Maryland leaders warn of potential $2B Medicaid cuts due to House proposals

The Prince George's County Board of Health convened on June 17, 2025, to discuss significant changes proposed in the House reconciliation bill that could impact Medicaid coverage for local residents. The meeting focused on the implications of these changes, particularly concerning work requirements and eligibility checks for Medicaid recipients.

The primary agenda item addressed was the introduction of work requirements for individuals in the Medicaid expansion population, which includes nearly 60,000 residents of Prince George's County. Under the proposed changes, these individuals would need to demonstrate proof of work—approximately 80 hours per month—every month to maintain their Medicaid coverage. This requirement is expected to create bureaucratic hurdles, potentially leading to a loss of coverage for an estimated 56,000 adults in the county. The discussion highlighted that many Medicaid recipients are already employed, and those who are not often have valid reasons, such as caregiving responsibilities.

Additionally, the meeting revealed concerns about increased eligibility checks. Currently, Medicaid recipients undergo annual checks, but the new proposal would require biannual checks for the expansion population. This change could result in approximately 130,000 Marylanders losing coverage due to the increased frequency of eligibility verification, contributing to what is known as "churn" in the Medicaid program.

The financial implications of these proposed changes are substantial. The Maryland Department of Health estimates that the state could lose between $1 billion to $2 billion in federal funds, significantly affecting healthcare services and local economies. The meeting underscored the potential for increased uncompensated care for hospitals and healthcare providers, which could strain the healthcare system further.

Another critical point of discussion was the proposed penalties for states that provide coverage for undocumented children and families. Maryland's Healthy Babies Equity Act, which offers coverage to pregnant individuals regardless of documentation status, could face penalties that might lead to a loss of $400 million in federal funds.

The meeting concluded with a call for innovative solutions to manage the anticipated administrative burdens resulting from these changes. The Board expressed a commitment to exploring technology and other resources to streamline processes and maintain coverage for vulnerable populations.

Overall, the discussions at the Board of Health meeting highlighted the potential risks associated with the proposed Medicaid changes, emphasizing the need for careful consideration of their impact on residents' health and the broader community.