In April, 2026, the Maryland Comptroller’s Office has issued a report entitled Maryland Industry Analysis: Healthcare and the Economy that stated the following key findings:
Section 1 (Industry Employment Data)
- The health care and social assistance sector is the largest industry in Maryland for employment. The industry employs 427,000 people in all corners of the state, supporting 16% of all jobs in Maryland.
- Compared to other industries in Maryland, health care and social assistance has been the leading job generator, adding more jobs than any other industry for seven of the past 10 years. Growth trends in health care vary significantly by subsector – hospitals, ambulatory health care services, nursing and residential care facilities, and social assistance.
- Key drivers of employment growth in health care include demographic shifts, increased access, morbidity trends, state policies and programs, and insurance coverage changes.
Section 2 (Occupation Data)
- There are 274,000 health care workers in Maryland. Registered nurse is the largest health care occupation (50,000 jobs). Home health and personal care aides grew the most among health care occupations in 2024, adding 7,000 jobs from the previous year.
- Wages for health care occupations on average are higher in Maryland than the U.S. and all neighboring states except for Washington, D.C. Most physicians are an exception.
- There is a disproportionately high share of foreign-born, women, and Black residents employed in health care occupations in Maryland compared to their population share and compared to other states and the U.S. overall.
Section 3 (Economic Activity Data)
- Beyond employment, the health care industry has a broader economic impact through wages, GDP, and the purchasing power of hospitals and other health care providers.
Section 4 (Challenges)
- Federal policy changes associated with H.R. 1 (the One Big Beautiful Bill Act) are expected to result in Medicaid coverage losses and funding cuts to Maryland.
- Workforce shortages are a persistent challenge, especially for nurses and home health aides.
- Health care costs continue to rise, increasing spending by governments, employers, and patients.
The report stated: “The health care industry creates clear economic benefits to the state through sustainable jobs, wages, and spending. The industry also helps keep the entire state labor force healthy. However, not all growth is good when it comes to health care, and expansion in health care does not necessarily signal a healthy economy.”
As of 2024, 18% of Maryland’s residents are 65 and over, totaling 1.1 million residents. The share and number of
residents 65 and over has been the fastest-growing age group in Maryland over the past decade and is projected to continue to increase.
The implications for health care demand are substantial. A study in the National Library of Medicine found that while the health status of older Americans has improved over the last decade, adults 65 and over have far higher health care utilization than other age groups, and the majority have at least one chronic condition requiring care – commonly hypertension, cancer, or heart disease. As Maryland’s population of older adults grows, so will the need for workers to care for them.
Aging is not the sole factor driving rising demand. The incidence of chronic conditions is on the rise across all age groups, both nationally and in Maryland. According to the Maryland Department of Health (MDH), about half (52%) of Marylanders have at least one chronic health condition. Since 2015, rates of obesity, hypertension, high cholesterol, and diabetes have all increased in the state. Rates of mental illness are increasing as well, in part fueled by the COVID-19 pandemic. At the same time, stigma around mental health is decreasing. These factors drive up demand for health care and trigger employment growth.
Climate change is an emerging driver of health care demand. Extreme weather events, such as heat waves, hurricanes, and floods, are increasing hospital admissions, while warming temperatures are expanding the prevalence of vector-borne diseases like Lyme disease and West Nile Virus. The World Economic Forum estimates an additional $1.1 trillion “treatment burden” due to the climate crisis by 2050.
Since 2015, hospital employment has grown by 7%, adding 7,000 jobs in Maryland. While meaningful, this represents about half the national hospital employment growth rate (15%) during the same period. However, by many other metrics – including hospitals’ financial stability, patient outcomes, and cost control – Maryland has excelled. Both trends are in large part attributed to the “Maryland Model”: Maryland’s unique system regulating how much (and by whom) hospitals are paid for the services they provide. It is intended to control hospital cost growth, increase the quality of care, and improve population health.
Growth in health care is positive because it creates jobs, but increased utilization, especially in more expensive care settings, comes at a cost borne by governments, businesses, and households. This growth in spending cannot be readily controlled because people typically don’t have a choice about whether or not to obtain care. Rather than growing the overall economy, increased health care spending creates a crowding-out effect by redirecting resources from more productive investments, ultimately hindering long-term economic growth and lowering overall employment growth. The result is that health care becomes a larger slice of the economic pie. A data point explaining this trend is the increase in health care employment as a percent of overall employment: 25 years ago, health care jobs accounted for 11% of all jobs in both the U.S. and Maryland. Today, they are 16% in both the state and the nation.
Medicaid
In Maryland, approximately 1.6 million residents (or one in four residents) are enrolled in Medicaid, which grants them access to primary care, behavioral health, dental care, hospital care, nursing facilities and more, at no cost. This includes 728,000 children (under 21), 800,000 adults (21+), 240,000 people with disabilities, and 63,000 pregnant women. H.R. 1, or the One Big Beautiful Bill Act (OBBBA), makes significant changes to Medicaid, which are estimated to cause 130,000 Marylanders to lose health insurance coverage.
In Maryland, 58% of total Medicaid program costs are federally funded. In FY26, combined state and federal Medicaid spending in Maryland totaled $15.4 billion. This represents about 23% of the total state FY26 operating budget ($66.9 billion).
Approximately 300,000 Marylanders currently obtain coverage through the ACA individual market, with about 244,000 of those individuals purchasing coverage through Maryland’s health insurance Marketplace – Maryland Health Connection. These are typically residents who earn too much to qualify for Medicaid, but do not have access to health insurance through work: the self-employed, small business owners, part-time workers, etc.
In January 2026, the Maryland Health Benefits Exchange estimated that 30,000 ACA Marketplace customers would drop coverage in 2026 due to the loss of the enhanced federal subsidies (90,000 if it were not for the temporary state subsidy). Initial enrollment data for 2026 suggests no drop-off to date, though it is too early in the year to understand the full impact of this federal policy change on consumers.
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