Montgomery County Puts Its Medicaid Loss Estimate at 1,082 Residents as Open Enrollment Opens

Montgomery County health officials gave the County Council a new figure Oct. 29 for how many residents are affected by a federal law that narrowed Medicaid eligibility for noncitizens starting Oct. 1: 1,082. Officials described the number in two ways. A slide shown to the Council’s Health and Human Services (HHS) Committee said “1,082 specific Montgomery County residents face direct disenrollment risks, with specific immigrant cohorts and SSI recipients heavily targeted.” A county health official told the committee the 1,082 residents “no longer have Medicaid” and called the number the latest in a series of estimates.

That figure replaces a rougher estimate from the same committee’s Oct. 26 staff memo, which said “approximately 700 to 1,200 County residents are expected to be affected” and called that Council staff’s own working estimate, noting “the state has not yet provided updated estimates for Montgomery County.”

The coverage losses stem from H.R. 1, the federal budget reconciliation law signed in July 2025. Beginning Oct. 1, 2026, the law narrowed the noncitizens who qualify for Medicaid to lawful permanent residents, certain Cuban and Haitian entrants, and citizens of the Marshall Islands, Micronesia and Palau under the Compacts of Free Association. According to the staff memo, noncitizens who lost eligibility after Sept. 30 include asylees, refugees, people whose deportation or removal has been withheld, victims of trafficking, Violence Against Women Act self-petitioners, and certain Afghan and Ukrainian humanitarian parolees. “In Maryland, the eligibility changes do not apply to pregnant women and children who would otherwise be affected,” the memo says.

Where the 1,082 figure comes from

The 1,082 figure does not appear in the written staff memo, which still cites the 700-to-1,200 estimate. It surfaced in the meeting itself, on the presentation slide and from Sean Gibson, OESS’s health insurance manager. About one hour and eight minutes into the committee’s video, Gibson said: “However, as you see in Orange, there are 1,082 individuals in Montgomery County who no longer have Medicaid.”

Thirteen minutes later, Gibson described the number as a revision: “Good news, bad news is originally the initial statewide estimate was 4500. That was a lot. And then we went to 3472. Now in Montgomery County, we’re down to 1,082, thank goodness.” That revision history, including the 3,472 figure, does not appear in the written packet, which gives the statewide figure as “up to 4,500 Maryland residents.”

What the county is doing

The Council has scheduled a Nov. 10 public hearing, at 1:30 p.m., on Supplemental Appropriation #27-29, a $1.2 million request from County Executive Marc Elrich for the DHHS Aging and Disability Services division. The request is tied directly to H.R. 1. Elrich’s Oct. 8 memo to the Council says the money would pay for “essential support services (residential and personal support)” for “High-Need Medicaid Clients in Aging and Disability Services who are no longer eligible for waiver services from the Maryland Department of Health,” including people previously served through the Developmental Disabilities Administration, Community First Choice and Nurse Monitoring services. The state health department “has indicated that it does not have the financial resources to continue serving these clients,” and without county money, the memo warns, affected residents could require “emergency intervention through hospital systems or Adult Protective Services.”

On the video, Gibson also said automatic Medicaid eligibility for Supplemental Security Income recipients ends in January, a change that does not appear in the committee’s written memo for Oct. 29.

Care for Kids enrollment nearly halves

The same Oct. 29 meeting also covered Care for Kids, the county’s health program for uninsured children. A DHHS and Primary Care Coalition slide shows enrollment falling from 10,898 in fiscal 2024 to 10,062 in fiscal 2025 to 7,984 in fiscal 2026, with a projected 5,906 in fiscal 2027, the current fiscal year.

The slide gives two reasons for the decline: “PCC lost county funding in FY24, and families lost support and enrollment began to decline,” and “Immigration enforcement has created significant fear among many immigrant families.” The written staff memo for the same item says total visits dropped 25% between fiscal 2024 and fiscal 2026, from 9,949 to 7,399.

The Council is also holding a Nov. 10 hearing on Supplemental Appropriation #27-39, a separate $487,096 request to fund seven “broker” positions to process Care for Kids and Senior Dental applications. As Moderately MOCO reported Oct. 23, the county was not processing new applications for either program because “there aren’t staff to process them,” in council staff’s words. As of Oct. 29, the county’s Care for Kids page still listed the backlog for applications filed “on or after July 1, 2026,” and added a detail not there Oct. 22: an automatic six-month eligibility renewal for anyone due to redetermine between July 1, 2026, and Feb. 28, 2027.

Where to get help

• Maryland Health Connection, the state’s insurance marketplace: open enrollment runs Sunday, Nov. 1, through Jan. 15, 2027. Enrolling by Dec. 31 starts coverage Jan. 1; enrolling Jan. 1-15 starts coverage Feb. 1. Consumer Support Center: 1-855-642-8572.
• Montgomery County DHHS, for Medicaid, Care for Kids or Senior Dental questions: MC311, 311 inside the county or 240-777-0311.
• Care for Kids: 301-628-3450.

Still unanswered

• Has the state given Montgomery County a documented county-level estimate since the Oct. 26 memo, or does 1,082 remain DHHS’s own count?
• Why does the 1,082 figure, shown on video and on a presentation slide, not appear in the written Oct. 26 staff memo?

We have not yet put these questions to DHHS or Council staff; this story will be updated with any response.

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