The Affordable Care Act 2019 in Maryland and on the Eastern Shore

George Shivers • December 19, 2018

The period for signing up for the ACA for 2019 ended on December 15. Axios reports that this may be the worst season ever, certainly in part because of Trump administration policies, but also for other reasons. Sam Baker of Axios states that nation-wide, as of December 14, the number of people who had signed up through HealthCare.gov was down by 12% from the same time last year and down slightly from the year before.

On average, premiums are lower this year, and in many areas there are more plans to choose from. Axios attributes the decline in enrollment to the fact that although premiums have gone down, the coverage is still expensive and unemployment is low. The ACA program is primarily designed to provide access to health insurance to those who do not receive it through their jobs. Also contributing to the decline is the fact that the Department of Health and Human Services has severely cut the budget for advertising and enrollment outreach. It has also expanded short-term plans with minimal coverage that don’t have to cover pre-existing conditions, perhaps removing some healthy people from the ACA.

In our state, the Maryland Health Connection is the official health insurance marketplace. An article by Christina Acosta in the Kent County News on December 13 reports that enrollment in Maryland bucked the national trend and rose by 5% over last year. Acosta quotes Michele Eberle, the Executive Director of the Maryland Health Benefit Exchange stating that for the first time in 20 years premiums were lowered and, still, 9 out of 10 people who come to the system will receive financial assistance. During 2018 almost 154,000 Marylanders enrolled in qualified health plans. Those enrolling in 2019 are finding a 13% average price drop. The Democratic legislature and Governor Hogan took actions that partially negated or cancelled out the Trump administrations actions to undermine the ACA.

On the lower Eastern Shore, the Lower Shore Health Insurance Assistance Program acts as a partner for the Maryland Health Connection. All the qualified health plans sold through the Health Connection, except for catastrophic plans, provide the same benefits and offer free preventative services. The covered benefits are: (1) doctor visits; (2) hospitalization; (3) emergency care; (4) maternity and newborn care; (5) pediatric care, including dental and vision; (6) prescription drugs; (7) lab tests; (8) mental health care; (9) substance abuse treatment.

The uninsured rate on the Lower Shore is 5% in Worcester County, a decrease of 9% from 2013; 7% in Somerset County, a decrease of 11% from 2013; and 6% in Wicomico County, a decrease of 10% from 2013.

Meanwhile, just as the enrollment period ended, a Republican federal judge in Texas (appointed by George W. Bush) declared the ACA unconstitutional in response to a case brought by the Republican attorneys general of 20 states. Attorneys general in other states, including California, will be filing an appeal. The Department of Health and Human Services has stated that the ACA will continue undisturbed while the legal process proceeds. Maryland’s Attorney General Brian E. Frosh had already filed a lawsuit in the U.S. District Court for the District of Maryland against the Trump Administration, seeking a declaratory judgment that the Affordable Care Act (ACA) is constitutional and the federal government must stop taking actions to dismantle it, arguing that elimination of the ACA would imperil the health of millions of Marylanders, wreak havoc on our state budget, and destabilize Maryland’s health insurance markets and health care system.

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Six Reasons Why the House Budget Bill Will Hurt Rural America

By Michael Chameides, Barn Raiser • May 21, 2025

Right now, Congress is working on a fast-track bill that would make historic cuts to basic needs programs in order to finance another round of tax breaks for the wealthy and big corporations.

Who Will SNAP Cuts Affect in Maryland? On the Eastern Shore?

By Catlin Nchako, Center on Budget and Policy Priorities • May 21, 2025

The House Agriculture Committee recently voted, along party lines, to advance legislation that would cut as much as $300 million from the Supplemental Nutrition Assistance Program. SNAP is the nation’s most important anti-hunger program, helping more than 41 million people in the U.S. pay for food. With potential cuts this large, it helps to know who benefits from this program in Maryland, and who would lose this assistance. The Center on Budget and Policy Priorities compiled data on SNAP beneficiaries by congressional district, cited below, and produced the Maryland state datasheet , shown below. In Maryland, in 2023-24, 1 in 9 people lived in a household with SNAP benefits. In Maryland’s First Congressional District, in 2023-24: Almost 34,000 households used SNAP benefits. Of those households, 43% had at least one senior (over age 60). 29% of SNAP recipients were people of color. 15% were Black, non-Hispanic, higher than 11.8% nationally. 6% were Hispanic (19.4% nationally). There were 24,700 total veterans (ages 18-64). Of those, 2,200 lived in households that used SNAP benefits (9%). The CBPP SNAP datasheet for Maryland is below. See data from all the states and download factsheets here.

Not Law Yet

By Jan Plotczyk • May 21, 2025

Apparently, some people think that the GOP’s “big beautiful bill” is a foregone conclusion, and that the struggle over the budget and Trump’s agenda is over and done. Not true. On Sunday night, the bill — given the alternate name “Big Bad Bullsh*t Bill” by the Democratic Women’s Caucus — was voted out of the House Budget Committee. The GOP plan is to pass this legislation in the House before Memorial Day. But that’s not the end of it. As Jessica Craven explained in her Chop Wood Carry Water column: “Remember, we have at least six weeks left in this process. The bill has to: Pass the House, Then head to the Senate where it will likely be rewritten almost completely, Then be passed there, Then be brought back to the House for reconciliation, And then, if the House changes that version at all, Go back to the Senate for another vote.” She adds, “Every step of that process is a place for us to kill it.” The bill is over a thousand pages long, and the American people will not get a chance to read it until it has passed the House. But, thanks to 5Calls , we know it includes:

Eastern Shore Delegation: 2025 “Highlights”

By Jared Schablein, Shore Progress • May 13, 2025

Let's talk about our Eastern Shore Delegation, the representatives who are supposed to fight for our nine Shore counties in Annapolis, and what they actually got up to this session.

Democrats reach historic goal: A full slate in Virginia House races

By Markus Schmidt, Virginia Mercury • May 12, 2025

For the first time in recent memory, Virginia Democrats have candidates running in all 100 House of Delegates districts — a milestone party leaders and grassroots organizers say reflects rising momentum as President Donald Trump’s second term continues to galvanize opposition.

2025 General Assembly Report: Results for Working Families on the Eastern Shore

By Jared Schablein, Shore Progress • April 22, 2025

The 447th legislative session of the Maryland General Assembly adjourned on April 8. This End of Session Report highlights the work Shore Progress has done to fight for working families and bring real results home to the Shore. Over the 90-day session, lawmakers debated 1,901 bills and passed 878 into law. Shore Progress and members supported legislation that delivers for the Eastern Shore, protecting our environment, expanding access to housing and healthcare, strengthening workers’ rights, and more. Shore Progress Supported Legislation By The Numbers: Over 60 pieces of our backed legislation were passed. Another 15 passed in one Chamber but not the other. Legislation details are below, past the budget section. The 2026 Maryland State Budget How We Got Here: Maryland’s budget problems didn’t start overnight. They began under Governor Larry Hogan. Governor Hogan expanded the state budget yearly but blocked the legislature from moving money around or making common-sense changes. Instead of fixing the structural issues, Hogan used federal covid relief funds to hide the cracks and drained our state’s savings from $5.5 billion to $2.3 billion to boost his image before leaving office. How Trump/Musk Made It Worse: Maryland is facing a new fiscal crisis driven by the Trump–Musk administration, whose trade wars, tariff policies, and deep federal cuts have hit us harder than most, costing the state over 30,000 jobs, shuttering offices, and erasing promised investments. A University of Maryland study estimates Trump’s tariffs alone could cost us $2 billion, and those federal cuts have already added $300 million to our budget deficit. Covid aid gave us a short-term boost and even created a fake surplus under Hogan, but that money is gone, while housing, healthcare, and college prices keep rising. The Trump–Musk White House is only making things worse by slashing funding, gutting services, and eliminating research that Marylanders rely on. How The State Budget Fixes These Issues: This year, Maryland faced a $3 billion budget gap, and the General Assembly fixed it with a smart mix of cuts and fair new revenue, while protecting working families, schools, and health care. The 2025 Budget cuts $1.9 billion ($400 million less than last year) without gutting services people rely on. The General Assembly raised $1.2 billion in fair new revenue, mostly from the wealthiest Marylanders. The Budget ended with a $350 million surplus, plus $2.4 billion saved in the Rainy Day Fund (more than 9% of general fund revenue), which came in $7 million above what the Spending Affordability Committee called for. The budget protects funding for our schools, health care, transit, and public workers. The budget delivers real wins: $800 million more annually for transit and infrastructure, plus $500 million for long-term transportation needs. It invests $9.7 billion in public schools and boosts local education aid by $572.5 million, a 7% increase. If current revenue trends hold, no new taxes will be needed next session. Even better, 94% of Marylanders will see a tax cut or no change, while only the wealthiest 5% will finally pay their fair share. The tax system is smarter now. We’re: Taxing IT and data services like Texas and D.C. do; Raising taxes on cannabis and sports betting, not groceries or medicine; and Letting counties adjust income taxes. The budget also restores critical funding: $122 million for teacher planning $15 million for cancer research $11 million for crime victims $7 million for local business zones, and Continued support for public TV, the arts, and BCCC The budget invests in People with disabilities, with $181 million in services Growing private-sector jobs with $139 million in funding, including $27.5 million for quantum tech, $16 million for the Sunny Day Fund, and $10 million for infrastructure loans. Health care is protected for 1.5 million Marylanders, with $15.6 billion for Medicaid and higher provider pay. Public safety is getting a boost too, with $60 million for victim services, $5.5 million for juvenile services, and $5 million for parole and probation staffing. This budget also tackles climate change with $100 million for clean energy and solar projects, and $200 million in potential ratepayer relief. Public workers get a well-deserved raise, with $200 million in salary increases, including a 1% COLA and ~2.5% raises for union workers. The ultra-wealthy will finally chip in to pay for it: People earning over $750,000 will pay more, Millionaires will pay 6.5%, and Capital gains over $350,000 get a 2% surcharge. Deductions are capped for high earners, but working families can still deduct student loans, medical debt, and donations. This budget is bold, fair, and built to last. That’s why Shore Progress proudly supports it. Click on the arrows below for details in each section.