Maryland hearing spotlights plan to use ACA segregated premiums to fund abortion grants

Delegate Leslie Lopez asked the House Health and Government Operations Committee on Monday to give HB 930 a favorable report, saying the bill would establish a public‑health grant program under the Maryland Department of Health to reimburse providers for abortion costs "without a penny from taxpayers." Lopez said the measure would draw on segregated accounts created under the Affordable Care Act that are earmarked for abortion coverage and that the Maryland Insurance Administration estimates hold about $25,000,000 now and generate roughly $3,000,000 annually.

Why this matters: Supporters said the fund would shore up access to abortion care amid closures and rising demand after the U.S. Supreme Court's Dobbs decision curtailed federal protections and as nonprofit abortion funds struggle to meet needs. Critics called the plan a state bailout of abortion providers and said it would compel private insurance policyholders to subsidize services they oppose.

Sponsor’s case: "This fund comes from surplus insurance premiums mandated by the Affordable Care Act," Delegate Leslie Lopez said in opening remarks. Lopez described the fund as a sustainable, non‑general‑fund source that would require MDH to award 90% of program funds to grantees for direct services and allow 10% for administration.

Medical and advocacy witnesses who testified in favor echoed that access gaps persist even in Maryland, where voters recently enshrined reproductive rights in the state constitution. Karen Nelson, president and CEO of Planned Parenthood of Maryland, said providers are seeing uncompensated care and capacity strain: "Having this fund would limit the stress that's put on providers and most importantly the patients themselves," Nelson said. Lynn McCann Yeh of the Baltimore Abortion Fund said demand has surged; her group estimates needing $6–7 million to meet client needs while operating on about $2 million.

State agencies and legal offices backed the concept. Dr. Nilesh Kalyanaraman, deputy secretary for public health at the Maryland Department of Health, said the department has worked with providers on an abortion access strategy and that grant funding would help cover services not fully met by insurance or Medicaid. A representative of the comptroller's office told the committee the proposal would be a "sustainable model" because it leverages funds dedicated to abortion coverage under federal ACA rules.

Opposition and concerns: Speakers from Maryland Right to Life, the Maryland Family Institute and other groups argued the measure would expand public support for abortion and raise moral and constitutional objections. Laura Boegely, executive director of Maryland Right to Life, called the bill a bailout that would "force state taxpayers to pay millions more each year to bail out abortion businesses." Speakers also raised questions about whether the money ultimately derives from taxpayer dollars via federal and state tax flows.

Process and privacy: Lopez and witnesses said the ACA‑created $1 per member per month accounts are kept separate by insurers and accrue interest; HB 930 would direct those segregated funds into the newly established Public Health Abortion Grant Program Fund. The bill would also include privacy protections for patient information and prohibit grantees from imposing restrictions inconsistent with law.

What the committee did: The hearing collected extensive testimony and closed with the chair noting committee members will deliberate; no formal committee vote on HB 930 was recorded at the hearing.

Context and next steps: Supporters said the program represents a non‑general‑fund way to stabilize access, while opponents argued it expands public subsidization of abortions. The committee will consider the testimony as it decides whether to advance the bill for floor consideration.