Maryland regulators tell Health and Government Operations Committee ACA, reinsurance and subsidies cut uninsured rate and kept premiums low

Acting Maryland Insurance Commissioner Marie Grant and Michelle Everly, executive director of the Maryland Health Benefit Exchange, told the Health and Government Operations Committee on a joint briefing that federal and state actions tied to the Affordable Care Act have lowered Maryland's uninsured rate and helped keep marketplace premiums among the lowest in the nation.

"The Affordable Care Act has really helped lower our uninsured rate," Marie Grant said, noting Maryland's uninsured rate fell from about 10.2 percent in 2013 to about 6.3 percent in 2023. She reviewed state and federal consumer protections that now apply in Maryland, including essential health benefits, guaranteed issue, prohibitions on annual and lifetime limits, and limits on cost sharing for preventive services.

The briefing focused on three policy levers the presenters said have driven those results: Maryland's reinsurance program, state-level protections that mirror federal requirements, and enhanced premium tax credits created by the American Rescue Plan Act and extended through the Inflation Reduction Act. Everly described enrollment and program outcomes from the exchange, Maryland Health Connection.

Why it matters: Committee members pressed for details about how these programs affect premiums, provider participation and health outcomes. Committee members were told reinsurance and program…