More Black, Hispanic and young Marylanders enrolled in state insurance marketplace

A record-breaking 247,000 Marylanders got private health insurance through the state’s insurance marketplace during the just-ended 2024 open enrollment period, an increase which includes more Black, Hispanic and young Marylanders enrolling in private health care, new data shows.
The Maryland Health Benefit Exchange, which manages the state’s insurance marketplace under the Affordable Care Act, said in a Friday press release that the latest open enrollment period saw a 16% increase in enrollees compared to the 2023 count, with a total of 247,243 Marylanders buying health coverage from the marketplace in 2024.
“We’re really thrilled,” Michele Eberle, executive director for MHBE, said Friday. “Last year … I said to my team, ‘Let’s try to get 250,000 this year,’ and they all thought I was crazy. Lo and behold — we came up with over 247,000. So, we’re getting pretty darn close to that.”
She was also pleased that the record-breaking enrollment numbers included increases among targeted demographics for the exchange, which includes Black and Hispanic populations along with young adults.
Open enrollment, when people can sign up for a health insurance plan or make changes to their current plan, ran from Nov. 1 through Jan. 15. The most recent number continues a seven-year climb in enrollments on the state marketplace, according to data from the exchange.
More than one-third of the 2024 enrollments were from people aged 18-37, the young adult population that can qualify for a subsidy that helps bring their health care costs down by an average of $38 per month, depending on financial needs.
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There were 89,642 in that age group who enrolled this year — a 21% increase compared to the young adult enrollment in 2023, which was 73,858.
“That’s 36% of our total enrollments (this year),” Eberle said.
Of the nearly 90,000 young adults enrolled this year, 72% qualified for the young adult subsidy. It was created in 2022 as a pilot program to bring costs down for qualifying young people, who tend to make up one of the largest uninsured populations, Eberle said. Some members of the General Assembly are interested in making the youth subsidy permanent through legislation in the 2025 session.
Eberle said said that having young healthy people enrolled in the insurance pool helps keep premium costs down for everyone, while also ensuring that younger adults are covered during unanticipated medical situations.
“We’ve done a lot to educate younger folks,” she said. “You don’t know when there’s going to be a pandemic, If you’re going to have an unintended pregnancy. You don’t know if you get a chronic condition or a cancer — or if you just fall and break your leg.”
She was also pleased with the increase in enrollments among Black and Hispanic Marylanders.
Enrollment by Black Marylanders grew 23% in 2024 — from 41,611 in the 2023 enrollment period to 51,086 in the most recent period. For Hispanic Marylanders, those enrollment numbers grew from 28,701 to 35,883, an increase of 25%.
While the overall number of enrollments was rising, the number of new enrollees decreased compared to last year. In 2023, there were 56,220 new enrollments to the marketplace. For 2024, there were 54,255 new enrollments — a decrease of 4%.
Eberle is not worried about that drop.
“The reason is that all last year, we had the public health emergency unwind. So as people were moving off of Medicaid, it qualified them for a special enrollment, and they could come in and get coverage through the exchange,” she said. “We started our renewals at a much higher level than we had in years past.”
Those renewing their insurance on the marketplace grew instead, with a 22% increase in the latest period. That means that about 193,000 people renewed coverage on the marketplace this year compared to 158,000 last year.
“Part of that is because we have very affordable health plans – we refer to that as the ‘stickiness’ of insurance. If people like their health plans and they feel it that it’s affordable for them then they stay in their coverage,” she said. “So those are all good signs.”
While Eberle and others at the health exchange are excited about the recent enrollment numbers, they said that the next year will be focused on responding to any potential federal policy changes under the incoming Trump administration that could reduce access to affordable health care plans for some people on the marketplace.
That could include a couple hundred Deferred Action for Childhood Arrivals (DACA) recipients, or so-called “Dreamers.” Those people, undocumented immigrants who were brought to the U.S. as children, has been barred from buying private health insurance through the state marketplace, but a federal change by the Biden administration allowed them to buy on the marketplace for the first time this year.
About 249 Marylanders with DACA status purchased health care on the exchange this year. Depending what the Trump administration has in store, Eberle is worried that their new access to the marketplace could be at risk, among other concerns.
“I think we’ll just be on guard for any changes coming down from the federal government,” Eberle said. “We’ll be eyes wide open. We’ll be prepared for what may come out of Congress or what may come out of the new federal administration and how we can make sure that we can get health coverage for Marylanders.
“That will be our largest challenge this year,” she said.
