Maryland delays implementing Exchange coverage for undocumented residents amid federal rule and data‑sharing concerns
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Summary
The Maryland Health Benefit Exchange has postponed implementation of its Access to Care Act waiver to allow time to reconcile new federal requirements and avoid creating data records that the Exchange says could be subject to federal requests.
The Maryland Health Benefit Exchange said it will delay implementation of the Access to Care Act waiver — which would allow residents regardless of immigration status to enroll on the state marketplace without federal premium tax credits — because of recent federal rule changes and concerns about data sharing.
Michelle Everly, the Exchange’s executive director, told the committee the waiver had been approved but not implemented. The Exchange set an implementation target of Jan. 1, 2028, but Everly said that date is not firm: the agency will try to move sooner if it can reconcile HR 1 implementation and the marketplace integrity rule requirements. The Exchange framed the delay as a protective choice made to avoid placing undocumented individuals at greater risk of federal data requests or other unintended harms.
Everly said several factors led to the decision: - Federal rules issued this summer add new verification and reporting requirements that the Exchange has to incorporate into its systems quickly. - The Exchange staff weighed the risk that federal authorities could request data; the Exchange said it currently does not hold evidence of undocumented individuals in its system and was concerned about creating records that could later be requested. - The Exchange’s existing alternatives allow undocumented individuals to shop plans directly with carriers, use navigators and Spanish‑language brokers, or get in‑person help; the Exchange also plans virtual enrollment support and outreach.
Everly said the Exchange ran a 30‑day public comment period on implementation. She told lawmakers the agency will prioritize consumer protections and only implement the waiver when HR 1 and related operational requirements are addressed or clarified.
What stays the same The Exchange said anyone can still shop plans on Maryland Health Connection and purchase private coverage directly from carriers. The Exchange also highlighted planned improvements — including a new small‑business portal and expanded navigator services — intended to help consumers while the Access to Care waiver implementation remains paused.
Ending The Exchange said it remains committed to the goal of expanding access but will not implement the waiver in a way that could expose undocumented individuals to federal data requests or create other harms; officials said they will revisit implementation as federal rules and guidance evolve.