The League of Women Voters of Maryland believes that accessible, affordable, equitable, quality health care should be available to all Maryland residents. League healthcare advocates will continue to actively support this goal during the 2026 legislative session.

Recent federal actions are making it harder for Marylanders to afford health insurance. In 2025, about 250,000 Marylanders were enrolled in ACA (Obamacare) health plans offered by the Maryland Health Benefit Exchange (MHBE). Almost 200,000 of those enrollees had been getting help paying their monthly premiums through the federal enhanced premium tax credit program. But because Congress allowed that program to expire on 12/31/25, those healthcare premiums will become much more expensive. Without the enhanced subsidies, many thousands of lower-income residents will be unable to pay the substantially higher costs, and will drop coverage. The adverse effects of this will affect all Marylanders, raising costs for everyone.

Of note, a bipartisan majority in the U.S. House of Representatives voted on 1/8/2026 for a three-year extension of the enhanced subsidies. As of this writing, the measure is in the Senate for consideration. While the bill is not expected to pass the Senate, its unexpected success in the House reinforces one of the League’s key missions: the importance of contacting your elected representatives with your concerns. It is thought that pressure from constituents led some members of the House to change their votes and support the subsidies.  

In order to mitigate the impact of the projected (and now realized) reduction in federal premium tax credits, last year the Maryland General Assembly passed a bill to establish a state-based health insurance subsidies program. The LWVMD submitted testimony in favor of that bill, as well as for legislation to continue providing additional state premium assistance to low-income young adults aged 18 to 37. 

But because the state budget deficit is higher than had been projected, Maryland will not be able to fully replace the federal aid for all enrollees who had been receiving it. Ongoing uncertainty about future changes to Medicaid eligibility and enrollment included in the federal reconciliation act (H.R.1: One Big Beautiful Bill Act), set to take effect 1/1/2027, will result in additional thousands of Marylanders losing their health coverage.  The League will continue to support legislative efforts to help more Marylanders obtain and keep their health insurance, now and in the future.

Maryland is facing major healthcare access difficulties:

• While the League supported the 2024 Access to Care Act, enabling non-citizens to purchase state Marketplace health coverage, the implementation date was recently pushed back from 11/1/25 to 2028.
• Building the administrative framework to handle the planned 2027 changes to the Medicaid program will cost Maryland millions of dollars in 2026. These are dollars that could have been used to deliver actual health care.
• Planned Medicaid cuts will adversely affect low-income rural areas in particular. Maryland was only allotted $168M of the special $50B federal contribution to rural health care that had been designed to offset those Medicaid losses. This is the seventh lowest amount granted to a state.
• Residents in Maryland’s long-term care facilities will be adversely affected by CMS’ (Centers for Medicare and Medicaid Services) recent repeal of minimum nursing home staffing requirements. And Marylanders seeking care in hospital Emergency Rooms continue to be faced with some of the longest wait times in the nation. 

In 2026, League healthcare advocates will study and support initiatives to:

• Increase the availability of behavioral health care for children and adults
• Support measures to improve healthcare quality and protect patients’ rights in Maryland’s hospitals and long-term care facilities
• Increase consumer protections around medical debt collection
• Expand the healthcare workforce
• Support science-based public health measures, including maintaining vaccine availability and affordability, in keeping with Maryland’s participation in the Northeast Public Health Collaborative
• Ensure the availability of equitable reproductive and maternal-child health care throughout the state