What Maryland Residents Need to Know About Obamacare for 2022

Essential facts about the Affordable Care Act (ACA or Obamacare) in Maryland, including whether you must get health insurance, how much it costs, and how you can save money.


How To Sign Up for Obamacare in Maryland
Do I Have to Get Health Insurance in Maryland?

Last Reviewed: Mon, Aug 15, 2022

In Maryland, Affordable Care Act (Obamacare) open enrollment is over, but you may still qualify for 2022 coverage.

This website provides information about getting health insurance under the Affordable Care Act (ACA), including:

To begin, keep in mind these key points about health insurance in Maryland:

1. Maryland open enrollment has ended, but you may be able to use a special enrollment period to get covered.

In Maryland, open enrollment for 2022 Affordable Care Act (Obamacare) coverage has ended. This means that, unless you qualify for an exception or your income is low enough for Medicaid, you won't be able to get health insurance through Maryland Health Connection until open enrollment for 2023 begins next fall.

If you’ve lost your job or significant income in the past 60 days, whether due to the COVID-19 pandemic or for any other reason, you might qualify for a special enrollment period (SEP). A SEP allows you to sign up for a new health insurance plan or change your current plan outside the open enrollment window.

In addition to job or income loss, many other qualifying events may make you eligible for a SEP. To learn more, see What Happens If I Missed the Maryland Obamacare Enrollment Deadline?

2. You may qualify for new Affordable Care Act subsidies.

Last year, President Biden signed the American Rescue Plan Act (ARPA). The law provides $1.9 trillion of federal aid to Americans struggling with the COVID-19 crisis. The relief measures include additional premium subsidies for those who purchase health insurance through $EXCHANGE. People who apply for 2022 coverage under a special enrollment period can access these subsidies. (Under the Inflation Reduction Act, the additional subsidies are set to expire at the end of 2025.) In addition, Maryland has created a special program to help young adults pay for health insurance. Here’s a quick summary of the types of available subsidies.

Federal tax credits. Under ARPA, no one will have to pay more than 8.5% of their household income for a mid-level plan purchased from Maryland Health Connection. Technically, the subsidies are tax credits, but you can choose to have them automatically deducted from the cost of your monthly premiums. These increased subsidies will be available only through the end of 2022 unless Congress enacts legislation to extend them. (If they revert to the previous level, subsidies will be available only to those with household income between 100% and 400% of the federal poverty level. For example, the cutoff for a family of four in Maryland would be $111,000. For an individual, it would be $54,360.)

Cost-sharing subsidies. More than half of the people who purchase coverage through Maryland Health Connection receive assistance in the form of cost-sharing reductions (CSRs). CSRs automatically reduce your premiums and lower your costs when you use your insurance benefits—for example, when you go to the doctor, get lab work, or have to stay in the hospital.

CSRs are available to people who make between 100% and 250% of the federal poverty level. (For 2022 health plans, that means a family of four in Maryland can’t earn more than $69,375 and an individual not more than $33,975.) But these benefits are available only on silver plans. If you think you may qualify, look carefully at costs for the silver plans available at Maryland Health Connection while shopping for coverage.

Medicaid. You may qualify for free or low-cost coverage through Medicaid in Maryland if your income is very low.

Assistance for young adults. Maryland has created a new program to help people aged 18 to 34. If your income doesn't exceed 400% of the federal poverty level ($54,360 for an individual) and you're eligible for federal premium subsidies, the state will further reduce your premiums. These adjustments will be applied automatically when you sign up for a plan at Maryland Health Connection.

For more information, see Ways to Save Money on Obamacare in Maryland.

3. For 2022, more plans are available in Maryland and average premiums have decreased.

For 2022 health insurance plans sold through Maryland Health Connection, the Maryland Insurance Commissioner held average premium rate increases to 2.1%. The moderate increase comes after three years of declining rates for Marylanders, primarily due to a tax that Maryland imposes on insurance carriers; the tax money goes into a fund that helps insurers cover costly claims. This strategy is known as a “reinsurance program.” In 2022, the new subsidies available under ARPA (discussed above) should more than cover the rate increases for most people.

All three insurers offering plans in 2021--CareFirst, Kaiser Permanente, and UnitedHealthcare -- will continue to offer plans for 2022.

4. You won’t face a tax penalty for going without health insurance in 2022—but there are big downsides to being uninsured.

Obamacare’s tax penalty went away in 2019. That means that if you don’t have health insurance, you won’t have to pay a penalty when you file your federal income taxes. That said, think hard about whether it makes sense to forego health insurance. A medical crisis could knock the financial wind from your sails and do more damage than the penalty would. (A study published in 2019 showed that a lapse in health insurance coverage can double a person's chances of ending up in bankruptcy.)

5. Maryland limits short-term insurance plans to fewer than three months.

In 2018, the Trump administration made it easier to purchase short-term insurance plans. These plans don’t have to cover preexisting conditions or the essential health benefits provided by Obamacare plans. The new federal rules say that short-term plans can last for as long as three years. In Maryland, however, short-term plans must last fewer than three months and cannot be automatically renewed.

If you’re genuinely caught without health insurance and need it for a few months to cover a new health condition, you might want to consider a short-term plan to get you through to the next open enrollment period. Otherwise, be careful of plans that don’t meet the requirements of the Affordable Care Act. Shop around to look for coverage that truly meets your needs.

Remember, if your income is very low, you may qualify for free or low-cost coverage through Medicaid in Maryland.

6. You can get help signing up if you need it.

The Biden administration is greatly increasing enrollment assistance plans, making it much easier to get the information you need to get covered. To connect with local support resources, see How To Sign Up for Obamacare in Maryland.


Jurisdictional relevance: There are versions of this article for each State.
Selected State: Maryland
How To Sign Up for Obamacare in Maryland
Do I Have to Get Health Insurance in Maryland?