By Phil Galewitz and Amanda Seitz, KFF Health News

The Trump administration’s move to give deportation officials access to Medicaid data is putting hospitals and states in a bind as they weigh whether to alert immigrant patients that their personal information, including home addresses, could be used in efforts to remove them from the country.

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Warning patients could deter them from signing up for a program called Emergency Medicaid, through which the government reimburses hospitals for the cost of emergency treatment for immigrants who are ineligible for standard Medicaid coverage.

But if hospitals don’t disclose that the patients’ information is shared with federal law enforcement, they might not know that their medical coverage puts them at risk of being located by Immigration and Customs Enforcement.

“If hospitals tell people that their Emergency Medicaid information will be shared with ICE, it is foreseeable that many immigrants would simply stop getting emergency medical treatment,” said Leonardo Cuello, a research professor at Georgetown University’s Center for Children and Families. “Half of the Emergency Medicaid cases are for the delivery of U.S. citizen babies. Do we want these mothers avoiding the hospital when they go into labor?”

For more than a decade, hospitals and states have assured patients that their personal information, including their home addresses and immigration status, would not be shared with immigration enforcement officials when they apply for federal health care coverage. A 2013 ICE policy memo guaranteed the agency would not use information from health coverage applications for enforcement activities.

But that changed last year, after President Donald Trump returned to the White House and ordered one of the most aggressive immigration crackdowns in recent history. His administration began funneling data from a variety of government agencies to the Department of Homeland Security, including tax information filed with the IRS.

The Centers for Medicare & Medicaid Services, part of the Department of Health and Human Services, agreed last spring to give ICE officials direct access to a Medicaid database that includes enrollees’ addresses and citizenship status.

Twenty-two states, all but one led by Democratic governors, sued to block the Medicaid data-sharing agreement, which the administration did not formally announce until a federal judge ordered it to do so last summer. The judge ruled in December that in those states, ICE could access information in the Medicaid database only about people in the country unlawfully. KFF Health News contacted more than a dozen hospitals and hospital associations in states and cities that have been targets of ICE sweeps. Many declined to comment on whether they’ve updated their disclosure policies after the ruling.

Of those that responded, none said they are directly warning patients that their personal information may be shared with ICE when they apply for Medicaid coverage.

“We do not provide legal advice about federal government data-sharing between agencies,” Aimee Jordon, a spokesperson for M Health Fairview, a Minneapolis-based hospital system, said in an email to KFF Health News. “We encourage patients with questions about benefits or immigration-related concerns to seek guidance from appropriate state resources and qualified legal counsel.”

Information on applications

Some states’ Emergency Medicaid applications specifically ask for a patient’s immigration status — and still assure people that their information will be kept secure and out of the hands of immigration enforcement officials.

For example, as of Feb. 3, California’s application still included language advising applicants that their immigration information is “confidential.”

“We only use it to see if you qualify for health insurance,” states the 44-page form, which the state’s Medicaid program, known as Medi-Cal, posted on social media in January.

California Department of Health Care Services spokesperson Anthony Cava said in a statement that the agency, which oversees Medi-Cal, will “ensure that Californians have accurate information on the privacy of their data, including by revising additional publications as necessary.”

Until late January, Utah’s Medicaid website also claimed its Emergency Medicaid program did not share its information with immigration officials. After KFF Health News contacted the state agency, Kolbi Young, a spokesperson, said Jan. 23 that the language would be taken down immediately. It was removed that day.

Oregon Health & Science University, a hospital system based in Portland, offers immigrant patients a Q&A document developed by the state Medicaid program for those with concerns about how their information might be used. The document does not directly say that Medicaid enrollees’ information is shared with ICE officials.

Hospitals rely on Emergency Medicaid to reimburse them for treating people who would qualify for Medicaid if not for their citizenship status — those in the country illegally and lawfully present immigrants, such as those with a student or work visa. The coverage pays only for emergency medical and pregnancy care. Typically, hospital representatives help patients apply while they are still in the medical facility.

The main Medicaid program, which covers a much broader range of services for over 77 million low-income and disabled people, does not cover people living in the country illegally.

Examining Emergency Medicaid enrollment is the most obvious way, then, for deportation officials to identify immigrants, including those who might not reside in the U.S. lawfully.

HHS spokesperson Rich Danker said in an email that CMS — which oversees Medicaid, a joint state-federal program — is sharing data with ICE after the judge’s ruling. But he would not answer how the agency is ensuring it is sharing information only on people who are not lawfully present, as the judge required.

With ICE now getting direct access to the personal information of millions of Medicaid enrollees, hospitals — while “definitely in a tough position” — should be up-front about the changes, said Sarah Grusin, an attorney at the National Health Law Program, an advocacy group.

“They need to be telling people that the judge has permitted sharing of information, including their address, for people who are not lawfully residing,” she said. “Once this information is submitted, you can’t protect it from disclosure at this point.”

Grusin said she advises families to weigh the importance of seeking medical care against the risk of having their information shared with ICE.

“We want to give candid, honest information even if it means the decision people have to make is really hard,” she said.

Those who have previously enrolled in Medicaid or can easily search their address online should assume that immigration officials already have their information, she added.

Emergency Medicaid

Emergency Medicaid coverage was established in the mid-1980s, when a federal law began requiring hospitals to treat and stabilize all patients who show up at their doors with a life-threatening condition.

Federal government spending on Emergency Medicaid accounted for nearly $4 billion in 2023, or about 0.4% of total federal spending on Medicaid.

States send monthly reports to the federal government with detailed information about who enrolls in Medicaid and what services they receive. The judge’s ruling in December limited what CMS can share with ICE to only basic information, including addresses, about Medicaid enrollees in the 22 states that sued over the data-sharing arrangement. ICE officials are not supposed to access information about the medical services people receive, per the judge’s order.

The judge also prohibited the agency from sharing the data of U.S. citizens or lawfully present immigrants from those states.

Deportation officials have access to personal Medicaid information of all enrollees in the remaining 28 states.

The federal health agency has not clarified how it is ensuring that certain states’ information on citizens and legal residents is not shared with ICE. But Medicaid experts say it would be nearly impossible for the agency to separate the data, raising questions about whether the Trump administration is complying with the judge’s order.

The Trump administration’s efforts to deport immigrants living in the country illegally have had implications on immigrant families seeking care. About a third of adult immigrants reported skipping or postponing health care in the past year, according to a KFF/New York Times poll released in November. (KFF is a health information nonprofit that includes KFF Health News.)

Bethany Pray, the chief legal and policy officer at the Colorado Center on Law and Policy, warned that sharing Medicaid data directly with deportation officials will force even tougher decisions upon some families.

“This is very concerning,” Pray said. “People should not have to choose between giving birth in a hospital and wondering if that means they risk deportation.”

©2026 KFF Health News. Distributed by Tribune Content Agency, LLC.

By MIKE STOBBE

NEW YORK (AP) — Daniel Moore was about 30 the first time it happened. At the end of a long, hot, stressful day, he chugged an ice-cold glass of milk.

“It felt like a bunny rabbit trying to jump out of my chest,” said Moore, now 60.

Moore, a radiologist, knew what it was: A-fib.

Dr. Daniel Moore poses for The Associated Press with his dogs Nani, left, and Gracie Feb. 2, 2026, in Coppell, Texas. (AP Photo/Julio Cortez)

Short for atrial fibrillation, A-fib is a quivering or irregular heartbeat that is a worrisome stage-setter for blood clots, stroke and heart failure. Some researchers believe more than 10 million Americans have it — most of them older. And it’s expected to become even more common in the years ahead.

Yet, University of Utah heart researcher Dr. T. Jared Bunch sees reason for optimism.

“Even though we see more of the disease, we’re better at treating it,” said Bunch, who co-authored a book on A-fib.

Symptoms can include shortness of breath

A-fib occurs when the heart’s upper chambers, called the atria, beat out of sync with the lower chambers, the ventricles. Not everyone is aware something is wrong, but some people suffer alarming symptoms like a pounding heartbeat and shortness of breath.

“I definitely have no exercise tolerance when I’m in it,” Moore said. “I can’t run. Walking is tiring faster. I get a little light-headed standing up.”

The heart can surpass 200 beats per minute for someone with A-fib, more than double the 60 to 100 beats typical for a healthy adult’s resting heart rate.

Symptoms can come and go, and it’s not usually life-threatening by itself. But the erratic beating can lead to blood pooling in the heart that can become clots in days or even hours. Those clots, in turn, can travel to the brain and cause strokes.

A-fib also can increase the risk of developing ventricular fibrillation — a more serious condition.

Diagnosis is becoming more common

Experts say smartwatches and other devices that can detect erratic heartbeats are one reason A-fib diagnoses are increasing.

Many people who experience symptoms don’t understand what is happening.

The American Heart Association found that more than half of people with A-fib didn’t know about the condition before they were diagnosed.

Studies have suggested 15% or more of strokes can be tied to A-fib, and that the percentage rises in older people. The condition is one reason that U.S. stroke deaths rose in the last decade, although the stroke death rate has dipped in the last few years.

What causes A-fib?

Researchers attribute A-fib to damage in the heart’s upper chambers and its electrical signaling. Genetics can play a role, but other contributors include high blood pressure, diabetes, stress, sleep apnea, smoking and alcohol.

Those harms accumulate over time, which is one reason why the condition tends to hit older adults. About 70% of A-fib cases are people 65 and older, Bunch said.

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Viruses can also pose a threat because they can affect the proteins behind the heart’s electrical signals or prompt an immune response that damages heart tissue. COVID-19 is among the list of viral culprits, and likely contributed to A-fib in some patients, experts say.

Studies have found no link to COVID-19 shots, said Dr. Jose Joglar, a Dallas-based expert who helped author American Heart Association guidelines on A-fib diagnosis and management.

Doctors have a range of treatment options

There’s no cure, but a number of therapies can help manage the problem.

“We’re miles beyond where we used to be” in treating A-fib, said Dr. Laurence Epstein, of Hofstra University and Northwell Health. “The technology has really evolved.”

One initial treatment is a cardioversion, which involves using a defibrillator to deliver an electric shock to the heart to restore rhythm. It’s often successful, but sometimes only temporarily.

For some patients, doctors may recommend implanted devices. Pacemakers can regulate heart rhythm, and a device called a Watchman can close off a clot-prone area of the upper heart.

And then there’s ablation. It’s a procedure in which a doctor uses heat, cold or electric pulses to zap certain areas of the heart, creating scars that block faulty electric signals. Traditionally, ablation was used when other approaches failed, but in recent years ablation techniques have become more advanced and it has become a first choice for certain patients, including those with heart failure.

Medications to regulate the heart or thin the blood to reduce stroke risk can have problematic side effects.

How to lower your risk

People can lower their risk of developing A-fib by living a healthy lifestyle. That includes exercising, getting enough sleep, eating a healthy diet, managing high blood pressure, and avoiding tobacco products and alcohol.

Doctors also have long warned about excessive levels of caffeine, although some new evidence suggests that at least a little may be OK. One small study published recently found that patients who averaged one cup a day saw less recurrence of symptoms than those who abstained entirely.

If symptoms do develop, it’s important to take them seriously, said Amy Stahley, who was first diagnosed three years ago.

She went to bed one night and her heart began racing to more than 150 beats per minute. She immediately went to a hospital.

“If you’re feeling a little off, get it checked out,” said Stahley, who is a nurse and dean of Davenport University’s College of Health Professions in Michigan.

Moore, a radiology professor at UT Southwestern Medical Center in Dallas, agreed.

“The longer you stay in A-fib, the more likely you are to stay in it for life,” he said.

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

Edward Lotterman

Disturbances in the force of the economy have been common in recent news. Prices of crypto currencies, especially bitcoin, did a deep-knee bends, ditto for gold and silver.

The Dow and S&P indexes are up setting records, and then down. Some foreign banks and countries apparently are reducing their holdings of U.S. dollars.

In a financial hangover from their bidding binge that raised farmland prices over 50% in five years, U.S. farmers want a large bailout. Housing prices remain out of reach for the children and grandchildren of baby boomers.

The common factor in all of this is the Federal Reserve (albeit acting in very good faith in response to successive defense, financial and health crises) increased the amount of money sloshing around relative to the size of the economy to unprecedented levels. The Fed, the media and many economists prefer to focus elsewhere — on the causes, not the results. And events will force us to do so.

If one wants to be prepared for that, it is necessary to understand banking — and central banking — from the ground up.

Start with the very basics. These were visible in Venice, Milan, Geneva and Amsterdam in the 1400s. Ditto in the Minnesota counties of Martin, Olmstead, Pipestone and others 150 years ago.

In all modern ages, some people have money that they save now so they can spend later. They want it safe and hope to earn some return on it in the meantime by investing. Others want to spend now. Some will have income in the future, but have no cash at the moment. They are willing to pay a fee to borrow spendable money today and pay it back later.

At some point in history, people started accepting money from people wanting to save and lending it to those who want to borrow. The borrowers pay interest, which is income for this intermediary. We call it a “bank” from the bench at which Italian merchants did business. A bank pays interest on deposits. The rate is low on small accounts or those with frequent deposits and withdrawals. It may be higher on larger amounts or to those who agree to leave alone for longer periods of time.

There are two dangers to any bank and its depositors. If some borrowers never repay their loans, a bank might not have cash to meet withdrawals by depositors.  This would be “insolvency.” The bank is “busted” or “broke.” Even if the borrowers offer collateral, say real property like with a mortgage, the repossession or foreclosure process could take more time than the bank has to meet its depositors’ demand. To prevent this, its bank owners must have money of their own, capital, in the bank business as well as the funds of depositors. If a loan turns bad, the cushion of adequate capital plus the collateral protects depositors.

The second danger is that, even if all loans are safe and will be repaid when promised, a large number of depositors may suddenly want to withdraw their money. This flows from “mis-matched maturities.” Deposits can be demanded but loans may not be due until a ship returns from its voyage, wheat is harvested or the mercantile sells its large stock of calicos, coffee pots and pickaxes. This problem is “illiquidity,” or the lack thereof. Assets exceed liabilities but these assets cannot be converted into cash rapidly enough to satisfy withdrawals of deposits.

To guard against this, banks don’t lend out 100% of their deposits. If these total 10,000 dollars or guilders or ducats, wise bankers may lend out only 9,000 and keep 1,000 in reserve.

Having both adequate owners’ capital against insolvency and deposit reserves against illiquidity were voluntary prudence early in this historical evolution. But guilds of merchants in places like Venice or banking commissions in states like Minnesota eventually set uniform regulations. They may perform audits to ensure that rules are being followed.

Smaller banks also developed business relationships with larger banks. If a bank in Coblenz, Germany, had reserves greater than needed for prudence or legal compliance and no local borrowers, it might deposit money with a larger one in Amsterdam. One from Litchfield might put it in a Minneapolis bank. That Minneapolis bank or one from Des Moines or Lacrosse, with too much cash might place it with a still larger bank in Chicago or New York, and so on.

Moreover, funds might flow the other way. When Twin Cities banks were flush with cash from Dayton’s, Donaldsons and other merchants just finishing holiday sales, or from Cargill having shipped wheat to New York and Pennsylvania, they might lend it to smaller banks in Marshall or Chippewa Falls. These would lend to farmers facing spring planting needs for seed, new plows and additional horse feed.

Small town banks borrowing such cash temporarily unneeded by regional city banks had to put up collateral. This would be promissory notes signed by their own local customers. If a small town bank did not repay a Minneapolis bank, that larger one could collect directly from the farm or main-street borrower.

If a small bank had $20,000 in promissory notes signed by farmers and main street merchants and wanted to borrow from a Twin Cities bank, they knew they might be able to get only $19,000. The IOUs presented as collateral would be “discounted.” The office of the large bank that handled such deals was its “discount window.” The bigger bank would be the “correspondent bank” for the smaller one.

A city correspondent bank that had an established, trusted relationship with the small-town bank might be willing to help this client with cash if it faced illiquidity. And, after careful examination of books, it might be willing to advance funds to a small bank that actually faced going broke because one of its major borrowers defaulted on its debts. The larger bank might demand a temporary or permanent ownership share in the troubled bank in return for saving it from total failure.

All of this is commercial banking, all done with minimal government involvement. It first took place under rules of merchant-bank guilds and later under government banking laws. However, some large, major-city banks, say in London or Stockholm, gradually became dominant as bankers for smaller banks. They had few or no business customers themselves. Hence the rise of central banking, or what is known in America as the Fed.

Eventually these got special charters from government. The Riksens Ständers Bank (“Bank of the Estates of the Realm”) established in Stockholm in 1668, was directly run by the Swedish government. The Bank of England, chartered in London in 1694, was a private joint-stock business but one with special privileges and duties.

Governments created these entities to facilitate commerce. However, funding governments, especially for military operations, was an underlying need. The Swedish bank was established soon after a war with Russia at the end of the 1650s and facilitated the Great Northern War of shifting coalitions that engulfed the Baltic from 1700-1721. The Bank of England mobilized money for two decades of English wars against Louis XIV’s France.

The economies of the 13 American colonies were not complex. There were few true banks. Philadelphia, New York, and Boston had merchants who functioned much like those in Florence, Venice or Amsterdam centuries earlier. Tobacco, rice and indigo planters dealt directly with England through “factors,” or merchants, in London or Bristol. These sold their products, procured supplies and luxury goods, and wrote mortgages on their plantations and slaves when spenders like Thomas Jefferson lived beyond their means.

After independence, more banks regulated by individual states, if at all, were established. Out on the frontier west of the Alleghenies or north of the Ohio River, “wildcat banks” with little supervision but that could issue their own “banknote” currencies with little “backing” by gold or silver flourished. Failures were common. Deposits often disappeared, loans often not repaid. Regional inflations and deflations were common as were “panics” that slowed economic activity sharply causing much social pain.

This review of banking basics that are universal, plus some historical and institutional details for our country, facilitates understanding the challenges we face now.

The U.S. financial system, including its commercial banks, has been a source of true wealth for us. By “true wealth,” an economist means that we achieve high levels of satisfaction of the needs and wants of our people from resources we have available. But in recent decades, our financial system has become more erratic, “needing” more frequent and larger government intervention to stave off possible catastrophes. Exactly how and why that is playing out is something to explore next week.

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St. Paul economist and writer Edward Lotterman can be reached at stpaul@edlotterman.com.

By Kevin Hardy, Stateline.org

As Americans grow increasingly frustrated over their electricity bills, states are trying to keep the nation’s growing number of data centers from causing higher energy costs for consumers.

For years, many states competed aggressively to land data centers, sprawling campuses full of the computer servers that store and transmit the data behind apps and websites. But many officials are now scrutinizing how those power-hungry projects might affect the electric bills of households, small businesses and other industries.

Oregon last year became one of the first states to enact a law requiring utilities to charge data centers different electric prices than other industries because of how they drive up the cost of energy production and transmission.

“We are now making data centers pay a higher rate commensurate with the amount of energy they’re sucking out of the system,” said Oregon state Rep. Tom Andersen, a Democrat.

Republican and Democratic leaders in at least a dozen states have targeted data centers with separate, higher electric rates to protect other customers. States also are requiring long-term commitments and financial guarantees through collateral before greenlighting infrastructure investments for new data center projects. But lawmakers acknowledge that numerous factors affect energy prices, so targeting data center-specific costs can be complicated.

An increasingly digital world and the rise of energy-intensive artificial intelligence has led to major expansion of data centers: Consultant McKinsey & Company expects companies to spend nearly $7 trillion worldwide on data centers by 2030. But the industry is facing growing scrutiny, from neighbors who don’t want to live near the massive server farms and from residents worried about how data centers will affect their own swelling utility bills.

Delaware legislation that would charge data centers higher rates advanced out of committee last week. On Tuesday, a Florida state Senate committee approved a bill that would create new rate structures for data centers.

In Oklahoma, a Republican state senator has proposed a moratorium on new data centers until late 2029, allowing the state to study how data centers affect utility rates, the environment and property values.

Separate legislation from state Rep. Brad Boles will seek to protect other ratepayers from the costs of data centers. Boles, the Republican chair of the state Energy and Natural Resources Oversight Committee, said his in-the-works measure would ensure data centers pay their fair share.

Boles told Stateline that his constituents are increasingly worried about data centers, with a dozen potential major ones proposed across the state.

“We’re trying to ensure that those data centers pay for their own infrastructure and we don’t shift that cost or burden to everyday Oklahomans,” he said.

In Oregon, Andersen’s legislation created a new rate structure for data centers with long-term contracts and required regulators to separate the costs of those facilities from other ratepayers.

But consumer advocates have already accused the state’s largest utility of trying to skirt the new law by making residential customers pay part of the long-term cost of supplying large data centers in a pending rate case.

Andersen, a member of the state House Committee on Climate, Energy and Environment, said the new rate structure is unlikely to immediately lower consumer bills. Rather, it aims to curb future increases as data centers require more power generation and transmission.

“We’re not going to change the rates that are being currently paid by the ratepayers and the users of the electricity,” he said. “It’s just going to stop future raises.”

The data center boom

Rising utility bills continue to outpace inflation, sparking anger from consumers and more scrutiny from state regulators, governors and lawmakers.

The boom of data centers is frequently cited as a prime reason for rising electricity prices, as their operation requires more power generation, transmission and distribution upgrades. A Bloomberg News analysis in September found wholesale electricity costs as much as 267% more for a single month than it did five years ago in areas with significant data center activity.

Data center companies say they aren’t the only reason prices are rising.

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“It’s inaccurate to draw a clear line between large load customers like data centers coming online and increases in prices. It’s just not that simple,” said Lucas Fykes, senior director of energy policy and regulatory counsel at the Data Center Coalition, a trade group representing data center owners and users, including Amazon, Meta and Visa.

He said many factors have contributed to higher electricity prices, including extreme weather events and the nation’s aging electric grid.

Fykes said his organization opposes rate structures that treat data centers differently from other large electric users such as industrial sites. The organization is working with regulators as states increasingly implement practices to ensure residents and small businesses aren’t on the hook for big energy investments if major projects including data centers don’t come to fruition.

Fykes said the country is likely just in the “beginning innings” of a longer ramp-up in technology and power needs.

“We are also in a global race to build out data centers, to support AI, to support cloud infrastructure,” he said. “It’s important to make sure that we maintain those assets here in the United States.”

That can pose competing interests for political leaders, including mayors, who have pushed hard to land investments from tech companies.

“We want to be leaders in AI, but we don’t want the infrastructure needed to support it,” said Rusty Paul, the mayor of Sandy Springs, Georgia, in the Atlanta metro area.

He was among several mayors addressing the issue of data centers at last month’s winter meeting of the United States Conference of Mayors in Washington, D.C. On a data center panel, Paul acknowledged the effect of Georgia’s tax incentives for data centers: “They’re just popping up everywhere,” he said.

But utilities and regulators are also making long overdue grid upgrades that aren’t tied to data centers, he said.

“The cost of electricity is going up for everybody — and it’s not all related to data centers,” he said.

A bipartisan push

The Georgia Public Service Commission last year created new rules that officials said would protect ratepayers from data center costs. In addition to covering costs of power consumed at their facilities, data centers would have to fund the costs incurred by upstream generation, transmission and distribution, the regulator said.

But lawmakers aren’t convinced those steps went far enough.

State Sen. Chuck Hufstetler, a Republican, is again pushing legislation that would solidify the regulator’s rules into law. His bill would prohibit utilities from passing along the fuel, generation or transmission costs of data centers to other customers.

He told Stateline that the regulator’s rules need to be codified into law so they can’t be weakened later.

Hufstetler said rising utility bills are among the biggest issues facing his constituents. High prices played a key role in November’s election, when Democrats flipped two seats on the state’s Public Service Commission board — the first time Democrats won statewide constitutional office in nearly two decades.

“I saw people with MAGA hats going into the election polling places that were saying, ‘I’m not voting for those guys that raised my rates,’” Hufstetler said, referring to the Republican incumbents who lost.

Hufstetler said the bill, which passed out of committee last year, has already gained major bipartisan support in the Senate, where it is sponsored by multiple Republicans and Democrats.

“This is very bipartisan,” he said. “We have all heard from our people around the state of Georgia.”

The Georgia Public Service Commission agrees in principle with the legislation, said agency spokesperson Tom Krause. But he said the regulator worries about losing flexibility if its rules are written into law.

“Not just this bill, but whenever the legislature codifies a rule that we put in place, we get a little nervous because it can tie our hands in special circumstances,” he said.

A complex challenge

As part of implementing a law enacted last year, Maryland’s utility regulator is weighing a new rate structure for data centers and other large load users.

Proposed regulations would require certain preapproval analysis for heavy power users, a separate rate tariff for data centers and collateral to ensure other ratepayers don’t end up paying for major investments if projects do not come to fruition.

Maryland’s Office of People’s Counsel, an independent agency representing residential utility users, said the proposed changes meet statutory requirements but could do more to protect consumers.

In a news release last month, Maryland People’s Counsel David S. Lapp said residents are already facing higher costs from data centers from outside the state.

“While we push for better federal rules to address those costs, Maryland has the power—and customers a clear need—to make sure data centers within Maryland take on every cost that they impose on residential customers,” Lapp said.

Democratic Gov. Wes Moore recently joined 12 other governors and the Trump administration in urging the regional grid operator, PJM Interconnection, to shield residents and businesses from the infrastructure costs from data centers.

Maryland state Del. Lorig Charkoudian, a Democrat, said the grid operator has for years failed residents in the 13 states plus the District of Columbia that it serves. By delaying renewable energy projects, she said, PJM has kept older, more expensive power plants online, driving up prices as data centers increase demand.

PJM’s board last month rolled out a new data center plan that it said would improve demand forecasting, accelerate the addition of new generation projects and give states a larger role.

Charkoudian said states and utilities struggle to determine just how much power is needed. Data center users shop around for sites, which can cause wildly inaccurate forecasts of just how much power a utility will need.

“It actually has a very concrete financial impact on ratepayers,” she told Stateline. “And so that’s why one of the things that really could make a difference for ratepayers is if we actually had an accurate count of how much we’re getting online.”

While some of those challenges lie outside the realm of state control, Charkoudian said there are things the state can do, including the new rate structure for larger users. She’s crafting a bill encouraging data centers to curtail their power usage during peak periods, such as hot days, when the electrical system is taxed by heavy usage of air conditioners, Maryland Matters reported.

Charkoudian said adding solar generation and storage are low-cost ways to respond quickly to demand. And states can avoid the need for more generation by doubling down on energy efficiency programs that lower demand and also consumer costs.

“The best time to fix this was five years ago,” she said. “The next best time is right this minute, because it’s only going to get worse.”

Stateline reporter Robbie Sequeira contributed to this story. Stateline reporter Kevin Hardy can be reached at khardy@stateline.org.

©2026 States Newsroom. Visit at stateline.org. Distributed by Tribune Content Agency, LLC.