Bill allowing undocumented residents to more easily buy health care finally clears Senate hurdle

Members of Maryland’s immigrant population and their advocates are celebrating the Senate approval of legislation that would allow undocumented residents to more easily purchase private health care coverage off of the state’s insurance marketplace.

On Friday, the Maryland Senate approved the “Access to Care Act” on a party line vote of 34-13. With the House version of the bill already approved, the legislation is in good position to make its way to the governor’s desk.

“Passing it out of both chambers is amazing. Our members are so excited,” said Ninfa Amador-Hernandez, a policy analyst for the immigrant advocacy group CASA. The Access to Care Act is one of the group’s main legislative priorities during the 2024 session.

“Maryland is a home for immigrants, and we see this bill as just another step forward to ensuring that all our Maryland residents have the best access and quality of life and care that they can have,” she said.

The legislation is similar to a bill from the 2023 session that passed in the House of Delegates but stalled in the Senate.

SB 705, sponsored by Sen. Antonio Hayes (D-Baltimore City) and Sen. Clarence K. Lam (D-Howard and Anne Arundel), will prompt the Maryland Health Benefit Exchange to seek a waiver from the federal government in order to allow Maryland residents to purchase an individual private health care plan, regardless of immigration status.

Lam said that SB 705 “hits home for a variety of reasons, as a child of immigrants.”

“I think this bill is really important for people that otherwise wouldn’t have care,” Lam said.

Currently, federal laws say that undocumented residents are “not eligible to enroll in federally funded coverage… or to purchase coverage through the ACA (Affordable Care Act) Marketplaces,” according to KFF, a nonprofit health policy research and polling organization.

California and Washington state have sought federal waivers for similar initiatives, which were approved.

The Access to Care Act does not provide subsidized or free health care options for undocumented immigrants, usually an economically disadvantaged group. It’s not clear how many undocumented residents will actually be able to afford the health care options that would be open to them on the Maryland Health Benefit Exchange.

“I have been trying to get that answer all throughout session…unfortunately, I haven’t been able to find a specific data point to say ‘X’ number of individuals will be able to buy it,” Amador-Hernandez said.

But she believes that the bill will help some members of CASA and other undocumented migrants as they shop for health care plans.

“Private plans and trying to compare and shop for those plans is very confusing, very complicated,” Amador-Hernandez said.

“When we think about the community that CASA serves, primarily immigrant, Black and brown, Latino immigrants, their access level is less than the broader community. Their ability to navigate government services may not be as well equipped as other individuals. Having access to the state marketplace is a big, real game-changer for them,” she said.

Sen. Justin Ready (R-Carroll and Frederick). Photo by Bryan P. Sears.

Opposition for the legislation came from Republican senators, who asserted that the bill incentivizes undocumented immigrants to come to Maryland and not worry about trying to become legal citizens.

“What we are seeing in our country today is a surge of illegal immigration,” Minority Whip Justin Ready (R-Carroll and Frederick) said on the Senate floor.

“We’ve done everything imaginable to have a flashing green neon sign that says, ‘Hey, come here. Come here’…Maryland is moving forward with policies that make our state much more attractive for people to come here who should not be in the country. They’re here illegally,” he said.

Sen. Johnny Mautz (R-Middle Shore) also opposed the bill.

“What we’re doing with this law, changing this law, is there’s no incentive, there’s no drive to make anyone try to assimilate or want to become a citizen,” Mautz said. “That in of itself is a problem and it’s setting up a situation where there’s no incentive.”

However, supporters of the bill believe that providing health care coverage to more Marylanders, regardless of immigration status, would help the state save a some money on what’s called “uncompensated care” and help reduce Maryland’s extended emergency room wait times.

“I think this is a common sense bill,” said Senate President Bill Ferguson (D-Baltimore City).

“At the end of the day, everyone benefits from more people having health insurance, and so the more residents that are covered in the lower the cost it is for everyone. We should do whatever we can to expand access to health plans here in the state and this is a bill that pushes that objective,” he said.

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