Renewed Push to Expand Healthcare for Undocumented Marylanders

TL/DR –

Thousands of uninsured, undocumented immigrants in Maryland could potentially gain access to private health insurance through the state’s marketplace, pending renewed efforts by some members of the House of Delegates. The proposed Access to Care Act would prompt the Maryland Health Benefit Exchange to file a federal waiver allowing undocumented Marylanders to purchase and use individual health care plans, similar to a bill from the 2023 session that previously stalled in the Senate. However, even if the Act becomes law, affordability could still be an issue for many undocumented immigrants due to the high cost of the plans currently offered on the marketplace.

Maryland Delegates Work Towards Health Insurance Access for Undocumented Immigrants

In Maryland, thousands of undocumented immigrants lack health insurance for routine medical needs. Some members of the House of Delegates are attempting to enable these individuals to purchase private health insurance via the state’s insurance marketplace.

Referred to as the Access to Care Act, this legislation is similar to a bill from 2023 that passed the House of Delegates but stalled in the Senate. The Act would request the Maryland Health Benefit Exchange to file a federal waiver allowing undocumented Maryland residents to purchase and use individual health care plans. Federal laws currently restrict undocumented residents from enrolling in federally-funded insurance or buying coverage via the ACA marketplaces.

Expounding on the idea, Michele Eberle, the Executive Director for the Exchange, said the waiver has been approved in other states, allowing all residents to access health care through the exchange, regardless of their documentation status. It is estimated that approximately a third of the 300,000 uninsured Marylanders lack proper documentation.

Del. Bonnie Cullison, who filed the legislation, believes the Act would be beneficial to both families and the state. She argued that having more healthy people in the insurance pool stabilizes insurance rates. Insurance companies, she added, have expressed that expanding health care options to undocumented immigrants would be good for business.

Maryland’s emergency room wait times, some of the worst in the country, could also be mitigated as people gain access to primary and preventive care.

However, there are concerns about affordability should the Access to Care Act pass. Many undocumented immigrants might struggle to afford the plans offered on the marketplace. Providing health coverage to undocumented populations could cost Maryland taxpayers billions, according to health department analysts. As such, lawmakers suggest it’s unlikely that state funds will create required subsidies in the 2025 budget. The Act includes a provision authorizing future legislatures to create such subsidies if they choose.

Senate President Bill Ferguson stressed that the current focus is on normalizing the state budget amidst multiple financial pressures. “In a world of inexhaustible resources, it would be an easy answer, but we have a lot of competing pressures,” he said.

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