ANNAPOLIS — Maryland is setting aside $25 million to pay community health clinics to keep treating people who lose their health insurance, a one-year bet that routine checkups and chronic disease care will cost less than emergency room visits.
Gov. Wes Moore announced the Uncompensated Care Grant opportunity Oct. 20 at the Bloomberg American Health Initiative Summit. The Maryland Health Care Commission will run the program. Grants will go to federally qualified health centers, the nonprofit clinics that see patients regardless of ability to pay, and to local health departments in areas without such a center.
The state says the money responds to H.R. 1, the federal law signed in July 2025 that adds new Medicaid requirements and is expected to increase the number of uninsured Marylanders. The program is a grant opportunity, not completed awards; no clinic, county or region has been announced as a recipient.
Paid per patient, per month
A draft plan the commission released in August spells out how the money would flow. The funding comes from a one-time shift approved by the state’s hospital rate-setting agency, the Health Services Cost Review Commission, at its July 22 meeting, moving dollars from hospital rates into community care.
- $22.5 million would pay grantees a set monthly fee for each eligible uninsured patient they see, minus anything the patient pays that month.
- $2 million would go to end-of-grant bonuses based on quality measures.
- $500,000 would cover administration, evaluation and monitoring.
The draft sets the grant period as calendar year 2027, with payments starting in January, subject to available funds. The monthly per-patient rate had not been set when the draft was issued.
Not every uninsured patient would qualify. Under the draft, patients must have no other source of payment for the care and be at risk of ending up in the emergency room, shown by two or more chronic conditions, an acute condition or a chronic condition that isn’t under control. Covered visits include office visits, adult preventive visits, follow-up care after a hospital stay and behavioral health crisis care.
Clinics would report monthly on who they see and what care they provide. The commission plans to judge results by tracking potentially avoidable emergency visits by uninsured patients and how long they wait for an appointment.
What it could mean locally
Because the grants are open to local health departments only where no federally qualified health center serves the area, the Calvert, Charles and St. Mary’s county health departments could be eligible depending on how the commission maps clinic coverage. The draft refers to a map identifying areas that may lack a local health center but does not list them. Neither the release nor the draft names any Southern Maryland provider.
The scale of the coverage loss is still unclear. The commission’s draft says only that tens of thousands of Marylanders will be uninsured or underinsured because of federal policy changes. The Chronicle has reported that 4,500 Maryland immigrants are losing Medicaid while thousands of low-income adults face January work rules, and an earlier survey found nearly half of adults struggled to afford health care last year.
“My number one priority is the health and security of all Marylanders,” Moore said in announcing the grants.
Other state moves on coverage
The governor’s office tied the grants to other steps the state has taken as federal support shifts. Maryland created a state premium assistance program through Maryland Health Connection for eligible residents with household incomes below 400% of the federal poverty level after enhanced federal premium tax credits expired at the end of last year. The state says that help will continue in 2027 at the same level as 2026.
The administration also pointed to a new search tool connecting residents with more than 900 job training and development programs, aimed at helping people meet new federal work requirements for Medicaid and SNAP.
The release did not give an application opening date or deadline. Clinics and health departments interested in the grants can watch the Maryland Health Care Commission’s website for the final plan and application details ahead of the January 2027 start.
