Maryland Health Insurers See Enrollment Shifts Amid Rising Costs, State Program Offers Lifeline

Annapolis, MD – Data released by the Maryland Health Benefit Exchange for the recent open enrollment period, which concluded on January 15, 2026, reveal a complex landscape for Maryland residents seeking health insurance. While overall enrollment saw a modest increase, a trend of consumers opting for less comprehensive and more affordable plans indicates a growing struggle with rising insurance costs. These figures come as the state’s Premium Assistance Program continues to play a crucial role in ensuring access to coverage for many families.

The enrollment period from November 1, 2025, to January 15, 2026, saw 255,612 individuals enroll in plans through the Maryland Health Benefit Exchange. This represents a 3% increase in total enrollment, a notably slower growth rate compared to the 16% surge observed in the previous year’s open enrollment for 2024-2025. During this latest period, enrollment among Black consumers rose by 4%, and Hispanic consumer enrollment increased by 2%. In contrast, the federally facilitated marketplace, Healthcare.gov, experienced a 9.2% decline in enrollment. New enrollments specifically decreased by 12%.

Amidst these trends, enrollment in dental plans saw a significant 9% rise, and vision plan enrollment surged by 42%. Young adults between the ages of 18 and 37 showed increased enrollment, with a 7% growth from the previous year. More than 74% of these younger enrollees qualified for subsidies established by Maryland in 2022 to encourage their participation in health insurance. However, the data also indicate a financial pressure point, with 5,743 individuals who previously held “gold” level plans downgrading to less expensive “bronze” plans.

These shifts in consumer behavior are occurring against a backdrop of increasing health insurance premiums. The failure of Congressional Republicans to extend enhanced Affordable Care Act premium tax credits at the end of 2025 has led to a national average premium increase of 18%. In Maryland, the average rate hike for marketplace plans was 13.4%.

In response to these rising costs and the anticipation of federal inaction, Governor Wes Moore and the Maryland General Assembly expanded the state’s Premium Assistance Program during the 2025 legislative session. This expansion aims to lower premiums for individuals purchasing health insurance through Maryland Health Connection with incomes below 400% of the federal poverty level. Currently, over 177,000 Marylanders are benefiting from this program. This initiative is designed to help mitigate the impact of premium increases for low and middle-income families, ensuring they can maintain health coverage.

While the open enrollment period has concluded, avenues for obtaining health insurance coverage remain available for Maryland residents. Individuals experiencing qualifying life events, such as losing employer-sponsored coverage, getting married or divorced, or aging off a parent’s plan at age 26, may be eligible for special enrollment. Additionally, individuals can indicate a need for coverage on their state income tax returns to enroll in programs managed by the Office of the Comptroller. Those who file for unemployment insurance may also gain access to coverage through the Maryland Department of Labor. Residents eligible for Medicaid can enroll at any time of the year.

Dynamic enrollment data from the Maryland Health Benefit Exchange is accessible on the marylandhbe.com website.

Article by Mel Anara, based upon information from the Office of Governor Wes Moore

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