Importance Score: 75 / 100 🔴
Maryland to Fund Abortion Access with ACA Surcharge
ANNAPOLIS, Md. – Maryland has enacted landmark legislation to bolster abortion access, becoming the first state to utilize funds from a surcharge on insurance plans under the Affordable Care Act (ACA) to finance abortion services. This initiative ensures that individuals can access abortion care, regardless of their insurance coverage. Democratic Gov. Wes Moore signed the measure into law on Tuesday.
Funding Details and Allocation
The newly signed legislation will allocate approximately $25 million, derived from a $1 surcharge that has accumulated unused since the ACA’s implementation in 2010. The program is anticipated to generate roughly $3 million annually in subsequent years.
- Initial Funding: $25 million available starting July 1.
- Annual Allocation: Estimated $3 million per year.
Governor Moore’s Stance on Reproductive Rights
“The lieutenant governor and I were very clear from Day 1 — that Maryland will always be a safe haven for abortion access,” Moore emphasized during the signing ceremony, highlighting the bill among approximately 170 signed into law.
Mechanism of Funding
The program will be sustained through the transfer of specific insurance premium funds collected by carriers, designated exclusively for abortion coverage in accordance with ACA guidelines. Proponents assert that other states possess similar surplus funds via their state exchange insurance systems.
Potential for National Replication
“If programs like ours are duplicated across the country, we could help millions of Americans access essential abortion care — without relying on taxpayer dollars,” stated Del. Lesley Lopez, a Democrat representing Montgomery County.
Interest from Other States
Officials from New York and Illinois have already engaged with Maryland officials to gain insights into the program, according to Lopez, who sponsored the bill.
States Mandating Abortion Coverage
According to KFF, a health care research nonprofit, the following twelve states mandate abortion coverage in ACA marketplace plans:
- California
- Colorado
- Illinois
- Maine
- Maryland
- Massachusetts
- Minnesota
- New Jersey
- New York
- Oregon
- Vermont
- Washington
State Health Department’s Role
The law establishes a grant program fund within the state’s health department to improve access to clinical abortion services. The department is tasked with awarding grants to nonprofit organizations, thereby promoting equitable access.
The Impact on Abortion Funds
Lynn McCann-Yeh, co-executive director of the Baltimore Abortion Fund, offering financial aid for abortion-related expenses to Maryland residents and those traveling to the state, indicated challenges in managing their $2 million annual budget.
Meeting the Demand
“We would need many, many more times over that to fully be able to meet the full logistic and medical support for each caller,” she stated.
McCann-Yeh believes the $3 million annual allocation could significantly improve their capabilities. The fund intends to apply for a share of this funding to enhance their services.
Long-Term Sustainability
“The $3 million is a great start, but it will take more than that and it will take sustained funding,” she added.
Political Context
Maryland’s legislature is controlled by Democrats. In response to the U.S. Supreme Court’s 2022 decision to overturn Roe v. Wade, Maryland voters approved a constitutional amendment enshrining abortion rights in the state constitution with 76% support.
Urgency Post-Dobbs Decision
“I think before the Dobbs decision, there just wasn’t quite the same type of urgency as there is now,” Lopez explained. “We’ve seen abortion bans in some form or another in double digits in states across the country, so we’ve got to make sure that we shore up all the support we can in a state like Maryland that has it as a constitutionally protected right.”
Abortion Restrictions in Other States
Currently, twelve states enforce abortion bans with limited exceptions at all stages of pregnancy. An additional four states have bans that take effect around six weeks of pregnancy.
Increased Demand in Maryland
The Dobbs decision, coupled with an influx of individuals from other states seeking abortion services in Maryland, has intensified the financial imperative, according to supporters of the legislation.
Rise in Out-of-State Patients
Maryland has witnessed an increase in patients coming from states with abortion bans. Last year, 15% of abortions performed in Maryland were for out-of-state patients, a slight decrease from 20% in 2023, according to the Guttmacher Institute.