The projections are in an interim report by Maryland's Health Care Reform Coordinating Council, which Gov. Martin O'Malley created in March to study how the federal healthcare reform law will affect the state.
While the report emphasizes that current and future projections are fluid, it cautions that the state must stay committed to reducing overall healthcare costs. That's because Maryland is projected to spend $46 million more in fiscal 2020 as a result of healthcare reform than it would without it.
"For this reason, the state must focus on bending the cost curve early in order to improve the outlook at the end of the decade," according to the report.
The council's report recommends taking steps to prevent healthcare costs by increasing access to primary care through patient-centered medical homes, in which teams of healthcare professionals provide primary care in a coordinated manner. The report also recommends building a health information technology infrastructure and reducing the number of hospital-acquired infections.
The report's projections are based on research by the Hilltop Institute of the University of Maryland, Baltimore County.
The major elements of federal healthcare reform become effective in 2014.
The peak savings for the state take place in fiscal 2016, when the state will save an estimated $250 million. But the savings begins dropping off in the next fiscal year to $145 million, then to $80 million in fiscal 2018 and $46 million in fiscal 2019.
Maryland currently has between 700,000 and 800,000 uninsured residents, according to state health department estimates. The report notes that after the federal law is fully implemented, that number will be cut in half.
The reason it will only reduce the rate by half is largely because the law doesn't apply to people who are not citizens and because not everyone who is eligible for Medicaid applies for it.
The report points out that federal healthcare reform will have unique effects in Maryland. That's because the state in recent years extended coverage to more than 200,000 people by expanding Medicaid eligibility to low-income adults.
Maryland also has helped small employers offer coverage. In 2003, Maryland formed a high-risk pool for people barred from insurance for health reasons.