A global pandemic was not top of mind 10 years ago when the Patient Protection and Affordable Care Act (ACA) came into being. But Maryland and many other places are vastly better positioned today because of it.

A decade ago, 12 out of every 100 Marylanders lacked health coverage. Today, it’s about 6 out of every 100. That’s the best ever recorded by the Census Bureau. An estimated 59,000 children in Maryland did not have health insurance in 2013 when this state and others launched their health insurance marketplaces under the ACA. Three years later, that total had dropped 24% to 45,000.¹

Communities that had lacked health insurance at higher rates prior to the ACA — young adults, African-Americans, Latinos — began closing that gap. Since 2015, consumers who identified as African-American when they enrolled in coverage through Maryland Health Connection have increased by 20% to more than 27,000. Enrollees self-identified as Hispanic tripled during that same period, up to 18,000 in 2020.

And because more people have health insurance, they have been able to get care and treatment for conditions that might have made them even more vulnerable in the current environment.

• The percentage of Marylanders who reported not having a doctor declined from 21% in 2013 to 16% in 2018², which was 10th best in the nation.
• By expanding Medicaid eligibility, Maryland extended smoking cessation coverage to about 70,000 adults not previously eligible for Medicaid³.
• A study of 69,000 patients found a 60% increase in the use of rehabilitation by young adult trauma patients due to expanded coverage⁴.

Enrollment in health coverage in Maryland has been so successful, in part, due to the 600+ trained navigators, insurance brokers and others who have provided free, expert assistance to help hundreds of thousands enroll in coverage. Health care affordability continues to be a priority in the country. In 2018,Maryland was able to provide $744 million to reduce premiums for 120,000 residents. The state continues to enact laws like a reinsurance program, which helped thousands of people save dramatically on their 2018 and 2019 premiums. 

Footnotes

1.  Georgetown University Health Policy Institute, “Nation’s Uninsured Rate for Children Drops to Another Historic Low in 2016,” September 2017
2.  State Health Access Data Assistance Center (SHADAC), University of Minnesota School of Public Health, State Health Compare
3.  Centers for Disease Control and Prevention (CDC), “State Medicaid Expansion Tobacco Cessation Coverage and Number of Adult Smokers Enrolled in Expansion Coverage — United States, 2016,” December 9, 2016 
4. JAMA Surgery, “Implications of the Patient Protection and Affordable Care Act on Insurance Coverage and Rehabilitation Use Among Young Adult Trauma Patients,” December 21, 2016