Favorable
Committee: Finance
SB0965
The Maryland Catholic Conference (MCC) is the public policy representative of the three (arch)dioceses serving Maryland, which together encompass over one million Marylanders. Statewide, their parishes, schools, hospitals, and numerous charities combine to form our state’s second largest social service provider network, behind only our state government.
Senate Bill 965 requires the Maryland Department of Health to collect and annually report data regarding the costs of birth, postpartum care, pregnancy care, and abortion; requiring the development of a standardized system to ensure consistent data collection from providers; and ensuring compliance with all applicable federal and State privacy laws in the process of collecting and reporting such data.
Maryland’s annual expenditure on women’s reproductive health care is difficult to determine due to the lack of publicly available aggregated data. Reproductive health care encompasses a wide range of services, including postpartum care, pregnancy care, labor and delivery, and abortion, with funding provided by state programs, federal contributions, and private insurance. Understanding the fiscal impact of these services is critical to assessing women’s healthcare needs and ensuring resources are allocated effectively.
One significant gap in Maryland’s healthcare reporting is the absence of abortion data, especially regarding its fiscal impact on Maryland citizens. The state has not reported abortion statistics to the CDC since 2006, and the Maryland Department of Health does not maintain official records on induced terminations. (1) This lack of data prevents a comprehensive understanding of how abortion affects women, children, and families across the state. Without regular reporting, public health agencies lack vital information on demographics such as age, race/ethnicity, marital status, prior pregnancies, and gestational periods at the time of abortion. These insights are necessary for effective public health surveillance, allowing policymakers to evaluate the socioeconomic and clinical outcomes associated with abortion and other reproductive health services.
In fiscal year 2022, the Maryland Department of Health reported that Medicaid funded 11,567 abortions, averaging $659 per procedure, totaling approximately $7.6 million. (2) These figures indicate that Maryland’s Medicaid program has been allocating substantial funds annually for abortion services, with recent increases to enhance provider reimbursements. With ongoing administrative decisions regarding Medicaid spending, further regulatory oversight is expected. The increase in abortion services in Maryland, particularly in the wake of the 2022 Dobbs v. Jackson decision, has also contributed to a rise in abortion-related travel, with Maryland becoming a destination for out-of-state residents seeking these services. According to WYPR news citing data from the Guttmacher Institute, in 2023 alone, Maryland saw over 38,000 abortions—a 29% increase from previous years—including approximately 8,100 procedures performed for non-residents. (3) As Maryland expands services to non-residents, collecting data is essential to assess the financial impact on taxpayers and understand the cost burden on state resources.
In fiscal year 2025, the Moore-Miller Administration allocated $5 million to increase Medicaid reimbursements for abortion care and reproductive health services. Additionally, the Maryland Department of Health granted $10.6 million to the University of Maryland, Baltimore, to oversee the state’s Abortion Care Clinical Training Program. (4) These expenditures highlight the substantial financial investment in reproductive healthcare, reinforcing the need for legislative oversight to ensure that funds are allocated responsibly. Maryland’s estimated annual cost for Medicaid-funded medication abortions is approximately $3.7 million, based on a national average cost of $600 per procedure and the state’s reported 11,567 Medicaid-funded abortions in 2022. (5) This estimate, assuming 53% of abortions are medication-based, does not include privately insured or out-of-pocket procedures.
The approximate average cost for prenatal care, labor/delivery, and postpartum care for Medicaid beneficiaries is $36,000. Moreover, newborns born to Medicaid-eligible mothers are deemed automatically eligible for Medicaid benefits for their first year and typically retain eligibility for subsequent years. (6) On average, Medicaid pays $9,700 for health care per eligible newborn annually (50% general funds and 50% federal funds). The extent of any increase in expenditures cannot be reliably estimated at this time. Federal fund revenues increase accordingly.
Access to comprehensive fiscal data is essential for assessing associated health risks and ensuring that adequate support is available for women. The current understanding of the fiscal scope of women’s reproductive health care is understood through Medicaid reporting and is solely underrepresenting the remainder of Maryland women who are not eligible for Medicaid or choose other insurance providers. The Maryland Catholic Conference remains committed to protecting women’s health and the sanctity of life from conception to natural death. Collecting and analyzing data on reproductive healthcare services would not only help address gaps in support for pregnant women but also provide a clearer picture of how to better serve women in need.
For these reasons, the Maryland Catholic Conference asks for a favorable report on SB 965. Thank you for your consideration.
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(1) https://lozierinstitute.org/abortion-reporting-maryland/
(2) https://mgaleg.maryland.gov/2023RS/fnotes/bil_0008/hb0958.pdf?utm
(3) https://www.wypr.org/2024-08-12/in-a-post-roe-u-s-maryland-is-seeing-rise-in-abortions-and-nonresident-visitors
(4) https://governor.maryland.gov/news/press/pages/governor-moore-announces-156-million-investment-to-improve-abortion-care-access-statewide.aspx?utm
(5) https://mgaleg.maryland.gov/2023RS/fnotes/bil_0008/hb0958.pdf?utm
(6) https://mgaleg.maryland.gov/2023RS/fnotes/bil_0008/hb0958.pdf?utm