As of June 30, 2025, Maryland Medicaid covers 1,508,710 participants, including 331,577 adults who qualify under the Affordable Care Act (ACA) expansion. H.R. 1 – One Big Beautiful Bill Act (OBBBA) passed by Congress and signed into law by President Trump will have substantial impacts on Marylanders.
Key Impacts of OBBBA on Maryland Medicaid:
- Major coverage losses: 175,000 Marylanders are projected to lose coverage.
- Significant funding cuts: In the future, Maryland will lose up to ~$2.7 billion in federal
funding annually when all bill provisions are implemented – note all provisions have
varied implementation dates and are not necessarily immediate (FY26 – FY34). The
majority of funding losses will be incurred over two years, beginning in FY 27 and FY 28
(period between July 2026 – June 2028). - Substantial new costs: Tens of millions of dollars needed to implement and administer
OBBBA requirements, particularly those pertaining to eligibility changes such as work
requirements.