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MD General Assembly Convened January 10, 2024

UULMMD Legislative Priority for 2024 is Access to Care

Access to Care Act -- HB 728 / SB 705

The proposed bill, which was introduced in the 2022 and 2023 sessions as well, will remove immigration status as a barrier to health care insurance coverage through the Affordable Care Act (Obamacare). Currently, 112,400 undocumented immigrants, many of whom, despite working and paying millions of dollars in federal, state and local taxes, are ineligible to enroll in health insurance coverage.

This bill will allow Marylanders to purchase health coverage from the MD Health Benefit Exchange regardless of their immigration status. This bill was introduced last year. passed the House of Delegates but did not get voted out of the Senate Finance Committee.


ACA currently excludes undocumented residents from accessing state exchanges. However, the ACA includes a State Innovation Waiver Program, Section 1332, that allows states to modify ACA requirements to bypass the Federal immigration prohibition, establishing a program that will allow qualified residents to enroll in Qualified Health Plans at no cost to the state.

Further Reading


According to the Kaiser Family Foundation, Non-citizens are significantly more likely than citizens to be uninsured. In 2019, among the non-elderly population, 25% of lawfully present immigrants and more than four in ten (46%) undocumented immigrants were uninsured compared to less than one in ten (9%) citizens. Among citizen children, those with at least one non-citizen parent are more likely to be uninsured compared to those with citizen parents (9% vs. 5%)


Read the full Kaiser Family Foundation assessment.

The Journal of the American Medical Association reported a study that found Low-income immigrants healthcare use and cost remains low, refuting the widely held belief that providing insurance to immigrants imposes a heavy fiscal burden. The study found that providing insurance to immigrants costs the health care system less than half the corresponding cost for US-born adults ($3800 vs $9428 per person per year).

Read the full JAMA Report HERE


Read the MD Health Benefit Exchange info HERE
Read about the 1332 waiver info HERE
Read CASA's info HERE

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