About 175,000 Marylanders will lose health insurance in the next couple years and the state is likely to lose about $2.7 billion in funding due to the Republican-led budget resolution passed at the end of June.

New analysis from the Maryland Department of Health finds that the biggest losses will come between July 2026 and June 2028, despite it taking a full ten years to implement the One Big Beautiful Bill Act.

The resolution hits some of the most vulnerable populations in the state, including asylum seekers, refugees and immigrants.

The changes create a conundrum for state lawmakers as they are already contending with a several billion dollar deficit in the budget.

“If people wind up getting kicked off of Medicaid, that could mean potentially hundreds of thousands of people were unable to go to the doctor, unable to treat chronic illnesses,” said Christopher Myer is a research analyst at the Maryland Center on Economic Policy. “It'll also have a broader impact on our economy. Federal dollars that flow through the state budget then wind up going into families pockets, and then they cycle that back into the economy by spending it on local businesses. That would actually reduce sales at local businesses and have a ripple impact of actually reducing state GDP.”

The budget adds work restrictions to Medicaid, limits coverage of refugees and restrictions federal funding to community providers who provide reproductive care.

MDH estimates it will also take on tens of millions of dollars in new costs as it implements checks on work eligibility.

Even more Marylanders may lose insurance as the resolution forces people to manually reenroll for their ACA health insurance plans and shortens enrollment periods.

Republicans are also likely to let the ACA premium tax credit expire at the end of the year, making health plans more expensive for people with incomes between 100% and 400% of the federal poverty level.