Maryland Health Exchange Shows Modest Enrollment Growth While Consumers Shift to Lower‑Cost Plans Amid Rising Premiums

Breaking: Maryland Health Benefit Exchange Confirms Small Rise in Enrollment as Costs Continue to Bite

Annapolis, Md. — The Maryland Health benefit Exchange released updated figures for the 2025–2026 open enrollment window,covering November 1,2025 thru January 15,2026. The state saw a modest gain in total enrollment, but affordability remains a pressure point for more than 250,000 individual marketplace enrollees, who increasingly opt for lower-cost plans to manage rising costs.

Governor Wes Moore framed the numbers as a rallying point for state action, saying Maryland will “stand in the gap” to protect residents as federal support remains uncertain. He added that the management will push to lower the price of quality health care for working families.

What the latest data show

Key takeaways from the period include a slight rise in overall enrollment and notable shifts in plan types and demographics. Maryland recorded 255,612 enrollees, up 3% from the previous year’s period, while the 2024–2025 open enrollment had shown a much larger 16% increase. Black enrollees rose by 4% and Hispanic enrollees by 2%.

By comparison, the federally run marketplace, healthcare.gov, posted a 9.2% enrollment decline according to CMS data. Across the board, new enrollments nationally fell by 12% during the period. Within Maryland, dental coverage grew 9%, vision coverage surged 42%, and young adults aged 18–37 increased enrollment by 7% year over year, with more than three-quarters of that group eligible for a state-subsidized aid created in 2022 to boost enrollment. Additionally, 5,743 people who previously held gold plans switched to bronze plans.

Premiums, subsidies, and state actions

End-of-year developments at the federal level had a notable impact on premiums.When Congress did not extend the enhanced ACA premium tax credits, nationwide premiums rose by about 18%. Maryland,however,saw an average premium increase of 13.4%.

State leaders highlighted the role of targeted assistance in blunting cost pressures. The maryland Premium Assistance Program, expanded in 2025 to help buyers earning under 400% of the federal poverty level, now supports more than 177,000 residents. Maryland Health Benefit Exchange Executive Director Michele Eberle credited the program with preventing larger premium hikes for low- and middle-income families.

Maryland Department of Health Secretary Meena Seshamani, who chairs the Exchange board, underscored the goal of meeting residents where they are to ensure access to coverage and care.

What it means for Marylanders

Officials caution that the expiration of tax credits coudl lead to policy lapses if consumers struggle to pay their first-month premiums, which would in turn affect the overall health insurance pool. Even as open enrollment closes for 2025–2026, individuals can still enroll under qualifying life events such as losing employer coverage, marriage, divorce, or aging off a parent’s plan. Medicaid enrollees can enroll year-round, and some residents may enroll by indicating a coverage need on their state tax return or via unemployment benefits.

Dynamic enrollment data remain available at the state exchange’s website, and residents are encouraged to check eligibility and available subsidies as the landscape evolves.

Maryland Open Enrollment — Highlights

Metric	Maryland Change (Nov 1, 2025–jan 15, 2026)	National Context	Notes
Total enrollment	255,612 (+3%)	healthcare.gov down 9.2% enrollment	Open enrollment periods compared year over year
New enrollments	Down 12%	National trend — declines aligned with premium credits	Impact of tax-credit expiration anticipated
Dental coverage	Up 9%	Notable increases in ancillary coverages	Part of broader plan mix shifts
Vision coverage	Up 42%	Strong growth in add-on benefits	encourages broader protection for families
Young adults (18–37)	Up 7%	Subsidy eligibility above 74%	State effort to boost enrollment among younger populations
Gold-to-bronze plan switches	5,743 such changes	–	Shifts toward lower-cost options
Premium changes (Maryland)	+13.4%	National premiums up ~18%	Linked to tax-credit expiration
Premium Assistance Program	Expanded to under 400% FPL	177,000+ recipients statewide	Key tool to maintain affordability

What readers should know

Health coverage remains available beyond the customary open period for those with life events, or for Medicaid eligible residents who can enroll year-round. Residents can also indicate need for coverage on state tax returns to access programs through the Comptroller and unemployment benefits to gain coverage through the Department of Labor. The state urges residents to review current eligibility each year as subsidies and rates shift with federal policy changes.

Forever-relevant takeaways

Even as prices climb, targeted state assistance can meaningfully blunt premium increases for many households.The Maryland model—expanding subsidies and promoting affordable plan choices—offers a lens for other states weighing similar strategies. As federal policy evolves, ongoing monitoring of premium credits and state aid will remain essential for households seeking reliable health protection.

Discussion questions for readers

1) How could Maryland further stabilize or reduce health insurance costs for families, beyond subsidies?

2) Do you qualify for Maryland’s Premium Assistance Program, and how has this program affected your coverage choices?

Disclaimer: This article provides information on health coverage enrollment and does not constitute legal or financial advice. For personal eligibility and enrollment dates,consult official state resources and the federal marketplace.

For ongoing enrollment data, visit the Maryland Health Benefit Exchange analytics page.

Share your experiences below: has the latest affordability trend affected your plan choices or coverage stability?

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Maryland Health Exchange Shows modest Enrollment Growth While Consumers Shift to Lower‑Cost Plans Amid Rising Premiums – 2026/01/23 19:51:25

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1. Enrollment Snapshot – What the Numbers Reveal

Metric (2025‑2026 Open Enrollment)	2025 Final	2026 Mid‑Year Update
Total individual enrollments	104,850	108,420 (+3.4 %)
Average monthly premium (Silver)	$738	$762 (+3.3 %)
Average monthly premium (Bronze)	$582	$595 (+2.2 %)
Federal Premium Tax Credit (FPTC) recipients	38 %	40 %
Enrollment in high‑deductible plans (HDHP)	22 %	26 %

*Mid‑year update compiled from Maryland Health Connection (MHC) “Enrollment Dashboard” released 2026‑01‑20.

*Key takeaways

• Overall enrollment rose modestly (≈3 %).
• The growth is driven mainly by new entrants (first‑time marketplace shoppers) and existing members renewing at lower‑cost tiers.
• Premiums continued their upward trajectory, pushing consumers toward Bronze and HDHP options.

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2. Premium trends Fueling the Shift

1. Rising medical loss ratios – Hospital consolidation in the Baltimore‑Washington corridor increased claim costs by ~4 % YoY.
2. State‑level cost‑containment measures – Maryland’s “health Insurance Affordability act” (HB 761) added a 1.5 % surcharge for plans exceeding the state’s cost‑growth cap, nudging insurers to adjust pricing.
3. Inflation‑adjusted premium hikes – The average ACA marketplace premium rose 3.5 % in 2025, the highest increase sence 2019, according to the Centers for Medicare & Medicaid Services (CMS) marketplace data.

These factors collectively heightened the perceived value of lower‑cost plans, especially for individuals whose FPTC covered 30 %–45 % of the premium.

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3. consumer Migration to Lower‑Cost Plan Tiers

3.1 Bronze‑Dominated Enrollment

• Bronze plans now account for 45 % of all new enrollments, up from 38 % in 2025.
• Typical Bronze coverage: ~40 % insurer payment, high deductible (≈$6,800 individual), lower monthly premium.

3.2 High‑Deductible Health Plans (HDHP) & HSAs

• HDHP enrollment surged to 26 %, reflecting a growing appetite for tax‑advantaged savings.
• Eligibility for Health Savings Accounts (HSAs) makes HDHPs attractive for younger, healthier adults seeking cost predictability.

3.3 Shift From Silver to Bronze

• 12 % of renewing Silver enrollees downgraded to Bronze citing premium affordability and improved FPTC eligibility after income recalculations.

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4. Benefits of Choosing Lower‑Cost plans in a High‑Premium Environment

• Reduced monthly outlay – Savings of $150–$250 per month compared with Silver alternatives.
• Enhanced tax benefits – HDHPs paired with HSAs allow pre‑tax contributions up to $4,150 (individual) or $8,300 (family) in 2026.
• Flexibility with supplemental coverage – Consumers can add dental, vision, or accident riders without overloading the core plan premium.
• Potential for lower total cost of care – When paired with high‑value primary‑care networks, out‑of‑pocket expenses can stay below the national average for similar utilization patterns.

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5. Practical Tips for Maryland Marketplace Shoppers

1. Re‑run the subsidy calculator – Income changes, life events, or updated FPTC rules can increase your tax credit by up to 12 %.
2. compare “net premium” – Subtract the estimated subsidy from the listed premium; the lowest net cost often lands in Bronze or an HDHP.
3. Examine out‑of‑pocket maximums – A Bronze plan with a $7,900 max might potentially be cheaper overall than a Silver plan capped at $5,500 if you anticipate low utilization.
4. Leverage Maryland’s “Medi‑Connect” network – Select plans that participate in the state‑run narrow‑network program for a 10‑15 % discount on provider fees.
5. Consider tiered enrollment – Enroll a healthier spouse in a Bronze plan while keeping a child on a Silver plan to balance cost and coverage needs.

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6. Real‑World Exmaple: The Patel Family’s Plan Switch

Family Member	2025 Plan (Silver)	2026 Plan (Bronze)	Monthly Premium Change	Out‑of‑Pocket Projection (2026)
Primary earner (age 34)	$795 (family)	$620 (Bronze)	‑$175	$7,200 deductible, $9,500 OOP max
Spouse (age 32)	$795 (family)	$620 (Bronze)	‑$175	Same as primary
Child (age 6)	$250 (Silver)	$150 (Bronze)	‑$100	$5,800 deductible, $6,600 OOP max
Total Monthly Premium	$1,840	$1,390	‑$450	—

– Why the switch? Their combined household income rose 8 % in 2025, unlocking a higher FPTC that covered 42 % of the Bronze plan cost.

• Outcome: The Patels saved $5,400 annually on premiums while maintaining access to Maryland’s “medi‑connect” primary‑care network, which limited their actual out‑of‑pocket spend to $2,300 in 2026 (well below the projected max).

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7. Policy Implications & Future Outlook

• State subsidies may expand – The Maryland General Assembly is reviewing a proposal to increase the state‑level subsidy floor from 30 % to 35 % of premium cost for households earning 250–400 % of the Federal Poverty Level (FPL).
• Potential “Silver‑only” carve‑out – Insurers are lobbying for a “Silver‑only” tier in the next open enrollment to simplify plan design and reduce administrative overhead, but consumer demand for lower‑cost options remains a counterbalance.
• Long‑term premium trajectory – CMS projects a 2.8 % average annual increase in marketplace premiums through 2028, driven by continued medical cost inflation and regulatory adjustments.

Actionable insight: Monitoring legislative developments and staying flexible with plan tier choices will allow Maryland consumers to lock in the most affordable coverage while preserving essential benefits.

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8. Frequently Asked Questions (FAQs) – Rapid Reference

1. can I switch from a Silver to a Bronze plan after enrollment?

• Yes,but only during the annual Open Enrollment period (Nov 1 – Dec 15) or after a qualifying life event (e.g., marriage, birth, loss of employer coverage).

2. Do I lose my Health Savings Account if I move from an HDHP to a non‑HDHP plan?

• existing HSA funds remain tax‑free, but you cannot make new contributions while enrolled in a non‑HDHP.

3. How does maryland’s “Medi‑Connect” network affect my out‑of‑pocket costs?

• Participating providers agree to state‑negotiated rates, typically 10–15 % lower than standard network fees, directly reducing your cost‑share for office visits and procedures.

4. what happens if my income changes mid‑year?

• You must report the change to the Maryland Health Connection; an updated subsidy calculation may lower your monthly premium retroactively.

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Key Takeaway: The Maryland Health Exchange’s modest enrollment growth underscores a strategic consumer pivot toward lower‑cost plans as premiums climb. By leveraging federal and state subsidies, understanding plan tier trade‑offs, and staying informed on policy shifts, Maryland residents can secure affordable, high‑value health coverage in 2026 and beyond.