Maryland becomes the second state after Washington state to apply for a waiver from the federal government and open up its health care exchange to undocumented immigrants. Similar proposals have failed twice in Maryland in recent years due to concerns about the potential costs of expanding the market. In a victory for those who argue that adding more people to the exchanges would lower overall costs for consumers, the measure remained in effect until Friday, despite no promises of subsidies.
“Enabling them to buy health care reduces costs for all of us,” said Sen. Antonio Hayes (D-Baltimore City), one of the Senate bill's sponsors.
Last month, as advocates pushed for the bill, doctors told lawmakers that undocumented family members who postpone regular doctor visits because they don't have insurance are at risk. He complained that there is a possibility of falling into. Ligia Peralta, a pediatrician in Silver Spring, said she saw a 6-year-old child in late January with an untreated sinus infection that had spread to his skull. Peralta said initial infections are often mild, and doctors rarely see such emergencies. It is very easily cured.
“This is something that happens every day,” she said at a news conference last month. “What is a very mild problem that is irrelevant to many of us becomes a serious problem for many people who are uninsured.”
For many lawmakers, that story justified opening up the market, but Rep. David Frazier-Hidalgo, chair of the Legislative Latino Caucus, said he wanted to make sure more uninsured people had access. He said it makes economic sense to reduce the burden of uncompensated care in emergency rooms. Your own medical plan bill.
“It's a humane thing to do,” he said. “And it's going to save the state a lot of money.”
Federal law limits access to the public market established under the Affordable Care Act to citizens, U.S. citizens, and legal residents. Illegal immigrants are not allowed to buy health insurance there. But the federal government has indicated it is willing to grant state-level exemptions if states decide to open exchanges to illegal aliens.
Washington State in 2022 became the first company to request a waiver from the federal government to allow undocumented immigrants to buy health insurance on the state exchange. The company's marketplace will be open to these individuals for the first time later this year. Colorado also provides insurance to illegal aliens, but has created a separate program for that purpose.
Several states, including Oregon, California, New York, Connecticut, Vermont, Colorado, and Hawaii, also offer subsidized health insurance to undocumented children, often with state Medicaid. funds are used.
Maryland's bill passed the House of Delegates in February and is now ready to go to the governor's desk. If the federal waiver is approved, undocumented immigrants in the state could buy health insurance on the Maryland Health Benefits Exchange as early as 2026.
Sen. Clarence K. Lamb (D-Howard), a co-sponsor of the Senate bill, said, “As a child of immigrants, I think this bill is extremely important for people who otherwise wouldn't need to be cared for. ” he said.
The Legislative Service's analysis shows that the bill would not have an immediate fiscal impact because the Maryland Health Benefit Exchange would be able to launch the program using resources already allocated to the agency. Ta. The report noted that ongoing costs will depend on program parameters and whether the exchange ultimately gains authority to provide subsidies to low-income immigrants. This bill does not do that.
“This is not an act of charity toward illegal aliens,” said Democratic Rep. Joseline A. Peña Melnyk (D-Prince George’s), co-sponsor of the House bill and vice chair of the Legislative Latino Caucus. “To be clear, they will be paying full freight on the items they purchase.”
About 6% of people living in Maryland are uninsured, about 2% less than the national average, according to data from the Census Bureau's American Community Survey. Undocumented immigrants make up about 30% of the state's uninsured population, according to an analysis by the Maryland State Department of Health.
The bill was supported not only by the Legislative Latino Caucus, but also by a large coalition, including advocacy groups CASA and the Maryland Health Care for All Coalition.
“This will cost the state no money and will cover more residents, reducing the number of uninsured people we all pay high premiums for,” said Vincent DeMarco, president of the Maryland State Department of Health. “Everyone will benefit from less hospital care.” Take care of everything.
Some opponents of the bill, mostly Republicans, expressed concern that expanding the exchange to include undocumented immigrants could make wait times for doctor's appointments even worse. Other lawmakers, including minority Sen. Justin Ready (R-Carroll), said they oppose the bill because it does not address border security issues and could fuel border security issues. .
But advocates say uninsured people are more likely to seek routine care in emergency rooms because they can't turn them away, which contributes to Maryland's emergency department wait times (the worst in the nation). The government argued that this could further worsen the situation.
“This resident is being treated in the emergency room, so the emergency room is overcrowded,” Peña-Melnyk said. “This bill removes barriers to health insurance coverage.”
