Public Health - Universal Health Care Program - Study and Commission

EXPLANATION: CAPITALS INDICATE MATTER ADDED TO EXISTING LAW.
[Brackets] indicate matter deleted from existing law.
*hb1316*

HOUSE BILL 1316
J1 6lr2610

By: Delegates Ruth, Allen, Behler, Ebersole, Fair, Lehman, McCaskill,
Palakovich Carr, Terrasa, and Woorman
Introduced and read first time: February 12, 2026
Assigned to: Health

A BILL ENTITLED

AN ACT concerning 1

Public Health – Universal Health Care Program – Study and Commission 2

FOR the purpose of requiring the Hilltop Institute at the University of Maryland, Baltimore 3
County to conduct a study on the feasibility of establishing a universal health care 4
program through a single –payer system in the State ; establishing the Advisory 5
Commission on Universal Health Care to assist the Institute in the development of 6
final findings and recommendations based on a certain study; and generally relating 7
to a study on the implementation of a universal health care program. 8

BY adding to 9
Article – Health – General 10
Section 13–5901 through 13–5904 to be under the new subtitle “Subtitle 59. Study 11
on Universal Health Care Program” 12
Annotated Code of Maryland 13
(2023 Replacement Volume and 2025 Supplement) 14

SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 15
That the Laws of Maryland read as follows: 16

Article – Health – General 17

SUBTITLE 59. STUDY ON UNIVERSAL HEALTH CARE PROGRAM. 18

13–5901. 19

(A) IN THIS SUBTITLE THE FOLLOWING WORDS HAVE THE MEANINGS 20
INDICATED. 21

(B) “COMMISSION” MEANS THE ADVISORY COMMISSION ON UNIVERSAL 22
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HEALTH CARE. 1

(C) “INSTITUTE” MEANS THE HILLTOP INSTITUTE AT THE UNIVERSITY OF 2
MARYLAND, BALTIMORE COUNTY. 3

13–5902. 4

(A) THE INSTITUTE SHALL CONDU CT A STUDY TO DETERM INE THE 5
FEASIBILITY OF ESTABLISHING A UNIVERSAL HEALTH CARE PROGRAM THROUGH A 6
SINGLE–PAYER HEALTH CARE SYSTEM IN THE STATE. 7

(B) THE STUDY SHALL EVALUATE ESTABLISHING A SINGLE–PAYER HEALTH 8
CARE SYSTEM MODEL THAT WOULD PROVIDE THE FOLLOWING TO ALL INDIVIDUALS 9
IN THE STATE: 10

(1) COMPREHENSIVE, AFFORDABLE, AND HIGH –QUALITY PUBLICLY 11
FINANCED HEALTH CARE COVERAGE PROVIDED IN A SEAMLESS AND EQ UITABLE 12
MANNER, REGARDLESS OF INCOME , ASSETS, HEALTH STATUS , CITIZENSHIP OR 13
IMMIGRATION STATUS, OR AVAILABILITY OF OTHER HEALTH CARE COVERAGE; 14

(2) A BENEFIT PACKAGE COVE RING PRIMARY CARE , PREVENTIVE 15
CARE, CHRONIC CARE, ACUTE EPISODIC CARE , REPRODUCTIVE CARE, INCLUDING 16
PREGNANCY, BIRTH CONTROL, AND ABORTION SERVICES, HOSPITAL SERVICES, AND 17
BEHAVIORAL HEALTH SERVICES, TO THE EXTENT THOSE SERVICES ARE AVAILABLE 18
UNDER STATE LAW; 19

(3) AT MINIMUM , THE 10 ESSENTIAL BENEFITS DESCRIBED UNDER 20
THE FEDERAL AFFORDABLE CARE ACT AND THE BENEFITS REQUIRED TO BE 21
COVERED UNDER MARYLAND HEALTH CONNECTIONS PLANS; AND 22

(4) THE REQUIRED BENEFITS UNDER THE MARYLAND MEDICAL 23
ASSISTANCE PROGRAM AND MEDICARE. 24

(C) IN CONDUCTING THE STUDY, THE INSTITUTE SHALL: 25

(1) REVIEW PLANS, ANALYSES, PROGRAMS, AND LEGISLATION IN 26
OTHER STATES REGARDING SINGLE–PAYER HEALTH CARE SYSTEMS; 27

(2) ANALYZE AND DEVELOP COST PROJECTIONS FOR PROVIDING AND 28
ADMINISTERING THE BENEFITS DESCRIBED UNDER SUBSECTION (B) OF THIS 29
SECTION AND THE COLLATERAL C OSTS OF OPERATING A SINGLE–PAYER HEALTH 30
CARE SYSTEM , INCLUDING THE AMOUNT S AND MECHANISMS NECESSARY TO 31
FINANCE THE SYSTEM; 32
HOUSE BILL 1316 3

(3) CONSIDER HOW A UNIVERSAL HEALTH CARE PROGRAM COULD: 1

(I) IMPROVE HEALTH OUTCOM ES, INCLUDING REDUCING 2
PREVENTABLE MORBIDITY; 3

(II) IMPROVE HEALTH CARE EQUITY; 4

(III) REDUCE HEALTH CARE DISPARITIES; AND 5

(IV) INCREASE HEALTH CARE ACCESS, PARTICULARLY IN URBAN 6
AND RURAL SETTINGS WITH LIMITED ACCESS TO HEALTH CARE SERVICES; AND 7

(4) EXAMINE AND MAKE RECOMMENDATIONS ON: 8

(I) FULLY INTEGRATING OR ALIGNING THE MARYLAND 9
MEDICAL ASSISTANCE PROGRAM, MEDICARE, PRIVATE INSURANCE , AND THE 10
PROVISION OF HEALTH CARE BENEFITS TO STATE, COUNTY, AND MUNICIPAL 11
EMPLOYEES INTO OR WITHIN A UNIVERSAL HEALTH CARE PROGRAM; 12

(II) TRANSITIONING THE STATE’S ADVANCING ALL–PAYER 13
HEALTH EQUITY APPROACHES AND DEVELOPMENT (AHEAD) MODEL TO A 14
SINGLE–PAYER HEALTH CARE MODEL; 15

(III) TRANSITIONING WORKERS DISPLACED BY CHANGES TO THE 16
HEALTH CARE SYSTEM; 17

(IV) CREATING AN OPERATING STRUCTURE FOR A 18
SINGLE–PAYER HEALTH CARE SYSTEM; 19

(V) CONTAINING COSTS BY R EDUCING UNNECESSARY 20
ADMINISTRATIVE EXPENSES; AND 21

(VI) WHETHER A SINGLE–PAYER HEALTH CARE SYSTEM SHOULD 22
INCLUDE DENTAL, VISION, HEARING, AND LONG–TERM CARE BENEFITS. 23

13–5903. 24

(A) THERE IS AN ADVISORY COMMISSION ON UNIVERSAL HEALTH CARE. 25

(B) THE PURPOSE OF THE COMMISSION IS TO ASSIST THE INSTITUTE IN THE 26
DEVELOPMENT OF THE RECOMMENDATIONS FOR THE INSTITUTE’S FINAL REPORT 27
ON THE RESULTS OF THE STUDY CONDUCTED UNDER § 13–5902 OF THIS SUBTITLE. 28
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(C) THE COMMISSION CONSISTS OF: 1

(1) ONE MEMBER OF THE SENATE OF MARYLAND, APPOINTED BY THE 2
PRESIDENT OF THE SENATE; 3

(2) ONE MEMBER OF THE HOUSE OF DELEGATES, APPOINTED BY THE 4
SPEAKER OF THE HOUSE; 5

(3) THE SECRETARY, OR THE SECRETARY’S DESIGNEE; 6

(4) THE SECRETARY OF BUDGET AND MANAGEMENT, OR THE 7
SECRETARY’S DESIGNEE; 8

(5) THE SECRETARY OF COMMERCE, OR THE SECRETARY’S 9
DESIGNEE; 10

(6) THE SECRETARY OF LABOR, OR THE SECRETARY’S DESIGNEE; 11

(7) THE SECRETARY OF SOCIAL AND ECONOMIC MOBILITY, OR THE 12
SECRETARY’S DESIGNEE; 13

(8) THE SPECIAL SECRETARY OF SMALL, MINORITY, AND WOMEN 14
BUSINESS AFFAIRS, OR THE SPECIAL SECRETARY’S DESIGNEE; 15

(9) TWO REPRESENTATIVES O F PUBLIC SECTOR LABO R UNIONS , 16
DESIGNATED BY THE PRESIDENT OF THE MARYLAND STATE AND DISTRICT OF 17
COLUMBIA AFL–CIO; 18

(10) TWO REPRESENTATIVES O F PRIVATE SECTOR LAB OR UNIONS , 19
DESIGNATED BY THE PRESIDENT OF THE MARYLAND STATE AND DISTRICT OF 20
COLUMBIA AFL–CIO; AND 21

(11) THE FOLLOWING MEMBERS APPOINTED BY THE GOVERNOR: 22

(I) THREE REPRESENTATIVES OF THE MARYLAND 23
ASSOCIATION OF COUNTIES, REPRESENTING THE GEO GRAPHIC AND POPULATI ON 24
DENSITY DIVERSITY OF THE STATE; 25

(II) THREE REPRESENTATIVES OF THE MARYLAND MUNICIPAL 26
LEAGUE, REPRESENTING THE GEOGRAPHIC AND POPULATION DENSITY DIVERSITY 27
OF THE STATE; 28

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(III) THREE REPRESENTATIVES OF THE BUSINESS COMM UNITY, 1
AT LEAST ONE OF WHOM REPRESENTS A SMALL BUSINESS; 2

(IV) ONE REPRESENTATIVE OF MEDCHI, THE MARYLAND 3
STATE MEDICAL SOCIETY; 4

(V) ONE REPRESENTATIVE OF THE MARYLAND HOSPITAL 5
ASSOCIATION; 6

(VI) ONE LICENSED NURSE WHO PRACTICES IN THE STATE; 7

(VII) ONE LICENSED SOCIAL W ORKER WHO PRACTICES IN THE 8
STATE; 9

(VIII) ONE REPRESENTATIVE FR OM A STATEWIDE ASSOC IATION 10
OF DENTISTS; 11

(IX) ONE REPRESENTATIVE OF A NONGOVERNMENTAL 12
ORGANIZATION THAT PR OVIDES HEALTH CARE A ND SUPPORTIVE SERVIC ES TO 13
INDIVIDUALS EXPERIENCING HOMELESSNESS IN THE STATE; 14

(X) ONE REPRESENTATIVE OF A NONGOVERNMENTAL 15
ORGANIZATION THAT PR OVIDES HEALTH CARE T O OR ASSISTS WITH OB TAINING 16
HEALTH CARE FOR INDIVIDUALS WHO ARE UNINSURED , UNDERINSURED, OR 17
UNABLE TO OBTAIN INSURANCE; 18

(XI) ONE REPRESENTATIVE OF A NONGOVERNMENTAL 19
ORGANIZATION THAT WORKS WITH FORMERLY INCARCERATED INDIVIDUALS; AND 20

(XII) ONE REPRESENTATIVE FR OM AN ORGANIZATION T HAT 21
ASSISTS IMMIGRANTS. 22

(D) THE MEMBERS OF THE COMMISSION MAY NOT BE APPOINTED OR 23
DESIGNATED BEFORE JANUARY 1, 2028. 24

(E) THE GOVERNOR, IN CONSULTATION WITH THE PRESIDENT OF THE 25
SENATE AND THE SPEAKER OF THE HOUSE, SHALL DESIGNATE A CH AIR OF THE 26
COMMISSION. 27

(F) TO THE EXTENT PRACTIC ABLE, IN MAKING APPOINTMEN TS TO THE 28
COMMISSION, THE GOVERNOR, THE PRESIDENT OF THE SENATE, AND THE 29
SPEAKER OF THE HOUSE SHALL ENSURE RE GIONAL, ECONOMIC, ETHNIC, AND 30
GENDER DIVERSITY IN THE MEMBERSHIP OF THE COMMISSION. 31
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(G) A MEMBER OF THE COMMISSION: 1

(1) MAY NOT RECEIVE COMPE NSATION AS A MEMBER OF THE 2
COMMISSION; BUT 3

(2) IS ENTITLED TO REIMBU RSEMENT FOR EXPENSES UNDER THE 4
STANDARD STATE TRAVEL REGULATIONS, AS PROVIDED IN THE STATE BUDGET. 5

(H) THE INSTITUTE SHALL PROVIDE STAFF FOR THE COMMISSION. 6

13–5904. 7

(A) ON OR BEFORE JUNE 1, 2028, THE INSTITUTE SHALL SUBMIT AN 8
INTERIM REPORT ON ITS PRELIMINARY FINDINGS AND RECOMME NDATIONS FROM 9
THE STUDY CONDUCTED UNDER § 13–5902 OF THIS SUBTITLE TO THE COMMISSION 10
FOR COLLABORATIVE DISCUSSIONS, FEEDBACK, AND THE DEVELOPMENT OF FINAL 11
RECOMMENDATIONS. 12

(B) ON OR BEFORE JUNE 1, 2029, THE INSTITUTE AND THE COMMISSION 13
JOINTLY SHALL SUBMIT A FINAL REPORT OF THEIR FINDINGS AND 14
RECOMMENDATIONS TO THE GOVERNOR AND, IN ACCORDANCE WITH § 2–1257 OF 15
THE STATE GOVERNMENT ARTICLE, THE SENATE BUDGET AND TAXATION 16
COMMITTEE, THE SENATE FINANCE COMMITTEE, THE HOUSE APPROPRIATIONS 17
COMMITTEE, AND THE HOUSE HEALTH COMMITTEE. 18

SECTION 2. AND BE IT FURTHER ENACTED, That: 19

(a) Section 1 of this Act is contingent on the Hilltop Institute at the University of 20
Maryland, Baltimore County receiving commitments for or receiving sufficient funding 21
through grants or private donations to conduct the study to determine the feasibility of 22
establishing a universal health care program in the State required under § 13–5902 of the 23
Health – General Article, as enacted by Section 1 of this Act. 24

(b) Within 5 days after determining that sufficient funding has been committed 25
or received, the Hilltop Institute shall notify the Department of Legislative Services. 26

(c) If notice of the commitment or receipt of sufficient funding is received by the 27
Department of Legislative Services on or before December 31, 2026, Section 1 of this Act 28
shall take effect on the date the notice is received by the Department of Legislative Services 29
in accordance with subsection (b) of this section. 30

(d) If notice of the commitment or receipt of sufficient funding is not received by 31
the Department of Legislative Serv ices on or before December 31, 2026, Section 1 of this 32
Act, with no further action required by the General Assembly, shall be null and void. 33
HOUSE BILL 1316 7

SECTION 3. AND BE IT FURTHER ENACTED, That , subject to Section 2 of this 1
Act, this Act shall take effect June 1, 2026. It shall remain effective for a period of 3 years 2
and 7 months and, at the end of December 31, 2029, this Act, with no further action required 3
by the General Assembly, shall be abrogated and of no further force and effect. 4