Though the first cuts won’t hit immediately, Marylanders on Medicaid fear they could suffer significant health setbacks under the “big, beautiful bill” that President Donald Trump signed Friday.
Some currently enrolled, including Samantha Pietrowski, a 40-year-old Somerset County resident and mother of six, already struggle to get the care they need.
Andy Harris, Pietrowski’s representative in the U.S. House of Representatives and a Trump ally, voted in favor of the bill after initially holding out.
“I voted to move the bill along in the process for the President,” Harris wrote on X after the vote. “There is still a lot of work to be done in deficit reduction and ending waste, fraud, and abuse in the Medicaid program.”
The bill will cut Medicaid by $793 billion nationwide over 10 years, according to the nonpartisan Congressional Budget Office.
Though Trump signed the bill Friday, Medicaid recipients like Pietrowski will not immediately lose access to their health insurance.
The new policies are set to phase in over time. For example, according to the Kaiser Family Foundation, the portion of the bill that institutes a work requirement to qualify for Medicaid does not go into effect until January 2027.
U.S. Health and Human Services Secretary Robert F. Kennedy Jr. must issue an implementation plan for the bill’s new Medicaid policies by Dec. 31, 2025.
Marylanders with questions about their health care coverage under Trump’s new policy can reach out to the Maryland Insurance Administration’s Health Coverage Assistance Team.
Without access to adequate health care, Medicaid recipients in Maryland worry they will languish.
‘Medically necessary’
Pietrowski had her most recent baby, a son, on April 2. He had been diagnosed in utero trisomy 3, a genetic disorder that can lead to developmental disabilities, congenital heart defects, abnormalities of the brain and spinal cord, eye problems, cleft palate, and a series of other issues.
According to the National Library of Medicine, children born with trisomy 3 have a median life expectancy of seven to 10 days. The majority don’t live to see their first birthday.
Pietrowski drove from the Eastern Shore to a Baltimore hospital for her delivery, but had a difficult time securing care for her son because of his condition.
“When I went there, their decision was they were not going to offer any kind of treatment, because they felt like he was incompatible with life,” Pietrowski said.
After his birth, a 13-day battle ensued with her insurance company for her son to be transferred to a hospital in Washington, D.C. The Medicaid provider that serves Pietrowski’s family deemed that it was not “medically necessary” to transport her child, who needed a tracheostomy and a gastrotomy tube placement.
After 16 days, her child was transported to a D.C. hospital with steadily declining health.
He died April 22.
“Who knows?” Pietrowski said. “If I didn’t have to have such large barriers to go through paperwork-wise, maybe my son would have had a little bit better chance.”
Her infant’s death wasn’t Pietrowski’s first tangle with the Medicaid system.
In November, her oldest child, a 15-year-old girl with autism, attention-deficit/hyperactivity disorder (ADHD), dyslexia and dyscalculia, briefly lost her Medicaid coverage due to clerical errors.
The teen, who regularly sees specialists for her health conditions, went without health insurance until January. At one point, Pietrowski was paying out of pocket for her daughter’s medications.
“Thankfully, because of the relationship we have with her care providers, they knew it was just an insurance holdup. They still gave her her appointments,” Pietrowski said. “That was another hurdle we had to get over.”
‘Very upset’
According to the Maryland Department of Health, more than 1.5 million state residents are covered through Medicaid. Over 660,000 Maryland children are Medicaid recipients.
Vinny DeMarco, the president of Maryland Health Care for All, a coalition of faith, business, labor and professional communities across the state that advocate for affordable health care access, said that, under Trump’s bill, “hundreds of thousands” of people could lose access to critically needed care, “which could destroy their lives.”
It could also strip Marylanders, like Towson resident Cheryl Gottlieb, 40, of their independence.
Gottlieb has cerebral palsy and was born prematurely, so her condition affects all of her muscles. Because she can’t walk very far, she uses an electric wheelchair and has issues with her fine motor skills and executive functioning.
In an interview with The Baltimore Sun before the bill’s passage Thursday, Gottlieb said she was “very upset.”
“I think that everybody’s life has value, and apparently not everybody agrees with that,” she said. “People are going to die from the results of this bill.”
Gottlieb has been enrolled in a variety of Medicaid programs through the years. While she also has private insurance through her parents’ policy, she currently receives care through the Medicaid developmental disability waiver program, which has an income requirement and mandates that she prove that she needs a nursing home-level of care and support that she can’t find in her community.
“I actually had to sign a piece of paper that said I was waiving my right to live in a nursing home in order to get these services,” Gottlieb said. “I’m waiving my right to the required service, which is an institutional level of care.”
Through her waiver program, Gottlieb receives support from aides who come to her home to help her with household tasks, like cooking and laundry, and provide transportation to places that mobility buses don’t go, like an adaptive yoga class she took in Glen Burnie.
The waiver program also reimburses her up to $7,500 in Uber and Lyft rides, so that she can see specialized doctors like her D.C.-based neurologist.
Her Medicaid waiver provides over $100,000 in care not covered by her private insurance policy, which does not cover home and community-based care services.
Drastic cuts to Medicaid could leave Gottlieb without coverage, which she said could be “detrimental” to her well-being.
“I can’t make up a six-figure budget on my own,” Gottlieb said. “I don’t have that kind of money.”
Have a news tip? Contact Hannah Gaskill at hgaskill@baltsun.com.
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