Feel free to change any and all of this as you wish. Text in red contains instructions and text in green points to consider as you draft what you want to say. 

You will notice that the letter begins by ensuring the person taking your phone call or reading your letter understands that you know about the governor. 

Next, I thank the governor for taking action on a specific issue that protected Michigan’s citizens. 

I then ask them to take action to help BCBSM choose a different strategy with their PPO mental health providers to support their constituents in Michigan. 

Feel free to edit, but keep that format. It is helpful.

Good luck! Sincerely, Dr. Burns

Your name, your credentials
Your address
Your phone
Your email

X/XX/26

Dear Governor Whitmer:

Thank you so very much for protecting the citizens of Michigan as Governor. I appreciate that you have worked tirelessly to raise the minimum wage to $15 per hour by January 2027, establish the Earned Sick Time Act requiring paid leave for workers, advocate for capping medical debt interest rates at 3%, and prevent wage garnishment for unpaid medical bills. 

As a graduate student in Western Michigan University’s Clinical Mental Health Counseling program, I hope you will also agree to protect Michigan’s citizens by intervening to stop BCBSM’s proposed PPO changes to incident-to billing in private practice settings.
I have dedicated years of my life to preparing for a career serving individuals, couples, families, and communities struggling with depression, anxiety, trauma, addiction, suicide, and other serious mental health concerns. I chose this profession because I believe every person deserves access to compassionate, qualified mental health care.
Today, I am deeply concerned that I may not even be able to complete my education or begin my career because of a recent policy change announced by Blue Cross Blue Shield of Michigan (BCBSM). While this may sound like a technical insurance change, its consequences are anything but technical. This policy threatens the future of thousands of aspiring mental health professionals like me and, more importantly, the future mental health workforce that Michigan desperately needs.
Graduate students in Clinical Mental Health Counseling programs are required to complete extensive practicum and internship experiences before graduation. These placements are not optional—they are mandatory for earning our degrees and eventually becoming licensed professionals. Many of these internship opportunities exist within private practices because they provide students with high-quality supervision, diverse clinical experiences, and exposure to real-world outpatient mental health care.
If private practices can no longer afford to train interns because BCBSM will not reimburse services provided under appropriate supervision, many internship sites will simply disappear. Without an internship placement, students cannot graduate. Years of education, thousands of dollars in tuition, and countless hours of preparation could be placed on hold indefinitely through no fault of our own.
Even if I am fortunate enough to graduate, my concerns do not end there.
Like every future Licensed Professional Counselor in Michigan, I must first practice under supervision while working toward independent licensure. Most limited licensed counselors gain those supervised clinical hours in private practice settings. If those practices can no longer employ limited licensed clinicians because BCBSM refuses reimbursement for services delivered under legally required supervision, many graduates—including me—may have nowhere to work.
This policy is not simply limiting reimbursement. It is threatening the entire professional pipeline that Michigan depends upon to produce future independently licensed mental health providers.
Removing private practice as a major training environment places the future of our entire behavioral health workforce at risk.
What makes this especially frustrating is that practical alternatives already exist. Michigan deserves a solution that protects patients without sacrificing the next generation of mental health professionals.
I entered this profession knowing it would require years of education, supervised clinical training, licensing examinations, and ongoing professional development. I accepted those challenges because I believe this work matters.
What I never expected was that an insurance company—not my university, not my licensing board, and not Michigan law—might become the reason I cannot complete my internship or begin my career.
At a time when anxiety, depression, substance use disorders, suicide, and trauma continue to affect countless Michigan residents, we should be expanding opportunities to train mental health professionals—not eliminating them.
This issue is about more than my future. It is about every graduate student preparing to serve Michigan's families, every limited licensed clinician working toward independent practice, every supervisor committed to training the next generation, and every patient who deserves timely access to mental health care.
Suddenly, in early June of 2026, BCBSM announced that they would no longer cover services for their PPO plan when treatment is provided by counselors, social workers, marriage and family therapists, and psychologists who are working towards independent licensure through something called incident-to billing in private practice settings. 

1. BCBSM claims this change is “to strengthen their ability to identify rendering providers.”
Currently, BCBSM is choosing not to allow interns and limited-licensed mental health practitioners to be paneled directly through its PPO plan. However, all interns and limited-licensed mental health practitioners can apply for an NPI number. If BCBSM allowed these individuals to be directly paneled with them, then BCBSM would know exactly who was directly providing mental health treatment to the client. 

2. BCBSM claims that they want to “improve oversight of quality of care.” However, BCBSM does not determine how any of those professions supervise their members working towards their independent licensure. Ethical codes for each of those professions set guidelines, as do Michigan state law rules and codes for all of those professions. For example, even if BCBSM makes this change, all supervision requirements for a Limited Licensed Professional Counselor remain exactly the same whether the supervisee works in a hospital or a private practice setting. 

3. BCBSM claims that they want to “ensure reimbursement is appropriately aligned with provider licensure and participation status with Blue Cross PPO and BCN.” BCBSM is now saying it is making its PPO plan equivalent to its HMO plan. What this comes down to is BCBSM doesn’t want to pay the supervisor, who has legal and ethical responsibilities for the patient the supervisee is treating, and who is also furthering the supervisee’s training through extensive consultation with the supervisee.

BCBSM wants to make it harder for patients on the PPO plans to get a mental health counseling appointment. This will result in far fewer places where PPO plan members can get mental health treatment, which will increase wait times for treatment, and people will have to travel farther to receive it. 

BCBSM flippantly states that a private practice can convert to an Outpatient Psychiatric Care Facility (OPCF) if it wants to bill for interns and graduates working toward independent licensure. However, BCBSM requires an OPCF to have a board-certified or board-eligible psychiatrist on staff. However, Michigan is currently 880 psychiatrists short, according to the National Center for Health Workforce Analysis (NCHWA). Most of our mental health private practices have just a couple of providers, and it’s not feasible for them to hire new staff from so many different professions. Further, those facilities must have emergency services available 24 hours a day. That’s just not financially feasible. 

Additionally, BCBSM flippantly states that all interns and individuals who have graduated and are working toward independent licensure can simply go to work at a hospital, an OPCF, or an MDHHS community mental health facility. In talking with MDHHS, they can’t accommodate all of these people. So again, this is also impossible.

But let’s look at how many limited licensed providers we currently have in Michigan. 
7,296 Social Workers
2,471 Counselors
   489 Psychologists
   144 Marriage and Family Therapists
10,400 Total

That’s not even talking about the folks doing practicums and internships within their graduate programs. And while some of those folks work in hospitals or in OPCF and MDHHS community mental health facilities, the majority do not. 

What’s really troubling here is that there are several ways BCBSM PPO could solve the “problem” they themselves created without reducing the number of mental health treatment providers. I’m just going to list a couple.

First, as I’ve mentioned, interns and limited licensed mental health practitioners can apply for an NPI number. And if BCBSM would allow them to be paneled directly with them, they could bill directly, and BCBSM would know exactly who is providing mental health treatment to the client. However, if BCBSM takes this route, they’ll pay the limited-licensed provider much less for seeing a client, and then they’ll force supervisors to charge supervisees for supervision directly. The supervisee is getting less money, and they’ll have to pay out of pocket for their own supervision. It’ll be a difficult hardship for the supervisee.

Second, Blue Cross Blue Shield of Illinois (BCBSI) is taking a very different track. They are recognizing the current and upcoming shortage of mental health treatment providers. They’re allowing covered services rendered by the supervisee to be billed under the supervising licensed clinician’s NPI (National Provider Identifier). BCBSI requires that the supervisor be available to the supervisee 100% of the time, enabling the supervisor to provide direction and intervene in the event of an emergency. Supervisors may supervise up to 4 trainees at a time, and the supervisee must receive the required minimum individual safe face-to-face supervision in compliance with Illinois state licensure requirements specific to the trainee’s level of licensure. So BCBSI is deferring, as they should, to Illinois state law for those professions, and they stipulate that supervisors and supervisees should work within the same organization or system. BCBSI also has a rule that the supervisee doesn’t make a direct payment to the supervisor for supervision while they’re pursuing their clinical hours for state licensure. Clearly, BCBSI recognizes the importance of the supervisory relationship and the ethical, legal, and consulting responsibilities of that supervisor to the supervisee. 

Clearly, there are many other ways BCBSM could be handling this, and it’s very telling that they are not. 

The reality is that BCBSM is now willfully cutting off access to over 10,000 limited licensed mental health practitioners in Michigan, making it harder for rural and underserved populations to receive care, resulting in longer wait times for mental health treatment for everyone who’s in their PPO plan in Michigan. Additionally, BCBSM is willfully cutting off the pipeline of licensed mental health practitioners that Michigan will have in the future. 

Please meet with BCBSM to get them to change this policy, hold legislative hearings on it, request impact studies, and require briefings for health policy committees.
Thank you for your time, your leadership, and your commitment to the people of Michigan. I sincerely hope you will stand with students, educators, mental health professionals, and the citizens who depend on us by advocating for a solution that preserves access to care and protects Michigan's future behavioral health workforce.
Sincerely,
Your name, your credentials