The state of Maryland’s House has passed a bill that would allow individuals to purchase health insurance through the state’s healthcare exchange, regardless of their immigration status. This will be made possible with the approval of a federal waiver.

The bill was passed by the House with a vote of 101-34 and will now be sent to the Senate. Similar legislation is currently being reviewed by the Senate.

The proposal mandates that the Maryland Health Benefit Exchange file a federal waiver request by July 1, 2025, in order to implement the program. This waiver is necessary due to federal limitations on the use of the marketplace by undocumented immigrants. Washington state was granted a similar waiver from the Centers for Medicare and Medicaid Services in late 2022. If a waiver is approved, the program in Maryland could potentially begin as soon as 2026.

The state of Maryland established its healthcare exchange in the 2011 legislative session with the purpose of offering a platform for individuals and small companies to buy reasonably priced health insurance. Using the Maryland Health Connection, residents of Maryland have the option to browse and compare rates for different health insurance plans.

According to Del. Joseline Pena-Melnyk, who leads the House Health and Government Operations Committee, Maryland has reduced its uninsured population by over 50% by implementing its health care exchange under the federal Affordable Care Act and expanding Medicaid. This decrease has brought the number of uninsured residents down from approximately 756,000 to 350,000, which accounts for about 6% of the state’s total population.

According to Pena-Melnyk, approximately 256,000 of the individuals in the state who do not have health insurance are undocumented immigrants. She noted that despite their status, these immigrants contribute to the state by working and paying taxes, and will also be responsible for the cost of their insurance plans if they enroll through the exchange.

Pena-Melnyk emphasized the importance of preventive medicine, noting that it is more cost-effective and beneficial for everyone. She also clarified that it is not free.

Del. Mark Fisher, a Republican from Calvert County, argued that US citizens in Maryland often face lengthy wait times for doctor’s appointments. He questioned the rationale behind the state’s decision to extend health insurance coverage through the exchange to non-citizens.

Fisher expressed frustration with the concept of health equity, stating that it holds no weight if individuals are unable to see a doctor. He believes it is absurd that this is the reality for many people in Calvert County and across the state. Fisher cannot comprehend why non-citizens should be prioritized over American citizens when it comes to accessing healthcare.

According to Pena-Melnyk, this proposal would benefit everyone. Currently, individuals without health insurance often seek medical treatment at emergency rooms, resulting in higher medical expenses.

According to Pena-Melnyk, a Democratic representative from Prince George’s County, our state has the longest emergency room wait times in the country, resulting in hospitals spending between $120 million and $150 million on uncompensated care last year. This has led to significant cost savings for us.