Maryland Health Insurance Changes Bring Cost Hikes and Access Barriers

As Marylanders navigate the current open enrollment period for health insurance, state officials emphasize that higher costs represent just one aspect of significant changes affecting coverage accessibility. Michele Eberle, executive director of the Maryland Health Benefit Exchange, urged consumers to carefully review their plans during a recent webinar, noting that multiple factors are converging to create challenges for approximately 300,000 residents. The expected expiration of popular federal tax credits for health care plans at year's end creates what Eberle described as a triple whammy of factors that could force difficult decisions, including going without insurance entirely.

Maryland Health Secretary Meena Seshamani identified raised premiums as a continuing problem if Congress fails to extend tax credits created during the COVID-19 pandemic. Insurance carriers requested an average 17.1% rate increase accounting for anticipated enrollment loss if tax credits expire, though the Maryland Insurance Agency ultimately approved a 13.4% average increase affecting all health benefit exchange participants. Some lower-income marketplace purchasers may see partial relief through state subsidies approved by the General Assembly to replace expiring federal credits, but those earning over 400% of the federal poverty level face significant impacts without assistance.

The Marketplace Integrity Rule from the Centers for Medicare and Medicaid Services has revoked DACA recipients' classification as lawfully present individuals, barring approximately 300 immigrants from accessing the Maryland Health Benefit Exchange after they gained marketplace access during the previous enrollment period. Additionally, around 18,000 lawfully present immigrants with incomes below 100% of the federal poverty level will lose tax credits that previously made health care more affordable. Eberle encouraged those facing coverage loss to utilize current benefits fully, noting that 2025 plans remain valid through year-end.

While much attention focuses on rising costs, Eberle highlighted that Maryland's subsidy for young adults aged 18-37 continues, helping maintain a healthier insurance pool. Current enrollment patterns also provide some temporary relief, as this marks the final year of an extended open enrollment window before federal policy shortens the period from November 1 through December 31 starting in 2026. Marylanders who need coverage beginning January 1 must commit to a plan by December 31, while those requiring additional time have until January 15 for February 1 coverage start dates.

Looking further ahead, another significant change arrives in 2028 when federal policy eliminates automatic enrollment in coverage. Currently, individuals with ACA marketplace plans who take no action are auto-renewed in the same plan if available, but future requirements will mandate manual renewal confirmation each year. Eberle expressed concern that without awareness of this change, coverage lapses could leave people ineligible for health insurance until the following year. Despite maintaining auto enrollment for two more years, officials strongly recommend all consumers review their coverage options given premium increases and evolving eligibility requirements.