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Maryland’s Health Insurance Marketplace Access Delayed for Undocumented Immigrants
Plans to allow undocumented immigrants access to Maryland’s state health insurance marketplace have been postponed until 2028. This decision comes in response to recent federal policies impacting immigrants and the overall uncertainty in health care markets.
Impact of Federal Policies on Maryland’s Health Care
During a joint virtual session of the Senate Finance and House Health and Government Operations committees, officials discussed how recent federal policies are expected to raise health insurance costs, create access barriers, and reduce federal funding for Maryland. The meeting also explored potential state responses to these changes.
Michele Eberle, executive director of the Maryland Health Benefit Exchange, expressed her disappointment over the delay in implementing the Access to Care Act, citing recent federal developments as a significant factor.
Current Access and Future Changes
At present, undocumented immigrants can purchase health plans directly from insurers but cannot use the Maryland Health Benefit Exchange to compare options. The 2024 Access to Care Act aimed to change this by allowing undocumented residents to access the marketplace for plan comparisons. This was contingent on obtaining a federal waiver, which was secured during President Biden’s administration.
Although the law would not have provided federal subsidies to undocumented residents, it would have enabled them to use the marketplace to evaluate their insurance options. However, due to the Trump administration’s policies and changes in health care funding, the exchange has decided to delay this access until 2028.
Challenges and Legislative Responses
Eberle noted, “We worked diligently under the previous administration to ensure approval, but unforeseen requirements like the Marketplace Integrity Rule and HR 1 have necessitated this delay.” These regulations overhaul parts of the Affordable Care Act, requiring states like Maryland to allocate resources to comply with new mandates.
The Marketplace Integrity Rule also reversed a decision that classified DACA recipients as “lawfully present,” affecting their access to federal health care subsidies. This change impacts approximately 300 DACA recipients in Maryland who currently benefit from these subsidies.
Rising Insurance Costs and Temporary Solutions
Insurance Commissioner Marie Grant highlighted the expected rise in insurance premiums, partly due to the anticipated expiration of pandemic-era federal tax credits. In September, the Maryland Insurance Administration approved an average premium increase of 13.4% for the next year, a significant burden for many families.
Health care advocates worry that the expiration of these credits will lead to people dropping their coverage due to unaffordability. Although the General Assembly has approved temporary state subsidies to offset these costs, analysts warn that these are not long-term solutions.
Urgency for Congressional Action
Grant emphasized the urgency for Congress to extend the tax credits, which is central to the current government shutdown debate. “The clock is ticking,” she stated. “Without immediate action, it may be too late to adjust rates for 2026 plans.”
