Moore signs law to fund abortion care for uninsured patients

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The Maryland Department of Health can access roughly $25 million to help abortion care providers cover costs for uninsured and underinsured patients under a bill that Gov. Wes Moore signed into law Tuesday.

“The lieutenant governor and I were very clear, from day one, that Maryland will always be a safe haven for abortion access,” Moore said during a bill-signing ceremony at the State House. “Now we write the next chapter in our work to protect and defend basic health care rights.”

The new law will allow the Maryland Department of Health to reimburse abortion providers, particularly for care for those who are uninsured or underinsured, using surpluses from insurance premiums under the Affordable Care Act.

The Affordable Care Act requires that qualified health plans offering abortion coverage must collect at least $1 per month from each enrollee, though the money that’s set aside can only be used for certain abortion services, bill testimony from the Office of the Attorney General states.

The accounts in which the carriers collect the premiums generate significant surpluses, as “the actuarial value of abortion coverage is far less than $1 per member per month,” according to the Office of the Attorney General.

As a result, Maryland’s carriers have unused surpluses of the earmarked funding totaling about $25 million, and growing by about $3 million annually, according to the Women’s Law Center of Maryland.

“By reimbursing providers for abortion costs regardless of a patient’s residency, immigration status, or insurance coverage, Maryland is keeping our clinics open, strengthening our provider network, and encouraging new facilities in underserved areas,” state Del. Lesley Lopez, a Montgomery County Democrat who sponsored the bill in her chamber, said in a statement. “This is equity in action.”

Maryland voters in 2024 were overwhelmingly in favor of enshrining the right to an abortion in the state’s constitution as part of a response to the U.S. Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization to overturn its ruling in Roe v. Wade decades earlier, leaving it to states to decide how to regulate abortion access.

Lopez said during her prepared bill testimony in February that while governors and lawmakers in states across the country, including Maryland, have set aside funding to help pay for abortion care, state abortion funds have been stretched thin in covering care for in-state residents and for an increasing number of people traveling from states where care is restricted.

Roughly one in every five abortion patients in Maryland has traveled from another state, according to the state Department of Health.

Maryland has among the most protective abortion policies in the country, but uncompensated, out-of-pocket costs that insurance reimbursements won’t cover can threaten people’s access, former Health Secretary Laura Herrera Scott wrote in her prepared testimony in February.

Public grants and private donations have helped clinics and patients cover costs, but financial support has waned following the initial surge of support in the wake of the Supreme Court’s Dobbs decision.