This bill amends Maryland law to require two new reporting streams: (1) the Department of Health must include recommendations in its annual Abortion Care Clinical Training Program report on how the State can ensure a sufficient number of health professionals to provide abortion care; and (2) the Maryland Insurance Commissioner must collect specified financial data on certain segregated accounts established under federal Affordable Care Act provisions from insurers, nonprofit health service plans, and health maintenance organizations and submit an annual aggregated report to the legislature.
The measure creates transparency about the financial flows tied to federally defined segregated accounts and builds a regular administrative mechanism for workforce planning around abortion care. Regulated carriers should expect a new recurring reporting obligation, while the Department and Insurance Commissioner will need processes and resources to collect, aggregate, and present the data the bill requires.
At a Glance
What It Does
The bill directs the Department of Health to add recommendations on ensuring sufficient abortion-care clinicians to its annual Program report due July 1. It also requires the Insurance Commissioner to collect receipts, disbursements, ending balances, and interest for segregated accounts identified by federal law and regulations and to deliver an aggregated report to the Senate Finance Committee and House Health Committee by January 1 each year, using calendar-year data from two years prior.
Who It Affects
The reporting requirement applies to insurers and nonprofit health service plans that provide hospital, medical, or surgical benefits and to health maintenance organizations whose policies or contracts are issued or delivered in Maryland. It also creates obligations for the Maryland Insurance Commissioner and obliges the Department of Health to expand the substance of its existing Program report; the legislature and policy analysts will be primary consumers of the new data and recommendations.
Why It Matters
The bill fills an information gap about funds held in federally referenced segregated accounts and introduces a formal link between program reporting and workforce recommendations. For regulators and lawmakers, the new aggregated financial data plus workforce recommendations could inform oversight, rulemaking, or budget choices; for carriers, it creates a repeating compliance task.
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What This Bill Actually Does
The first change alters the Department of Health's annual reporting on the Abortion Care Clinical Training Program. The Department must now include recommendations about concrete actions the State can take to secure a sufficient number of health professionals who provide abortion care.
The statutory reporting date remains July 1, but the amendment directs the Department to treat workforce capacity as an explicit subject of its yearly review.
The second change is a new Insurance Article provision that targets a specific class of financial accounts. The bill applies to insurers, nonprofit health service plans, and health maintenance organizations that issue or deliver hospital, medical, or surgical coverage in Maryland.
Those entities must provide the Maryland Insurance Commissioner with annual data on receipts, disbursements, ending balances, and interest for segregated accounts established under §1303(b)(2)(B) and (C) of the federal Patient Protection and Affordable Care Act and 45 C.F.R. §156.280.On timing and format, the Commissioner must aggregate the collected data and report it to the Senate Finance Committee and the House Health Committee by January 1 each year. The report must use calendar-year data from two years before the report date (for example, a report due January 1, 2028 will be based on calendar-year 2026 data).
The bill does not specify a required level of disaggregation beyond aggregate figures, nor does it create new statutory confidentiality exemptions for the data collected.Taken together, the two reporting tracks aim to improve oversight of both the financial flows related to the specified federal accounts and the human resources available to deliver abortion care. Carriers should prepare to provide four discrete financial fields annually; the Insurance Commissioner will need intake, aggregation, and publication procedures; and the Department of Health will need to translate its findings into actionable workforce recommendations.
The Act takes effect July 1, 2026.
The Five Things You Need to Know
The Department of Health must include recommendations on how Maryland can ensure a sufficient number of health professionals to provide abortion care in its annual Abortion Care Clinical Training Program report (due July 1 each year).
The Maryland Insurance Commissioner must collect from in‑state insurers, nonprofit health service plans, and HMOs annual data on receipts, disbursements, ending balances, and interest for segregated accounts established under ACA §1303(b)(2)(B) and (C) and 45 C.F.R. §156.280.
The Commissioner must submit an aggregated report to the Senate Finance Committee and the House Health Committee on or before January 1 each year using calendar-year data from two years before the report date.
The reporting obligation covers carriers that provide hospital, medical, or surgical benefits in policies or contracts issued or delivered in Maryland; it does not carve out small carriers or specify filing formats.
The act becomes effective July 1, 2026, creating the first reporting cycle that will produce an Insurance Commissioner report the following calendar year subject to the two-year data lag.
Section-by-Section Breakdown
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Add workforce recommendations to the annual Program report
This amendment requires the Department’s existing annual report on the Abortion Care Clinical Training Program to include recommendations on actions the State can take to ensure an adequate abortion-care workforce. Practically, the Department must move beyond descriptive reporting and propose policy or operational steps — e.g., training expansion, credentialing changes, or recruitment incentives — though the statute does not prescribe specific remedies or implementation timelines.
Scope — which carriers are covered
The new section starts by defining its coverage: insurers and nonprofit health service plans that provide hospital, medical, or surgical benefits on an expense‑incurred basis under policies issued or delivered in Maryland, and health maintenance organizations with contracts issued or delivered in the State. That language follows standard Maryland insurance coverage definitions and ties the obligation to where the policy is issued or delivered, not to an enrollee’s residence.
Data elements the Commissioner must collect
The statute specifies four data elements: receipts, disbursements, ending balances, and interest for segregated accounts established under ACA §1303(b)(2)(B) and (C) and 45 C.F.R. §156.280. It does not define reporting formats, thresholds, or filing deadlines for carriers, nor does it require reconciliation schedules or attestations, leaving implementation details to the Commissioner’s administrative processes.
Aggregation, reporting timeline, and data lag
The Commissioner must aggregate the collected data and deliver a report to the Senate Finance Committee and House Health Committee by January 1 each year. Critically, the statute requires the report to use calendar-year data from two years prior, creating a built‑in lag between financial activity and legislative reporting. The provision mandates aggregate reporting to legislative committees but does not require public posting or specify confidentiality protections for the data.
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Explore Healthcare in Codify Search →Who Benefits and Who Bears the Cost
Every bill creates winners and losers. Here's who stands to gain and who bears the cost.
Who Benefits
- Maryland Department of Health and state workforce planners — they gain a statutory prompt to translate program findings into concrete workforce recommendations, supporting longer-term planning and budgeting for training and recruitment.
- State legislators and policy analysts — they receive aggregated financial data and workforce recommendations that can inform oversight, budgeting, or statutory changes related to abortion access and insurer regulation.
- Researchers and advocacy groups focused on reproductive health — the aggregated account-level data should improve transparency around financial resources tied to the federal account types cited, enabling more evidence-based advocacy.
- Patients seeking abortion care (indirectly) — better-informed workforce and funding decisions could, over time, improve access and reduce service gaps if recommendations lead to concrete state actions.
Who Bears the Cost
- Insurers, nonprofit health service plans, and HMOs — they must assemble and submit four financial fields annually for the specified federal segregated accounts, creating recurring compliance and data‑collection costs.
- Maryland Insurance Commissioner’s office — the agency must build intake, aggregation, and reporting processes and absorb analytical workload; absent new funding, this will divert resources from other regulatory tasks.
- Maryland Department of Health — the Department must expand the scope of its annual Program report to include actionable workforce recommendations, which may require new data collection, stakeholder engagement, or contracted analysis.
- Carriers and regulators facing confidentiality and legal costs — because the statute does not specify confidentiality protections or data granularity, parties may incur legal or administrative costs negotiating disclosure limits or redaction.
Key Issues
The Core Tension
The bill balances the legitimate public interest in transparency and workforce planning against carriers’ operational burdens and confidentiality concerns: it demands financial visibility and workforce recommendations but gives regulators little procedural guidance or resources, and it ties legislative oversight to data that will always be at least two years out of date — trading responsiveness for regular, formal reporting.
The bill creates useful transparency but leaves key implementation details unresolved. It mandates collection of four financial variables for narrowly cited federal account provisions but does not define the reporting format, timing for carriers, thresholds for reporting, or verification standards.
That omission forces the Insurance Commissioner to fill multiple gaps administratively; without explicit statutory funding or procedural deadlines, building a reliable intake and validation process could be slow and uneven.
Another practical tension is the law’s mandated two‑year data lag: the Commissioner’s January 1 report must use calendar-year data from two years earlier, which reduces the report’s usefulness for rapid policy responses. The statute also omits explicit confidentiality rules or publication requirements, leaving carriers and the Commissioner to navigate trade secrets, competitive sensitivities, and patient privacy concerns under existing state law.
Finally, because the provision cites federal statutory and regulatory sections rather than describing covered accounts in plain terms, disagreement could arise about which accounts qualify, potentially spawning litigation or inconsistent compliance across carriers.
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