bureau….” This establishes that child support must be calculated in accordance with the Michigan Child Support Formula (MCSF), unless a deviation is justified and explained on the record.

More specifically, MCL 552.605a(2) requires courts to ensure that one or both parents provide health-care coverage for the child if it is “accessible to the child and available to the parent at a reasonable cost.” The same section provides that the court must designate which parent is responsible for coverage and how uninsured expenses are to be divided. In addition, MCL 552.611a allows for income withholding to cover health-insurance premiums, medical support, and child-care expenses, ensuring enforceability.

These statutory commands are supplemented by the Michigan Child Support Formula Manual, adopted by the State Court Administrative Office and revised regularly. The manual defines medical support as including both (a) health-insurance premiums and (b) uninsured medical expenses, and it defines child-care costs as “work-related child-care expenses necessary for a parent’s employment, education, or job search.”

II. THE MICHIGAN CHILD SUPPORT FORMULA AND ITS APPLICATION

The MCSF provides that the total child-support obligation consists of three parts, the base support amount, the medical support component (health-insurance premiums and uninsured medical expenses), and the child-care support component.

Courts are required to include all three elements in their calculation. The Formula states that “medical support must be ordered whenever accessible coverage is available to a parent at a reasonable cost.” (§ 3.04 of the MCSF). It further provides that uninsured expenses, such as co-payments, deductibles, prescriptions, dental, and vision costs, “shall be divided between the parents in proportion to each parent’s income.”

For child-care expenses, § 3.06 of the MCSF explains that such costs should be included when “necessary for a parent’s employment or reasonably necessary education.” The cost is shared between the parents according to their proportional incomes.

This framework ensures fairness: a parent earning 70 percent of the household income bears 70 percent of the uncovered medical and daycare costs.

III. HEALTH-CARE COVERAGE AND MEDICAL SUPPORT OBLIGATIONS

The requirement for health-care coverage in Michigan child-support orders is mandatory when feasible. The law seeks to ensure that every child has health-insurance protection.

MCL 552.605a(2) explicitly provides, “The court shall order one or both parents of the child to obtain or maintain health-care coverage that is accessible to the child and available to the parent at a reasonable cost.” This statutory command has been reinforced in Michigan appellate decisions emphasizing the need for specificity and fairness in allocating medical costs.

1. The Importance of Clear Judgment Language

   
   

The Michigan Court of Appeals addressed a dispute over whether a father was obligated to pay insurance premiums in addition to half of uncovered medical costs. The divorce judgment required him to pay “50 percent of all health-care expenses not paid by insurance.” The mother argued that this included insurance premiums. 

The Court of Appeals disagreed, holding that the language of the judgment is clear and unambiguous; defendant was required to pay fifty percent of all health-care expenses not paid by insurance, and that language does not encompass the cost of the insurance premiums themselves.

This decision clarified a recurring ambiguity in Michigan judgments — that unless an order explicitly states a parent must pay insurance premiums, the obligation to pay “uninsured medical expenses” does not automatically include those premiums. Furthermore, the need for precision in drafting support judgments and for distinguishing between premiums (insurance cost) and uninsured expenses (out-of-pocket medical costs).

2. Enforcement of Medical Support Orders

   
   

When a parent fails to maintain ordered health-care coverage, enforcement mechanisms exist. Under MCL 552.611a, the Friend of the Court can issue a National Medical Support Notice (NMSN) to the parent’s employer requiring automatic enrollment of the child in the parent’s employer-sponsored health plan and payroll deduction of premiums.

This process, also required under federal regulations (45 CFR 303.31), ensures that the child receives consistent medical coverage. The Michigan Department of Health and Human Services’ Child Support Manual § 6.06 explains that the NMSN must be issued promptly and that employers are required to comply.

IV. UNINSURED MEDICAL EXPENSES AND COST ALLOCATION

Uninsured medical expenses — co-pays, deductibles, and uncovered services — often create the most disputes between parents. The MCSF provides a clear framework for allocating these costs: each parent must pay a share proportionate to their income.

For example, if the father earns 60 percent of the combined income and the mother earns 40 percent, the father is responsible for 60 percent of uninsured medical expenses. This is consistent with the analysis contained in the Michigan Legislature’s 2001 House Bill 6009 analysis, which stated, “Any uninsured health-care expenses of the child should be apportioned between the parents, based on the ratio of their incomes.”

Courts and Friend of the Court offices across Michigan apply this formulaic method. Failure to follow this rule, or failure to order such a split, can constitute reversible error. In Ewald v. Ewald, 292 Mich.App. 706, 810 N.W.2d 396 (Mich. App. 2011), the Court of Appeals reaffirmed that the trial court must adhere to the MCSF or state sufficient reasons for deviation. The court emphasized that any departure from the formula — including omission of medical-cost allocations — must be justified on the record.

The Ewald court stated that a trial court may deviate from the child-support formula only if it determines that application of the formula would be unjust or inappropriate and states the reasons for its deviation. Thus, both statutory law and case law make clear that allocating uninsured medical costs according to income shares is not discretionary — it is required unless the court articulates a deviation.

V. CHILD-CARE COSTS IN MICHIGAN CHILD-SUPPORT ORDERS

Child-care expenses are often among the largest recurring costs for working parents, and Michigan’s child-support system accounts for them comprehensively.

Under the MCSF § 3.06, child-care expenses necessary for a parent’s employment, job search, or education are included in the total child-support obligation. The costs are divided between parents in proportion to their incomes, mirroring the rule for medical expenses.

The statute recognizes that child-care costs fluctuate, particularly for young children or when one parent’s work schedule changes. The MCSF provides that the support amount should reflect “the average monthly cost of child-care expenses,” and the court may adjust support orders as costs rise or fall.

Michigan courts have consistently held that these expenses must be explicitly included and apportioned. In Burba v. Burba (After Remand), 461 Mich 637, 610 N.W.2d 873 (2000), the Michigan Supreme Court examined whether trial courts could deviate from the child-support formula without sufficient findings.

The case involved a child-care expense deviation and reaffirmed that the MCSF is presumptively correct. The Court explained that a trial court must follow the child support formula unless it articulates specific reasons why the formula would be unjust or inappropriate in a particular case. The Burba decision remains a cornerstone of Michigan child-support jurisprudence, emphasizing the mandatory nature of the MCSF and, by extension, the proper inclusion of child-care costs.

Similarly, in Peterson v. Peterson, 272 Mich App 511, 727 N.W.2d 393 (2006), the Court of Appeals reiterated that deviations from the child-support formula — including adjustments for child-care costs — must be supported by detailed findings. The court reversed and remanded because the trial court’s deviation lacked sufficient justification. The Peterson court declared that the court’s failure to articulate a reason for deviation from the child support formula is legal error requiring remand.

In other words, courts cannot simply ignore or estimate child-care expenses outside the formula. They must calculate them per MCSF guidelines or make explicit, fact-supported deviations.

VI. DETERMINING “REASONABLE COST” FOR HEALTH-CARE COVERAGE

The concept of “reasonable cost” is crucial under MCL 552.605a(2). The term is not fixed by statute, but the MCSF and administrative guidance suggest that health-insurance coverage is reasonable when the cost to the providing parent does not exceed six percent (6%) of that parent’s gross income.

Michigan’s Department of Health and Human Services (MDHHS) reinforces this rule in its publicly available materials, explaining that “the reasonable cost for providing private health-care coverage may not exceed six percent of the providing parent’s gross income.”

This threshold prevents courts from imposing unmanageable insurance costs on low-income parents while ensuring that children still receive adequate coverage when feasible.

VII. THE ROLE OF THE FRIEND OF THE COURT AND ENFORCEMENT

Michigan’s Friend of the Court (FOC) offices play a vital enforcement role. Each county’s FOC assists in calculating support, monitoring compliance, and enforcing medical and child-care provisions.

The FOC typically tracks whether health-insurance coverage has been obtained, whether uninsured medical reimbursements are being exchanged timely (usually within 28 days after the expense), and whether documentation for child-care expenses is provided.

The Uniform Child Support Order (UCSO) used statewide includes specific fields for “ordinary medical expenses,” “extraordinary medical expenses,” and “child-care costs.” The UCSO typically orders that each parent pay their proportional share of uninsured expenses based on the MCSF income percentages.

When a parent fails to maintain health-care coverage, the FOC may initiate a National Medical Support Notice to the employer, as required under federal and state law. Similarly, if a parent fails to pay their share of uninsured or child-care costs, the FOC can initiate enforcement actions, including contempt proceedings, income withholding, or tax-refund interception.

VIII. PRACTICAL EFFECTS ON PARENTS

For parents, understanding how health-care and child-care costs influence support is critical to financial planning and compliance.

When one parent carries employer-sponsored health insurance, the court typically allocates the premium cost proportionally. If, for instance, the insurance cost attributable to the child is $200 per month and the parents’ income shares are 60/40, the parent paying the premium may receive a $80 credit against support (reflecting the other parent’s share).

Uninsured medical expenses — for example, a $500 dental bill not covered by insurance — would be split according to the same 60/40 ratio. Similarly, if a custodial parent pays $600 monthly for daycare so they can work, the non-custodial parent’s share would be calculated proportionally, again ensuring fairness based on income.

This proportionality principle, enshrined in both statute and the MCSF, is designed to ensure children’s health and developmental needs are met while preventing either parent from shouldering an inequitable financial burden.

IX. DEVIATIONS AND JUDICIAL DISCRETION

While the MCSF is presumptive, Michigan courts retain discretion to deviate when strict application would be “unjust or inappropriate.” MCL 552.605(2), a court may deviate but must identify the formula support amount, state the reason for deviation, and explain how the deviation serves the child’s best interests.

In Ewald and Peterson, the appellate courts made clear that unsupported deviations constitute reversible error. For example, a trial court might deviate if a child has chronic medical needs resulting in exceptional uninsured expenses, or if a parent’s irregular work schedule produces fluctuating child-care costs. But such deviations must be explicitly justified on the record.

X. CONCLUSION

Michigan’s child-support system reflects a comprehensive approach that ensures children’s essential needs — including health care and child care — are consistently met. The governing statutes, the Michigan Child Support Formula, and judicial interpretations ensure that support obligations are equitable and transparent.

These authorities emphasize several unshakable principles: health-care coverage must be ordered when available at a reasonable cost; uninsured medical and child-care expenses must be allocated proportionally to income; and deviations from the formula must be expressly justified.

For practitioners, the take-away is precision. Orders should clearly delineate who provides insurance, how premiums and uninsured costs are divided, and how child-care expenses are shared. For parents, the lesson is documentation and communication — maintain receipts, follow timelines, and cooperate with the Friend of the Court.

Ultimately, Michigan’s combination of statutory clarity, formula precision, and judicial oversight provides a balanced system — one that promotes fairness to parents while keeping the best interests of Michigan’s children at the heart of every child-support determination.