Maryland Medicaid – State officials warn that new federal paperwork and work requirements could strip healthcare coverage from nearly half of Maryland’s Medicaid expansion population.
By the time the calendar turns to 2027. hundreds of thousands of Marylanders will find themselves navigating a new. unforgiving landscape of federal healthcare and food assistance requirements. State officials are now signaling that the fallout could be immediate and severe. with administrative barriers—rather than actual changes in employment status—poised to strip coverage from the state’s most vulnerable residents.
Already, the impact of H.R.1, also known as the “Big Beautiful Bill,” is being felt in kitchens across Maryland. More than 36,000 residents have been removed from the Supplemental Nutrition Assistance Program (SNAP) as new work requirements take hold. Larry Handerhan of the Maryland Department of Human Services noted that roughly 80,000 new customers are now subject to these mandates. The reach is wide. affecting even those once shielded; some refugees and asylum seekers are finding themselves ineligible for benefits unless they possess a green card.
But the tightening of SNAP is only the precursor to a larger shift in healthcare. Starting January 1. 2027. the state’s Medicaid expansion program will see new work requirements and increased frequency of eligibility reviews affecting approximately 320. 000 people. Perrie Briskin. the state’s Medicaid director. estimates that up to 152. 000 of those individuals—nearly half of the enrolled population—could lose their coverage by the end of 2028.
The disconnect between the policy’s stated intent and the expected result is stark. While the legislation emphasizes work participation, state leadership expects the majority of coverage losses to stem from simple red tape. “The high numbers we predict of those losing coverage are due to red tape. not due to the fact that they aren’t already working. ” Briskin explained.
Behind these figures lies a scramble to mitigate the damage. The state is deploying a mix of outreach efforts. automation. and artificial intelligence to keep eligible residents from falling through the cracks. While these requirements carry exemptions for children and pregnant women, the burden remains on the individual to manage the paperwork.
For now. the state’s guidance is singular: recipients must keep their contact information updated and respond to renewal notices immediately. The next two years will determine whether that advice is enough to prevent a massive contraction in access to basic care for those currently covered under the expansion.
Maryland Medicaid SNAP benefits H.R.1 Big Beautiful Bill Medicaid expansion Larry Handerhan Perrie Briskin