Issues at a glance

Obamacare / Affordable Care Act

1. What is the Issue?

Complete or Partial Repeal of the Patient Protection and Affordable Care Act

What's At Stake for Marylanders

  • 476,000 could lose their health insurance coverage.

  • An additional 2.5 million could lose coverage or be charged more due to pre-existing conditions.

  • 41,000 young adults could lose coverage if they are on their parents plan.

  • More than 100,000 who receive premium subsidies would no longer be able to afford insurance.

  • Women could pay as much as 39 percent more for coverage.

  • More than 86,000 seniors and people with disabilities could lose $1,158 on prescription drugs savings. The ACA had closed the "donut hole".

  • Almost 3 million who have been using preventative services without co-pays, coinsurance or deductibles could lose those savings.

  • 2.25 million, including 585,000 children could incur lifetime limits on their health insurance policies.

  • Seniors could lose free annual wellness visits and cancer screenings.

  • Reduced or loss of coverage for treatment of substance use disorders and mental health issues.

  • Elimination of federal Medicaid funding for expansion of services, resulting in loss of coverage or reduced benefits for hundreds of thousands.

  • 52,000 private and public sector jobs could be lost by 2019.

  • Quality initiatives that led to a 10 percent decrease in hospital read missions are among Medicare beneficiaries that are at risk.             

Sources: Obamacarefacts.comUS Department of Health and Human Services, Urban Institute, Families USA, Commonwealth Fund, National Women's Law  Center, Consumer Health First


"Update on Coverage from Maryland Health Connection

With everything happening in Washington, D.C., you may have questions about what the latest news means for you and your coverage. We are monitoring any changes closely, and you can count on us to provide you with the facts.

We are with you every step of the way and will keep you updated on any changes that impact you. For now, here’s what you need to know:

  • If you signed up for health insurance for 2017, you should stay covered throughout the year by continuing to pay your premium on time. It’s more important than ever to ensure you don’t have a gap in coverage.

  • If you have concerns about your immigration status, current law clearly states that legal residents and those with qualifying documentation are able to purchase a plan through Maryland Health Connection. We use the information you provide in your health coverage application only to determine your eligibility for tax credits and health coverage through Maryland Health Connection.

  • It’s important to know that you can still apply for health coverage through Maryland Health Connection, even if not all of your family members have an immigration status that qualifies them for coverage. Individuals who are not requesting coverage will not be asked about their immigration status.

  • With tax season upon us, you still should report your health insurance status when you file. The IRS has said that for now, the rules remain the same. If you don’t have health insurance, you still may pay a fine. You can learn more by visiting

  • We will continue to keep you updated as any changes take place that may impact your coverage through Maryland Health Connection. Sign up for alerts from, and follow us on Twitter @MarylandConnect. We are committed to doing all we can to ensure quality, affordable coverage through Maryland Health Connection for the more than one in six Marylanders who now depend on it.

  • We will continue to help eligible people enroll during this special enrollment period – including those who experience certain life changes like losing their job, getting married or divorced, or having a baby. If you have questions on whether you are able to enroll now, see the life events that can qualify you to enroll outside of the open enrollment period, within 60 days. If you are eligible for Medicaid or MCHP, you can enroll at any time.

More than 588,000 residents currently have health insurance through Maryland Health Connection, with 9 in 10 receiving financial help to lower their costs.

Maryland has achieved an impressive drop in its uninsured rate, from 14% to about 6% in just five years. We have seen 400,000 people in the state gain coverage, including nearly 280,000 Marylanders who have free or low-cost coverage through the expansion of Medicaid.

About Maryland Health Connection

Maryland Health Connection is Maryland’s official health insurance marketplace for individuals and families to compare plans and enroll in health and dental coverage. It’s the only place to get financial help with health insurance. See if you qualify for financial help like tax credits or Medicaid/MCHP to make health insurance more affordable."

Source Maryland Health Connection

2. Background

The Patient Protection and Affordable Care Act (ACA), was signed into law by President Barack Obama on March 23, 2010.   Nicknamed “ObamaCare,” its goal was to reform the healthcare industry by giving more Americans access to affordable, quality health insurance and to reduce the growth in U.S. health care spending.

During the Obama presidency, Republicans unsuccessfully tried to repeal the ACA over 50 times. With the start of the new Trump administration in 2017 and a Republican majority in the House and Senate, a repeal of the ACA was at the top of their agenda.

3. Representatives to Contact:

Senator Ben Cardin

(202) 224-3121

United States Senate
Washington, D.C. 20510

Senator Chris Van Hollen

(202) 224-3121

United States Senate
Washington, D.C. 20510

4. Summary of Current Laws Governing this Issue

"Summary Coverage Offered by the Patient Protection and Affordable Care Act

Since President Barack Obama signed The Patient Protection and Affordable Care Act on March 23, 2010 a number of healthcare reforms have been implemented offering new provisions and new mandates in regards to the American Healthcare system. The following summary includes only part of the coverage offered under ObamaCare (AKA the Affordable Care Act).

• Most Americans, who can afford to, will be required to have health insurance starting in 2014, pay a per month fee on their tax returns, or get an exemption.

• Americans who cannot obtain affordable health care through employer coverage will be able to purchase insurance through a Health Insurance Exchange with premium and cost-sharing credits available to low-to-middle income Americans who cannot afford health insurance on their own. The cost of providing those who cannot afford health insurance will come from new taxes and cuts to wasteful spending occurring as relics of the healthcare system prior to the Affordable Care Act.

• In 2015 employers with over 50 full-time equivalent workers will pay penalties for employees that they do not cover. This, in most cases, will not raise the costs that the businesses currently pay providing health insurance to employees, although it may have minimal costs for those companies who currently do not provide health insurance to their employees.

• Regulations under the Affordable Care Act will prevent health insurance companies from denying coverage for any reason or changing a higher premium based on health or gender.

• Medicaid will be expanded to 138% of the federal poverty level ($15,856 for an individual and $32,499 for

a family of four by 2014) for all individuals under age 65. Many States have opted-out of Medicaid expansion so make sure to check if your State is participating.

• Around 40 Million Americans who currently do not have health insurance are projected to have coverage by 2019.

• The amount the Affordable Care act saves by cutting costs from health care programs that aren’t working is estimated to reduce the national deficit by $124 billion by 2019."


5. Immediate goals for this issue:

American Health Care Act

On March 6, 2017 the American Health Care Act was presented as the replacement for the ACA. According to Families USA, this bill would remove the subsidies many Americans qualify for under the ACA and replace them with tax credits determined by age, stripping coverage for millions. It also ends the Medicaid expansion, leaving our most vulnerable citizens at risk. Those with chronic illnesses and disease may pay more in premiums and deductibles. To date the bill's impact on the federal budget is unknown. -

Let your Representatives know that you want them to uphold the ACA and vote NO on the American Health Care Act!

6. Long-term goals for this issue


Helpful Links works to achieve high quality, comprehensive, and affordable health care for all Americans.

Urban Institute economic and social policy research

US Dept. of Health & Human Services

The Commonwealth Fund promotes a high performing health care system by supporting independent research on health care issues and making grants to improve health care practice and policy. 

National Women's Law Center/ACA Repeal Resource

Consumer Health First making Maryland a leader in health care reform with education, outreach, engagement and advocacy/action.

Maryland Health Connection: Update to the question, 'What happens to my Maryland health care coverage?'

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