EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
[Brackets] indicate matter deleted from existing law.
*sb0848*
SENATE BILL 848
J1, J5, J4 5lr2767
CF HB 930
By: Senator Guzzone
Introduced and read first time: January 28, 2025
Assigned to: Finance and Budget and Taxation
A BILL ENTITLED
AN ACT concerning 1
Public Health Abortion Grant Program – Establishment 2
FOR the purpose of establishing the Public Health Abortion Grant Program to provide 3
grants to improve access to abortion care clinical services for individuals in the State; 4
establishing the Public Health Abortion Grant Program Fund as a special, 5
nonlapsing fund to provide grants under the Public Health Abortion Grant Program; 6
requiring that certain premium funds collected by health insurance carriers be used 7
to provide certain coverage and to support improving access to abortion care clinical 8
services under certain circumstances; and generally relating to the Public Health 9
Abortion Grant Program and Fund. 10
BY adding to 11
Article – Insurance 12
Section 15–147 13
Annotated Code of Maryland 14
(2017 Replacement Volume and 2024 Supplement) 15
BY adding to 16
Article – Health – General 17
Section 13–5501 through 13–5503 to be under the new subtitle “Subtitle 55. Public 18
Health Abortion Grant Program” 19
Annotated Code of Maryland 20
(2023 Replacement Volume and 2024 Supplement) 21
BY repealing and reenacting, without amendments, 22
Article – State Finance and Procurement 23
Section 6–226(a)(2)(i) 24
Annotated Code of Maryland 25
(2021 Replacement Volume and 2024 Supplement) 26
BY repealing and reenacting, with amendments, 27 2 SENATE BILL 848
Article – State Finance and Procurement 1
Section 6–226(a)(2)(ii)204. and 205. 2
Annotated Code of Maryland 3
(2021 Replacement Volume and 2024 Supplement) 4
BY adding to 5
Article – State Finance and Procurement 6
Section 6–226(a)(2)(ii)206. 7
Annotated Code of Maryland 8
(2021 Replacement Volume and 2024 Supplement) 9
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 10
That the Laws of Maryland read as follows: 11
Article – Insurance 12
15–147. 13
(A) THIS SECTION APPLIES TO : 14
(1) INSURERS AND NONPROF IT HEALTH SERVICE PL ANS THAT 15
PROVIDE HOSPITAL , MEDICAL, OR SURGICAL BENEFITS TO INDIVIDUALS OR GR OUPS 16
ON AN EXPENSE –INCURRED BASIS UNDER HEALTH INSURANCE POL ICIES OR 17
CONTRACTS THAT ARE I SSUED OR DELIVERED I N THE STATE; AND 18
(2) HEALTH MAINTENANCE O RGANIZATIONS THAT PR OVIDE 19
HOSPITAL, MEDICAL, OR SURGICAL BENEFITS TO INDIVIDUALS OR GR OUPS UNDER 20
CONTRACTS THAT ARE I SSUED OR DELIVERED I N THE STATE. 21
(B) (1) ANY PREMIUM FUNDS COL LECTED BY AN ENTITY SUBJECT TO 22
THIS SECTION FOR ABO RTION COVERAGE IN AC CORDANCE WITH § 1303(B)(2)(B) 23
AND (C) OF THE FEDERAL PATIENT PROTECTION AND AFFORDABLE CARE ACT 24
SHALL BE USED: 25
(I) TO PROVIDE COVERAGE FOR ABORTION CARE CL INICAL 26
SERVICES FOR INSURED S OR ENROLLEES IN AC CORDANCE WITH § 15–857 OF THIS 27
TITLE; AND 28
(II) IN ACCORDANCE WITH P ARAGRAPH (2) OF THIS 29
SUBSECTION. 30
(2) IF AFTER THE 12–MONTH PERIOD FOLLOWI NG THE END OF A PLAN 31
YEAR THE AMOUNT OF T HE ENDING BALANCE OF A SEGREGATED ACCOUNT 32
ESTABLISHED FOR COVE RAGE OF ABORTIO N CARE CLINICAL SERV ICES EXCEEDS 33
DISBURSEMENTS , 90% OF THE ENDING BALANC E SHALL BE USED TO S UPPORT 34 SENATE BILL 848 3
COVERAGE OF ABORTION CARE CLINICAL SERVIC ES FOR WHICH THE USE OF 1
FEDERAL FUNDS IS PRO HIBITED. 2
(C) ON OR BEFORE MARCH 1 EACH YEAR, AN ENTITY SUBJECT TO THIS 3
SECTION SHALL SUBMIT TO THE COMMISSIONER AN ACCOU NTING OF RECEIPTS , 4
DISBURSEMENTS , ACCRUED INTEREST , AND THE YEAR –END BALANCE FOR 5
SEGREGATED ACCOUNTS ESTABLISHED BY THE E NTITY UNDER § 1303(B)(2)(B) AND 6
(C) OF THE FEDERAL PATIENT PROTECTION AND AFFORDABLE CARE ACT: 7
(1) ON A FORM APPROVED B Y THE COMMISSIONER ; AND 8
(2) WITH ANY RELATED DOC UMENTATION REQUIRED BY THE 9
COMMISSIONER . 10
(D) (1) SUBJECT TO PARAGRAPH (2) OF THIS SUBSECTION , THE 11
COMMISSIONER SHALL OR DER THE TRANSFER OF FUNDS FROM EACH ENTI TY’S 12
SEGREGATED ACCOUNT E STABLISHED BY THE EN TITY FOR COVERAGE OF ABORTION 13
CARE CLINICAL SERVIC ES TO THE PUBLIC HEALTH ABORTION GRANT PROGRAM 14
FUND ESTABLISHED UNDE R § 13–5503 OF THE HEALTH – GENERAL ARTICLE IN THE 15
FOLLOWING AMOUNTS : 16
(I) ON OR BEFORE SEPTEMBER 1, 2025, 90% OF THE AMOUNT 17
OF THE ENDING BALANC E OF THE SEGREGATED ACCOUNT THAT EXCEEDS 18
DISBURSEMENTS FOR EA CH OF PLAN YEARS 2014 THROUGH 2023; AND 19
(II) ON OR BEFORE JULY 1 EACH YEAR, BEGINNING IN 2026, 20
90% OF THE AMOUNT OF THE ENDING BALANCE OF A SEGREGATED ACCOUNT TH AT 21
EXCEEDS DISBURSEMENT S AFTER THE 15–MONTH PERIOD FOLLOWI NG THE END OF 22
A PLAN YEAR. 23
(2) (I) THE AMOUNT ORDERED TO BE TRANSFERRED UNDER 24
PARAGRAPH (1)(I) OF THIS SUBSECTION S HALL INCLUDE THE AMO UNT OF INTEREST 25
ACCRUED TO THE SEGRE GATED ACCOUNT AS OF DECEMBER 31, 2025. 26
(II) THE AMOUNT ORDERED TO BE TRANSFERRED UNDER 27
PARAGRAPH (1)(II) OF THIS SUBSECTION S HALL INCLUDE THE AMO UNT OF 28
INTEREST ACCRUED TO THE SEGREGATED ACCOU NT AS OF DECEMBER 31 OF THE 29
IMMEDIATELY PRECEDIN G CALENDAR YEAR . 30
(E) A PARTY AGGRIEVED BY A N ORDER OF THE COMMISSIONER UNDER TH IS 31
SECTION HAS THE RIGH T TO A HEARING AND T HE RIGHT TO APPEAL F ROM THE 32
ORDER OF THE COMMISSIONER UNDER §§ 2–210 THROUGH 2–215 OF THIS ARTICLE. 33
4 SENATE BILL 848
Article – Health – General 1
SUBTITLE 55. PUBLIC HEALTH ABORTION GRANT PROGRAM. 2
13–5501. 3
(A) IN THIS SUBTITLE THE FOLLOWING WORDS HAVE THE MEANINGS 4
INDICATED. 5
(B) “ELIGIBLE ORGANIZATION ” MEANS AN ORGANIZATIO N THAT: 6
(1) (I) 1. IS OWNED BY OR EMPLOY S HEALTH CARE 7
PRACTITIONERS WHO AR E AUTHORIZED TO PRACTICE UNDER THE HEALTH 8
OCCUPATIONS ARTICLE; AND 9
2. PROVIDES EQUITABLE AC CESS TO ABORTION CAR E 10
CLINICAL SERVICES FO R INDIVIDUALS WITHOU T SUFFICIENT RESOURC ES; OR 11
(II) ADMINISTERS A FUND TO PROVIDE EQUITABLE AC CESS TO 12
ABORTION CARE CLINIC AL SERVICES FOR INDIVIDUALS WITHOUT SUFFICIENT 13
RESOURCES; 14
(2) IS IN GOOD STANDING I N THE STATE OR JURIS DICTION IN WHICH 15
THE ORGANIZATION IS REGISTERED OR INCORP ORATED; AND 16
(3) HAS POLICIES THAT DO NOT RESTRICT ACCESS TO ABORTION 17
CARE AND ARE CONSIST ENT WITH TITLE 20, SUBTITLE 2 OF THIS ARTICLE. 18
(C) “FUND” MEANS THE PUBLIC HEALTH ABORTION GRANT PROGRAM 19
FUND. 20
(D) “INDIVIDUALS WITHOUT S UFFICIENT RESOURCES ” MEANS INDIVIDUALS 21
WHO ARE: 22
(1) UNINSURED; 23
(2) UNDERINSURED , WITHOUT SUFFICIENT A BORTION COVERAG E; 24
OR 25
(3) UNABLE TO USE THEIR I NSURANCE DUE TO THE RISKS POSED BY 26
COMMUNICATION FROM I NSURANCE CARRIERS RE GARDING COVERAGE . 27
SENATE BILL 848 5
(E) “PROGRAM” MEANS THE PUBLIC HEALTH ABORTION GRANT 1
PROGRAM. 2
13–5502. 3
(A) THERE IS A PUBLIC HEALTH ABORTION GRANT PROGRAM. 4
(B) THE PURPOSE OF THE PROGRAM IS TO PROVIDE GRANTS TO IMPROVE 5
ACCESS TO ABORTION C ARE CLINICAL SERVICE S FOR INDIVIDUALS IN THE STATE. 6
(C) (1) THE SECRETARY SHALL PROVI DE OPERATING GRANTS TO 7
ELIGIBLE ORGANIZATIO NS TO SUPPORT EQUITA BLE ACCESS TO ABORTI ON CARE 8
CLINICAL SERVICES AC ROSS THE STATE. 9
(2) GRANT FUNDS PROVIDED UNDER THE PROGRAM SHALL BE USED 10
TO SUPPORT ABORTION CARE CLINICAL SERVIC ES FOR WHICH FEDERAL FU NDING 11
IS PROHIBITED FOR IN DIVIDUALS WITHOUT SU FFICIENT RESOURCES , INCLUDING 12
TO COVER REASONABLE ADMINISTRATIVE COSTS OF MANAGING SERVICES 13
PROVIDED UNDER THE G RANT. 14
(D) THE DEPARTMENT SHALL AWAR D AT LEAST 90% OF THE FUNDS 15
APPROPRIATED FOR THE PROGRAM AS GRANTS TO ELIGIBLE ORGANIZATIO NS. 16
(E) THE DEPARTMENT MAY NOT : 17
(1) RELEASE, PUBLISH, OR OTHERWISE DISCLOS E ANY IDENTIFYING 18
INFORMATION FOR : 19
(I) THE STAFF OF AN ELIGI BLE ORGANIZATION THA T APPLIES 20
FOR OR RECEIVES A GR ANT OR REIMBUR SEMENT FROM GRANT FU NDING UNDER 21
THE PROGRAM; OR 22
(II) AN INDIVIDUAL HEALTH CARE PRACTITIONER OR STAFF 23
WHO PROVIDES ABORTIO N CARE CLINICAL SERV ICES FOR AN ELIGIBLE 24
ORGANIZATION THAT RE CEIVES A GRANT OR RE IMBURSEMENT FROM GRA NT 25
FUNDING UNDER THE PROGRAM; OR 26
(2) COLLECT IDENTIFYING I NFORMATION FOR INDIV IDUALS WHO 27
REQUEST OR OBTAIN SU PPORT FOR ABORTION C ARE CLINICAL SERVICE S FROM AN 28
ELIGIBLE ORGANIZATIO N AWARDED A GRANT UN DER THE PROGRAM. 29
(F) THE DEPARTMENT MAY NOT : 30
6 SENATE BILL 848
(1) RESTRICT THE USE OF F UNDS GRANTED UNDER THE PROGRAM IN 1
A MANNER THAT IS INC ONSISTENT WITH TITLE 20, SUBTITLE 2 OF THIS ARTICLE; OR 2
(2) ALLOW AN ELIGIBLE ORG ANIZATION THAT IS AW ARDED A GRANT 3
UNDER THE PROGRAM TO RESTRICT T HE USE OF FUNDS IN A MANNER THAT IS 4
INCONSISTENT WITH TITLE 20, SUBTITLE 2 OF THIS ARTICLE. 5
(G) THE DEPARTMENT SHALL DEVE LOP STANDARDS FOR TH E GRANTS TO 6
ENSURE FUNDS ARE BEI NG USED IN ACCORDANC E WITH THE REQUIREME NTS OF 7
THIS SECTION. 8
13–5503. 9
(A) THERE IS A PUBLIC HEALTH ABORTION GRANT PROGRAM FUND. 10
(B) THE PURPOSE OF THE FUND IS TO PROVIDE GR ANTS UNDER THE 11
PROGRAM. 12
(C) THE SECRETARY SHALL ADMIN ISTER THE FUND. 13
(D) (1) THE FUND IS A SPECIAL , NONLAPSING FUND THAT IS NOT 14
SUBJECT TO § 7–302 OF THE STATE FINANCE AND PROCUREMENT ARTICLE. 15
(2) THE STATE TREASURER SHALL HOLD THE FUND SEPARATELY , 16
AND THE COMPTROLLER SHALL ACC OUNT FOR THE FUND. 17
(E) THE FUND CONSISTS OF : 18
(1) MONEY TRANSFERRED TO THE FUND UNDER § 15–147 OF THE 19
INSURANCE ARTICLE; 20
(2) MONEY APPROPRIATED IN THE STATE BUDGET TO THE FUND; 21
(3) INTEREST EARNINGS OF THE FUND; AND 22
(4) ANY OTHER MONEY FROM ANY OTHER SOURCE ACC EPTED FOR 23
THE BENEFIT OF THE FUND. 24
(F) THE FUND MAY BE USED ONLY FOR THE PROGRAM. 25
(G) (1) THE STATE TREASURER SHALL INVES T THE MONEY OF THE FUND 26
IN THE SAME MANNER AS OTHER STATE MONEY MAY BE IN VESTED. 27
SENATE BILL 848 7
(2) ANY INTEREST EARNINGS OF THE FUND SHALL BE CREDITE D TO 1
THE FUND. 2
(H) EXPENDITURES FROM THE FUND MAY BE MADE ONLY IN ACCORDANCE 3
WITH THE STATE BUDGET . 4
(I) ON OR BEFORE OCTOBER 1, 2025, THE GOVERNOR SHALL ALLOCATE TO 5
THE PROGRAM BY BUDGET AME NDMENT $2,000,000 IN FUNDING AS REQUIR ED TO 6
BE TRANSFERRED TO TH E FUND UNDER § 15–147(D)(1)(I) OF THE INSURANCE 7
ARTICLE. 8
(J) BEGINNING IN FISCAL Y EAR 2027, THE GOVERNOR SHALL INCLUD E IN 9
THE ANNUAL BUDGET BI LL AN APPRO PRIATION FOR THE FUND THAT IS AT LEAST 10
EQUAL TO THE FUNDING REQUIRED TO BE TRANS FERRED TO THE FUND UNDER § 11
15–147(D)(1)(II) OF THE INSURANCE ARTICLE. 12
Article – State Finance and Procurement 13
6–226. 14
(a) (2) (i) 1. This subparagraph does not apply in fiscal years 2024 15
through 2028. 16
2. Notwithstanding any other provision of law, and unless 17
inconsistent with a federal law, grant agreement, or other federal requirement or with the 18
terms of a gift or settlement agreement, net interest on all State money allocated by the 19
State Treasurer under this section to special funds or accounts, and otherwise entitled to 20
receive interest earnings, as accounted for by the Comptroller, shall accrue to the General 21
Fund of the State. 22
(ii) The provisions of subparagraph (i) of this paragraph do not apply 23
to the following funds: 24
204. the Victims of Domestic Violence Program Grant Fund; 25
[and] 26
205. the Proposed Programs Collaborative Grant Fund; AND 27
206. THE PUBLIC HEALTH ABORTION GRANT PROGRAM 28
FUND. 29
SECTION 2. AND BE IT FURTHER ENACTED, That: 30
(a) If, on or before June 30, 2031, the Centers for Medicare and Medicaid Services 31
advises the Maryland Insurance Administration that the provisions of Section 1 of this Act 32 8 SENATE BILL 848
violate § 1303 of the federal Patient Protection and Affordable Care Act, Section 1 of this 1
Act, with no further action required by the General Assembly, shall be abrogated and of no 2
further force and effect. 3
(b) The Maryland Insurance Administration shall notify the Department of 4
Legislative Services within 5 days after receiving notice that Section 1 of this Act violates 5
§ 1303 of the federal Patient Protection and Affordable Care Act. 6
SECTION 3. AND BE IT FURTHER ENACTED, That this Act shall take effect July 7
1, 2025. 8