The Maryland House of Delegates this week passed four bills backed by Democrats to ensure health care protections for state residents under the Trump administration.
Since taking office in January, Republican President Donald Trump has made numerous changes to health care. Funding reductions to a navigator program that helps people enroll in health insurance plans. A proposal shortening the Affordable Care Act’s enrollment period. Potential funding cuts to Medicaid.
Ahead of the impact on Maryland residents, legislators have pushed ahead four bills to preserve those protections, all of which are now in the Senate for review.
House Bill 718, sponsored by Baltimore City Del. Samuel Rosenberg and Del. Joseline A. Peña-Melnyk, who represents Prince George’s and Anne Arundel counties, would establish the Maryland Health Insurance Coverage Protection Commission.
The 21-member group would be responsible for monitoring changes to the Affordable Care Act, Medicaid, Medicare, the federal Mental Health Parity and Addiction Equity Act, the Maryland Children’s Health Program, and the Maryland All-Payer Model, assessing their impacts, and recommending actions to protect access to affordable health care coverage. It would also be required to submit annual reports.
If the Affordable Care Act were repealed, more than 600,000 Marylanders could become uninsured, according to the bill.
It’s not the first time lawmakers have sought to establish this commission. The bill is essentially a “reintroduction” of legislation brought forward eight years ago, Rosenberg said, which was at the outset of Trump’s first term in office. The commission produced six reports and concluded in 2023.
“I just think circumstances make clear how essential it is that we have a separate body conducting an ongoing review of Medicaid during the interim,” he said at the bill’s hearing in February.
The legislation establishing the commission would take effect June 1 and end June 30, 2029.
House Bill 974, sponsored by Montgomery County Del. Emily Shetty, would require the Maryland insurance commissioner to require each carrier to provide coverage for certain preventive services without cost-sharing requirements, consistent with recommendations and guidance in effect on Dec. 31, 2024, weeks before Trump took office.
Those services include immunizations, certain health screenings and birth control.
“This bill guarantees that Maryland will continue to make health care decisions based on evidence, and it also ensures that preventive services will continue to save lives,” Shetty said at the bill hearing.
House Bill 1045, sponsored by Peña-Melnyk, Montgomery County Del. Bonnie Cullison, Prince George’s County Del. Ashanti Martinez and Baltimore County Del. Jennifer White Holland, updates legislation passed in 2017 that ensured the continuity of family planning services in Maryland.
The measure changes the definitions of “legally protected health care” and “sensitive health services” to include gender-affirming care. It gives the state’s insurance commissioner and the Maryland Commission on Civil Rights the authority to address discrimination in health insurance.
“History has shown us that the risk of waiting to react is really difficult, that it’s difficult to anticipate what’s going to happen next,” Peña-Melnyk said. “This bill allows us to deal with the ripple effects of these health care disruptions that are going to come — because it’s not if they’re going to come, it is when they’re going to come — and for us to be ready.”
House Bill 1082, sponsored by Peña-Melnyk, Cullison and White Holland, creates a state-based health insurance subsidy program to mitigate the potential impact of reductions to federal advance premium tax credits. The program would maintain affordability for people purchasing health benefit plans through the Maryland Health Benefit Exchange.
The premium tax credits will remain in effect until the end of 2025 but will be eliminated at the end of the year if Congress does not take action, which could lead to rising health insurance premiums and loss of coverage. If the tax credits are extended through 2026 and 2027, though, the Maryland legislation would be repealed with no action from the legislature.
Michele Eberle, executive director of the Maryland Health Benefit Exchange, spoke in favor of the bill at a February House Health and Government Operations Committee hearing. She pointed out that the loss of these tax credits would sharply increase monthly premiums.
“Not only will this provide coverage continuity and individual market stability, but it will give the nearly 250,000 Marylanders who have purchased their own health insurance peace of mind,” she said.
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