Supporters say the measure would reduce uncompensated hospital care costs and improve emergency room wait times.
The Senate voted 34-13 for the measure. The Maryland House already passed a similar version of the legislation. Each chamber would need to vote to approve the other's before the legislation can be sent to Gov. Wes Moore.
The measure would require the Maryland Health Benefit Exchange to submit a federal waiver application by July 1, 2025, to implement the program. The waiver is needed because of federal restrictions on immigrants lacking permanent legal status using the marketplace. The program in Maryland could start as early as 2026, if a waiver is granted.
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