SB785 amends Maryland law to strengthen reporting tied to abortion access. It requires the Department of Health’s annual report on the Abortion Care Clinical Training Program to include actionable recommendations the State can take to ensure a sufficient number of clinicians provide abortion care.
Separately, the bill creates a new insurance reporting duty: the Maryland Insurance Commissioner must collect specified financial data about segregated accounts established under federal ACA authority and related HHS regulations from insurers, nonprofit health service plans, and HMOs that issue coverage in Maryland and submit an aggregated report to the General Assembly’s relevant committees.
Why this matters: the bill produces two kinds of information that can drive policy — workforce recommendations that could change training, recruitment, or credentialing strategies, and hard financial data about abortion-related segregated accounts that sheds light on how carriers are handling funds tied to abortion services. Both additions create compliance work for state agencies and carriers and give policymakers new analytical tools to shape access to abortion care in Maryland.
At a Glance
What It Does
Amends Health–General §13–4707 to require the annual Abortion Care Clinical Training Program report to include recommendations on actions the State can take to ensure enough health professionals provide abortion care. Adds Insurance §15–148 requiring the Commissioner to collect receipts, disbursements, ending balances, and interest for segregated accounts established under 42 U.S.C. §1303(b)(2)(B)–(C) and 45 C.F.R. §156.280, then report aggregated results to the legislature.
Who It Affects
Directly affects the Maryland Department of Health and the Abortion Care Clinical Training Program; the Maryland Insurance Commissioner; all insurers and nonprofit health service plans issuing hospital/medical/surgical coverage in Maryland; and health maintenance organizations contracting in Maryland. Indirectly affects providers, training institutions, policy analysts, and advocacy groups that use reporting data.
Why It Matters
The workforce recommendations can change state-level training and recruitment priorities, while the insurer data creates a quantitative view of how carriers handle federally required segregated accounts for abortion-related funds. That combination links financial transparency to workforce planning — a new axis for policymaking and oversight in abortion access.
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What This Bill Actually Does
SB785 does two, related but distinct things. First, it tightens the content requirement for the Department of Health’s annual report on the Abortion Care Clinical Training Program: that report must now include specific recommendations on actions the State can take to ensure there are enough health professionals to provide abortion care.
The bill does not prescribe the recommendations’ content or format, but it elevates workforce sufficiency into a required deliverable for the Program’s annual reporting.
Second, the bill adds a new reporting duty to the Insurance Article. It applies to insurers, nonprofit health service plans, and health maintenance organizations that issue or deliver hospital, medical, or surgical benefits in Maryland.
Those entities must provide the Insurance Commissioner with annual figures — receipts, disbursements, ending balances, and interest — for segregated accounts that are established under federal ACA authority (42 U.S.C. §1303(b)(2)(B) and (C)) and the implementing federal regulation (45 C.F.R. §156.280). The Commissioner must aggregate that data and deliver a report to the Senate Finance Committee and the House Health Committee by January 1 each year.
The bill requires the report to use calendar-year data from two years prior to the report date (a two-year lag).Operationally, SB785 leaves key implementation details to the Insurance Commissioner and the Department of Health. It specifies what financial elements to collect and who receives the resulting aggregated report, and it mandates that the Program report include workforce-focused recommendations.
The act becomes effective July 1, 2026, which starts the clock on both the enhanced Program reporting and the insurer data collection schedule.
The Five Things You Need to Know
The Department of Health must include recommendations in the annual Abortion Care Clinical Training Program report about actions the State can take to ensure a sufficient abortion-care workforce.
New Insurance §15–148 requires the Commissioner to collect, each year, receipts, disbursements, ending balances, and interest for segregated accounts tied to ACA §1303(b)(2)(B)–(C) and 45 C.F.R. §156.280.
The Insurance Commissioner must submit an aggregated report to the Senate Finance Committee and the House Health Committee on or before January 1 each year.
The report must use calendar-year data that is two years immediately preceding the report’s due date (i.e.
a two-year data lag).
SB785 applies to insurers, nonprofit health service plans, and HMOs that provide hospital, medical, or surgical benefits on policies or contracts issued or delivered in Maryland; it takes effect July 1, 2026.
Section-by-Section Breakdown
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Require workforce recommendations in Program report
This amendment adds a content obligation to the Abortion Care Clinical Training Program’s annual report: it must include recommendations on actions the State can take to ensure there are enough health professionals to provide abortion care. Practically, the Department of Health must move from descriptive reporting to prescriptive guidance — producing a set of recommended interventions for policymakers. The change does not define the scope or specificity of recommendations, leaving room for the Department to propose legislative, regulatory, funding, or programmatic steps.
Scope — which carriers are covered
Subsection (a) sets the statute’s coverage: insurers and nonprofit health service plans that issue hospital/medical/surgical benefits on an expense‑incurred basis in Maryland, plus HMOs issuing contracts in the State. That language binds both commercial carriers and licensed HMOs operating in Maryland markets and clarifies that the duty is tied to the place of issuance or delivery, not necessarily to the enrollee’s residence.
Data elements to collect from carriers
The Commissioner must collect four specific financial data elements for the federally required segregated accounts: receipts, disbursements, ending balances, and interest. Those elements require carriers to map segregated-account accounting to a reporting template; carriers will need consistent definitions and supporting documentation to supply reliably comparable figures.
Reporting schedule, aggregation, and data lag
The Commissioner must aggregate the collected data and report to the Senate Finance Committee and House Health Committee by January 1 each year, using calendar-year data from two years prior. The statute mandates aggregation (not plan-level disclosure) and imposes a two-year lag between the covered calendar year and the report date, which affects the timeliness of the information for policymaking but reduces immediate disclosure concerns.
Implementation timeline
The Act takes effect July 1, 2026. That date governs when the Department should begin adding recommendations to its Program report and when the Commissioner’s data-collection authority becomes operative, setting the schedule for the first round of insurer submissions and the first aggregated report under the new statutory scheme.
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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
- State policymakers and legislative committees: Gain new, aggregated financial data on federally required segregated accounts and formal workforce recommendations to inform oversight, budgeting, and statutory fixes.
- Department of Health and program planners: Receive a statutory mandate to produce actionable workforce recommendations that can justify resource requests or program redesigns.
- Researchers and advocacy organizations focused on reproductive health: Obtain standardized, state-level aggregated data to analyze financing patterns related to abortion coverage and to support policy proposals.
- Patients seeking abortion care (indirectly): Could benefit if the workforce recommendations lead to increased training, recruitment, or incentives that expand provider availability across the State.
Who Bears the Cost
- Insurers, nonprofit health service plans, and HMOs: Must extract and submit segregated-account financial data (receipts, disbursements, balances, interest), requiring accounting, compliance, and reporting resources and possibly system changes to produce consistent figures.
- Maryland Insurance Commissioner’s office: Faces increased administrative workload to collect, validate, aggregate, and report data; may need staffing or IT resources to manage submissions and produce the annual report.
- Smaller carriers or narrow-network plans: May experience disproportionate compliance burden if they lack robust accounting systems to track segregated-account flows, potentially increasing administrative costs.
- Department of Health and Program administrators: Will need to convert evaluation material into policy recommendations and may require analytic support, stakeholder consultation, or funding to develop implementable workforce strategies.
Key Issues
The Core Tension
The central tension is between transparency and program planning on one hand — giving policymakers the workforce recommendations and financial data needed to improve access — and protecting privacy and minimizing administrative burdens on carriers and state agencies on the other; the law increases oversight and data availability but leaves unanswered how to standardize, protect, and act on that information without creating harmful side effects.
SB785 creates transparency and planning value but leaves multiple implementation questions unresolved. First, the statute prescribes data elements to collect but not the reporting format, validation standards, or carrier submission deadlines, which the Commissioner must develop administratively; inconsistent definitions across carriers could limit comparability.
Second, the law requires aggregated reporting, which reduces plan‑level exposure but does not specify aggregation granularity (e.g., statewide only or broken out by market segment), leaving choices that affect usefulness versus confidentiality. Third, while the Program report must include recommendations, the bill does not allocate resources to implement those recommendations or require follow-up metrics, so the pathway from recommendation to policy change is not specified.
The bill also creates potential operational trade-offs. The two‑year data lag reduces immediacy but may ease carriers’ reporting burden; it also limits the data’s usefulness for rapid policy responses.
Collecting financial details tied to abortion-related segregated accounts risks raising privacy and commercial-sensitivity concerns, especially for small markets or carriers with limited activity. Finally, because the statute relies on federally defined accounts and federal regulation citations, differences in federal interpretation or future federal regulatory changes could require prompt state-level adjustments to reporting expectations.
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