Maryland health officials warned lawmakers last week that changes to the state’s Medicaid program under the Trump administration could cost Maryland nearly $3 billion in federal funding each year.
In a briefing to the Senate Finance Committee, Deputy Health Secretary and Medicaid Director Perrie Briskin said provisions in HR 1, the federal budget reconciliation bill passed in July 2025, could reduce Maryland’s federal Medicaid funding by $2.7 billion annually. Medicaid currently serves nearly 1.5 million Marylanders.
Much of the projected loss stems from reduced coverage. State estimates indicate that 15,000 undocumented individuals will lose coverage this fall due to new eligibility rules, and work requirements could lead an additional 115,000 people to lose coverage because of administrative barriers.
Together, these coverage losses account for an estimated $1.4 billion decline in funding. The remaining reductions would result from new federal restrictions on how states may finance their Medicaid programs.
In response, the Moore administration plans to invest in staffing and technology to help keep eligible Marylanders enrolled. The proposed FY 2027 budget would increase Medicaid spending to $16.9 billion, with the state contributing nearly $5.7 billion. Governor Wes Moore has also proposed $13 million in new funding to support implementation of HR 1 and minimize unnecessary disenrollments.
“If we can keep most people eligible,” Briskin told lawmakers, “…that $2.7 billion could shrink to $1 billion or even less.”
Health official warns that future Medicaid cuts could lead to $2.7 billion loss in federal funding
