Find Out What Fed Medicaid Changes Mean for MD at #MACoCon

Federal changes to Medicaid are expected to bring significant coverage losses and added strain to state and local health systems. Nearly 12 million people nationwide could lose coverage over the next decade, including thousands in Maryland.

MedicaidThe recently signed federal budget reconciliation bill, formally known as the “One Big Beautiful Bill Act,” makes sweeping changes to Medicaid that could have serious implications for Maryland. The new law aims to reduce $1 trillion in federal Medicaid spending over the next decade, primarily by cutting state aid and implementing stricter eligibility and work requirements. Maryland, which expanded Medicaid under the Affordable Care Act, could see roughly 130,000 residents lose coverage, according to a Maryland Matters article.

Two key provisions:

  • Work Requirements: By 2028, most Medicaid recipients with incomes above the federal poverty level will be required to demonstrate that they work at least 80 hours per month to maintain their coverage.

  • Biannual Eligibility Checks: Starting in 2027, those in Maryland’s expanded Medicaid population will be required to re-verify their eligibility every six months.

From the Maryland Matters article:

Analysts from the Maryland Department of Legislative Services say that the two provisions could slash $1.1 billion in Medicaid costs in Maryland, $112 million of which would be state dollars. Those savings would be slightly offset by the increased administrative costs of having to conduct more-frequent eligibility checks.

While some state savings are expected, a significant number of Marylanders are also expected to lose Medicaid coverage under the new federal law. An outcome that could strain already stretched health and social services at both the state and local levels.

Read the full article.

At the 2025 MACo Summer Conference Human Resources session, “Medicaid at a Crossroads: Preparing for Shifts in Federal and State Policy,” panelists will explore what federal policy changes could mean for service delivery, particularly in human services departments.

The 2025 MACo Summer Conference will be held at the Roland Powell Convention Center in Ocean City, MD from August 13-16. This year’s theme is “Funding the Future: The Evolving Role of Local Government.” More information can be found on our conference website.

Learn more about MACo’s Summer Conference: