The Maryland Department of Health is concerned about several proposals cutting Medicaid benefits in the Republican budget proposal for 2026.

The plan, which was released on Tuesday, holds a handful of cuts that would have serious impacts on Maryland residents and the economy, MDH Healthcare Financing and Medicaid Director Ryan Moran told reporters.

Moran said the proposals could throw hundreds of thousands of Marylanders off the Medicaid rolls, take billions of dollars from the state budget and have a large impact on health facilities and nursing homes.

“I cannot stress enough just how important Medicaid coverage is for providing coverage for nearly 25% of our state's population, making up an enrollment of north of 1.5 million people in our state,” Moran said.

Almost half of all children in Maryland are covered by Medicaid.

The Republican budget, in total, would cut $880 billion from Medicaid.

The proposal places work requirements on Medicaid recipients and mandates check-ins every six months to ensure eligibility — currently people check in every year.

The goal is to reduce the size of Medicaid, however, Moran says the requirements would actually be a larger burden on the government and economy.

Requiring people to check-in regularly would add $22.6 million in administrative costs to the state, according to MDH. In addition, many people on Medicaid may not be aware of the requirements or may not get their notifications, causing them to unduly lose coverage and therefore put more of a burden on the health system as a whole.

The plan would also reduce Medicaid expansion reimbursement, which went into effect in 2014. That allowed people with incomes up to 138% of the federal poverty level to receive Medicaid.

The federal government pays 90% of those expansion costs, under the new plan that would drop to 50%, putting about $1 billion in cost on the state.

Another proposal cuts reimbursement to zero.

It’s not just people who are insured by Medicaid who would be affected. Medicaid provides 80% of payments to nursing homes in the state and $2.9 billion to more than 1,000 providers for mental health and addiction services.

In total, Maryland pays about $15 billion in Medicaid costs each year; about $8.5 billion is paid for by the federal government.

Moran said at this point the budget is still in the nascent stages and still needs to go through committees and votes before it becomes law.

However, he said MDH and the state are first working to prevent any cuts before implementing contingency plans.

“The impact of the potential federal cuts to Medicaid will greatly depend on what is required and then when it is required for the state to implement,” Moran said. “These particular proposals also have different implementation timelines and requirements to them.”

The Congressional Budget Office predicts that 7.6 million people would lose Medicaid coverage nationwide if the proposals go into effect.