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SB 848

Enacting bank protections for eligible adults from financial exploitation

2025 Regular Session Introduced by Patricia Rucker and 1 co-sponsor

Creates a state fund and grants to expand access to abortion care for uninsured/underinsured Maryland residents, funded by insurer account transfers.

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Bill Summary · SB 848

SB 848 — Public Health Abortion Grant Program — Summary (Chapter 436, 2025)

Status
- Approved by the Governor and chaptered in 2025 (Chapter 436). Bill text states it takes effect July 1, 2025.

Purpose
- Establish a state-run grant program and dedicated fund to improve access to abortion care clinical services for Maryland residents—targeting people who are uninsured, underinsured for abortion care, or otherwise unable to use insurance because of risks from carrier communications.

Key provisions
- Public Health Abortion Grant Program (MDH)
- The Maryland Department of Health (MDH) will administer an operating grant program to eligible organizations to expand equitable access to abortion care clinical services.
- Grants may fund clinical services (including those for which federal funds are barred) and reasonable administrative costs.
- MDH must award at least 90% of funds appropriated for the program as grants.
- MDH must develop grant standards and may not collect or disclose identifying information about staff of grantee organizations, practitioners providing care, or individuals who receive support through the program.

  • Public Health Abortion Grant Program Fund (special, nonlapsing)

    • Fund is a special State fund administered by MDH. It receives transfers from insurers’ segregated abortion-coverage accounts, budget appropriations, interest, and other sources; interest stays in the fund.

  • Use of insurer segregated accounts / mandated transfers

    • Insurers, nonprofit health service plans, and HMOs that collect premium funds under ACA rules for abortion coverage must use those premium funds to provide abortion coverage for insureds and to support access if surplus funds exist.
    • If, after the specified post-plan-year period, a carrier’s segregated account ending balance exceeds disbursements, 90% of that excess must be used to support coverage or be transferred to the new Fund.
    • Initial transfers: by Sept 1, 2025 the Insurance Commissioner must order transfer of 90% of the excess balances for plan years 2014–2023 (including accrued interest). Thereafter transfers are ordered annually (by July 1) based on the statutory timing.
    • Carriers must report annually (by March 1) accounting for segregated account receipts, disbursements, interest, and year-end balances.

  • Definitions / eligibility

    • “Eligible organization” = entity that employs or is owned by licensed health practitioners and provides (or administers a fund to provide) equitable access to abortion care for individuals without sufficient resources; must be in good standing and have policies consistent with State law preserving abortion access.
    • “Individuals without sufficient resources” = uninsured, underinsured with inadequate abortion coverage, or unable to use insurance due to carrier communications risks.

  • Administrative and legal protections

    • Grantee and patient identifying information protections.
    • Parties aggrieved by an Insurance Commissioner transfer order may request hearing and appeal.
    • Uncodified termination clause: if CMS notifies Maryland that the law violates the ACA, specified termination procedures apply.

Fiscal impact (as reported)
- MDH special fund revenues: estimated increase of $19.3 million in FY2026 (initial transfers) and roughly $2.5 million annually thereafter from ongoing transfers.
- MDH expenditures: estimated $2.0 million in FY2026 and ~$2.5 million annually after FY2027 (mandated appropriation).
- General fund effect: minimal increase from interest earnings in early years.

Who is affected
- Eligible clinics and organizations that provide abortion clinical services (potential grantees).
- Individuals lacking sufficient resources for abortion care.
- Health insurers, nonprofit health plans, and HMOs that maintain ACA-required segregated accounts for abortion coverage (subject to reporting and transfer requirements).
- Maryland Department of Health and Maryland Insurance Administration (implementation, oversight).

Timing / next steps
- Initial transfers ordered by the Insurance Commissioner on or before Sept 1, 2025 (for plan years 2014–2023); ongoing annual transfers ordered by July 1 each year beginning 2026.
- MDH to establish grant standards and begin awarding funds per appropriation and fund availability.

Compiled from official sources — confirm details with the bill’s official record.

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