Medicaid at a Crossroads: Preparing for Shifts in Policy

Medicaid is at a pivotal moment under pressure from fiscal, political, and structural forces at both the state and federal levels. For Maryland’s counties, the ripple effects could redefine how essential services are delivered and funded.

Few programs touch as many lives or budgets as Medicaid. In Maryland, the program covers more than 1.5 million residents, spanning children, low-income families, older adults, and individuals with disabilities. At the federal level, lawmakers passed major reforms, including caps on federal spending, work requirements, and tighter eligibility rules. Meanwhile, Maryland’s own Medicaid waiver agreements and budgetary commitments face increased scrutiny amid competing fiscal pressures. These shifts could have wide-ranging consequences for how counties plan, staff, and fund critical human services.

Description:

Medicaid plays a vital role in supporting the health and well-being of more than a million Marylanders, including many who rely on county-level programs and services. As federal leaders consider new directions for Medicaid funding and eligibility, Maryland and its counties may face important decisions ahead. This session brings together state budget and policy experts with county human services leaders to explore what policy changes could mean for service delivery, local budgets, and intergovernmental coordination. With multiple proposals on the table, including shifts in program structure and eligibility criteria, understanding the landscape is essential to making informed choices and planning ahead.

Speakers:

Blaire Bryant, Legislative Director, Health, National Association of Counties
Perrie Briskin, Chief of Staff, Maryland Health Care Financing and Medicaid
Leslie Barnes-Keating, Deputy Chief Administrative Officer, Frederick County
Stephanie Klapper, Deputy Director, Maryland Health Care for All

Moderator: The Honorable Ben Kramer, MD State Senate

Date/Time: Friday, August 15, 2025; 1:00 pm – 2:00 pm

The 2025 MACo Summer Conference will be held at the Roland Powell Convention Center in Ocean City, MD, on 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.