Bills aiming to improve health care equity, access advance in General Assembly

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Bills aiming to get more Marylanders health coverage, improve access to behavioral health services and expand Medicaid coverage for gender-affirming health care have made strides in the General Assembly this legislative session.

Now that crossover day — the deadline for the House and Senate to pass bills to each other — is in the rearview mirror, lawmakers and advocates have a clearer picture of which bills are likely to end up on Gov. Wes Moore’s desk by the session’s conclusion April 10.


All five pieces of this year’s legislative agenda from the Maryland Health Care for All! Coalition have passed at least one chamber, making lawmakers and advocates hopeful that the measures will become law.

Most bills in a bipartisan Senate package that would bolster the state’s mental health care system also have moved forward, with many boosted by the support of cross-filed versions in the House.


And on Monday, after passing the House over the weekend, the Trans Health Equity Act passed the Senate, giving the bill a clear path to becoming law. Moore, who has been a vocal supporter of LGBTQ+ rights, is expected to sign the bill.

Bringing down cost of prescription drugs, expanding health coverage access

Though Maryland is one of the most well-covered states in the nation, there are still about 250,000 residents who don’t have health insurance, Moore said in his inaugural address. This legislative session, a group of Democratic lawmakers sponsored legislation to make health coverage more accessible and affordable.

House and Senate bills that automatically would enroll eligible SNAP recipients into Medicaid have each cleared one chamber. The legislation would help an estimated 65,000 uncovered Marylanders get insurance, while reducing paperwork, the Health Care for All! Coalition said Tuesday in a news release.

Another cross-filed measure — versions of which have also cleared the House and Senate — would extend a pilot program that provided state subsidies to decrease the cost of health insurance for young adults ages 18 to 34.

A bill that would allow people to purchase health coverage from the Maryland Health Benefit Exchange regardless of immigrant status has passed the House. And another measure, which would require the state to study how to expand Medicaid and the state’s Children’s Health Insurance Program coverage to all Marylanders and expand subsidies for private health coverage regardless of immigration status, has passed the Senate.

The Senate and House also passed versions of legislation that would confirm the authority of the Prescription Drug Affordability Board to set upper payment limits for prescription drugs that are purchased or paid for by state and local governments. And an additional $1 million for the board has been included in both the House and Senate versions of the budget.

Modernizing and improving access to Maryland’s behavioral health care system

The first bill to pass the Senate this year — SB003, which would fund the 988 suicide and crisis hotline through 2025 — was part of a seven-piece legislative package aiming to preserve telehealth access, strengthen home- and community-based services for children, and further study how the state could better deliver mental health care.

Last weekend, the House passed its own version of the 988 bill, which would require the governor to allocate $12 million to the hotline’s trust fund in 2025. Maryland is one of the only states in the nation to have a permanent funding stream for the crisis line — which Senate sponsor Malcolm Augustine, a Prince George’s County Democrat, said is “a demonstration of our values and our priorities.”


Another bill, SB534, would extend flexibilities in telehealth policies implemented earlier in the pandemic through June 2025. That means providers could continue to be allowed to deliver standard health care by telephone, without video, and be paid at the same rate for in-person and telehealth care.

SB534 has passed the Senate and is being reviewed by the House Health and Government Operations Committee.

Two measures have passed the Senate to create pilot programs for funding behavioral health care. One program to be run by the Maryland Department of Health would test a model for care based on rewarding providers for positive outcomes.

The other would create a similar value-based pilot program for children with complex behavioral health needs. With the goal of keeping kids out of the emergency department and allowing them to be cared for at home, that bill also would require the state health department to expand access to and provide reimbursement for certain wraparound, intensive in-home and case management services.

Another bill, SB101, would expand the “collaborative care” model in Maryland, which encourages health care centers to offer mental health and physical treatments in the same location. The legislation, which has passed the Senate, would require Medicaid to provide reimbursement for services offered under the model in primary care settings statewide.

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On Monday, the House passed a multi-faceted bill that would “attempt to get a handle on how Maryland delivers mental health and drug treatment services,” said Del. David Moon, a Montgomery County Democrat who sponsored the bill.


The state needs to improve its behavioral health and drug treatment system, which currently results in too many people winding up in the emergency department or the criminal justice system, Moon said.

HB1148 would force a system-wide audit by convening a state commission to identify gaps in the behavioral health care continuum and make recommendations for ways to bolster community-based, preventative services and limit emergency department visits and interactions with law enforcement.

Expanding access to gender-affirming health care

The Trans Health Equity Act, which passed the House and Senate by wide margins and has Moore’s support, would allow transgender, nonbinary, intersex and other gender-diverse Marylanders who are enrolled in Medicaid to get coverage for comprehensive gender-affirming care.

Though Maryland Medicaid already covers some gender-affirming treatments, the bill would expand the list of covered procedures to include services such as voice modification surgery and lessons, laser hair removal and fertility preservation.

The number of Medicaid recipients seeking gender-affirming treatment would increase by about 25 per year if the bill passes, according to the legislation’s fiscal and policy note. Last year, 98 people received gender-affirming treatment through Medicaid.

Republican lawmakers who opposed the bill proposed amendments that would have barred children under 18 from receiving gender-affirming care and would have required both custodial parents to grant permission for their child to receive such care, but those were rejected.