A five-part health agenda for Maryland’s legislature | GUEST COMMENTARY

Deciding to go to the doctor or undergo treatment should be based on what’s best for your health, not your pocketbook. But for a significant number of Marylanders who lack insurance, seeing a doctor or receiving care from a hospital carries potentially dire financial risk.

While Maryland has cut its uninsured rate in half and is one of the best states in the nation in making health care affordable, 6% of our population remains without health care coverage — hundreds of thousands of people. Without coverage, they often go without the care they need.


Some of the uninsured can’t afford it. Others are unaware of affordable insurance options. And some are stuck in limbo because of their immigration status; they work and pay taxes, but may not be eligible for coverage through the state of Maryland.

Congress recently took important action, passing the Inflation Reduction Act, which provides major support to make health insurance more affordable for many Americans. Now it’s time for Maryland to act and make sure every state resident has affordable health insurance. The General Assembly can make enormous progress toward that goal in 2023 by passing a five-part health agenda.


1. Subsidize coverage for young adults

To begin, we must continue to make health insurance affordable, and that includes extending state subsidies to bring down costs for young adults. A 2021 law sponsored by Sen. Brian Feldman and Del. Ken Kerr established a two-year program of health subsidies for lower income adults ages 18 to 34. That policy should be put in place permanently. Over 29,000 young people are benefiting now from this program and Maryland should do all it can to make sure that they and many others get the health care coverage they need.

2. Expand access regardless of immigration status

Maryland should also expand health coverage to state residents regardless of their immigration status. Sen. Clarence Lam and Del. Bonnie Cullison will introduce legislation that will allow people to purchase health coverage from the Maryland Health Benefit Exchange regardless of immigration status. A second bill would mandate a study about expanding Medicaid coverage to all income-eligible Marylanders.

3. Automatically enroll SNAP recipients in Medicaid

Another bill sponsored by Sen. Malcolm Augustine and Del. Lorig Charkoudian will automatically enroll people who receive SNAP (formerly known as food stamp) benefits into Medicaid. Many low-income Marylanders who receive SNAP benefits are also eligible for Medicaid but may not be enrolled. This common-sense bill would reduce the paperwork burden on low-income families and streamline their ability to get coverage.

4. Educate small businesses on affordable options

Maryland must also make sure employers — as well as their workers — know about affordable insurance options. Legislation sponsored by Sen. Katie Fry Hester and Del. Robbyn Lewis will appropriate funds to allow the Maryland Health Benefit Exchange to educate small businesses about how to get their presently uninsured employees enrolled in affordable plans. We encourage employers who don’t already offer health coverage to let their employees know that they have until Jan. 15 to get enrolled by going to


5. Fund the Maryland Prescription Drug Affordability Board

Finally, we can help to bring down health costs by fully funding the Maryland Prescription Drug Affordability Board. The first of its kind in the nation, the Board will play a key role in bringing down the costs of expensive medications over the next several years, and it’s critical to make sure that the Board has the funding it needs to do its work well.

Expanding insurance gives more Marylanders access to affordable care, ensuring that a health problem won’t cause financial distress. It’s the right thing to help Marylanders stay healthy. But it’s also the right thing to do to build a stronger health care system in Maryland. When people are uninsured, they often miss out on primary care. Untreated issues grow more complicated, and people often end up in the emergency room for care.

That is the most expensive way for our system to provide care, and it leads to uncompensated costs for hospitals and other providers. That in turn drives up costs to the system, which increases premiums for all the Marylanders with coverage. In short, getting every Marylander covered by health insurance will bring down costs for all, and that should be our goal.

Maryland has long been a leader in innovative health policies that have expanded access to care and brought down costs, but we still have work to do. With the Gov.-elect Wes Moore and Lt. Gov-elect Aruna Miller committed to leaving no one behind, one of the best Health Benefit Exchange teams in the nation and strong health care leaders in the General Assembly, Maryland has the opportunity in 2023 to make significantly more progress toward our goal of quality, affordable health care for all Marylanders.

Vincent DeMarco ( is president of the Maryland Health Care for All! Coalition.