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Montgomery Cares and Care for Kids report rising use; officials warn Medicaid changes could push thousands to county safety net
Summary
Montgomery Cares and Care for Kids are serving tens of thousands of patients, and county health officials warned that pending Medicaid changes for expansion adults—about 46,000 residents locally—could push thousands onto the county safety net, which lacks capacity to absorb a mass shift.
County public-health officials described the current clinical safety net and warned that proposed federal and state Medicaid changes could shift many residents onto county programs.
Dr. Davis and DHHS staff reported that Montgomery Cares served 22,729 unique patients with over 63,000 encounters as of April 30, FY25; the program had reached 88% of the FY25 budgeted encounters and was expected to exceed 76,000 encounters by month-end. Unduplicated patient counts rose 10% and encounters rose 13% compared with April FY24. About 8% of Montgomery Cares encounters were delivered by telehealth, and the county operates 11 health centers that participate in the program.
Care for Kids provided about 6,300 unique children with 7,400 encounters as of April in FY25. Officials said unduplicated participants were projected at about 10,000 for the year (initial FY25 projection had been 12,000); a point-of-entry program closure at Rocking Horse and immigration-related enrollment dynamics were cited as factors affecting projections.
DHHS staff told the Council that changes proposed for Medicaid would primarily affect expansion adults—about 46,000 Montgomery County residents—and that administrative burdens could cause a third to a half of those individuals (staff estimated 15,000–20,000) to lose coverage, potentially increasing demand on Montgomery Cares. Officials cautioned Montgomery Cares would have limited capacity to absorb a large influx and that losing Medicaid enrollees also reduces clinic revenue streams and could threaten provider solvency.
Officials said they are coordinating regionally with neighboring jurisdictions, philanthropic partners and the Council to prepare for possible shifts in coverage and are monitoring pending legislation closely.
