Feds strip thousands of immigrants living in Maryland of Medicaid coverage

About 4,500 immigrants legally living in Maryland lost their Medicaid coverage Thursday in the first wave of federal cuts that state officials estimate will ultimately cost many more people their health insurance.

Certain immigrants were specifically barred from Medicaid, the federal-state healthcare plan for low-income people. Known as the One Big Beautiful Bill Act, the federal law was signed into law by President Donald Trump on July 4, 2025.

Children and pregnant people living lawfully in the state aren’t affected, and the adults who lose their coverage may still be eligible for emergency care, according to the Maryland Department of Health.

More broadly, many Medicaid recipients will face new work requirements and extra rounds of paperwork to prove their eligibility. State officials estimate the new measures will affect about 320,000 Marylanders — with as many as 152,000 people losing coverage next year.

State health officials say those who lose Medicaid coverage will be able to buy plans on the Maryland health exchange. However, Maryland insurance regulators have approved a second consecutive year of hefty premium increases.

State insurance officials said last week that the average plan’s cost will rise 14.6%, slightly more than the increase the previous year. Those increases prompted many to downgrade to plans with lower monthly premiums and higher out-of-pocket costs.

Immigrants who have been cut from Medicaid will not be eligible for subsidies through the exchange, which have already been slashed across the board for everyone.

State officials have been scrambling since the Trump budget bill passed to ensure more people don’t lose coverage. They say those who are uninsured and underinsured will make more trips to emergency rooms, but won’t be able to pay. That will strain the healthcare system and drive up costs for everyone.

The higher health exchange rates affect about 482,000 Marylanders, or about 20% of the commercial insurance market.

State lawmakers last year enacted several measures to address the rising cost of healthcare, including temporary state-based subsidies that replaced some federal subsidies that the Republican-led Congress allowed to expire. A special commission formed to address healthcare affordability issues has also been meeting in Annapolis to consider proposals for the next legislative session, including a panel member’s plan to raise revenue to help cover healthcare costs.