Illegals may be a burden, but the losses caused by below cost Medicaid and Medicare reimbursements are higher.
Maryland is the only state in the Union which sets NON-federal reimbursement levels. Medicare and Medicaid are benchmark fees that hospitals nationwide struggle to hit (you try to keep the costs below the defined bill rate; sometimes you win, sometimes you lose).
Maryland inexplicably takes it one step further, defining bill rates regardless of insured status. While I believe Maryland has some of the finest hospitals in the country, such arrangements create ridiculous and unnecessary stresses on an overburdened apparatus.
I’m not too sure PG has a particularly large illegal immigrant population, but I will go out on a limb here and assume it has a higher than average medicaid-medicare burden, and there’s a critical mass beyond which hospitals/doctors cannot survive, especially with the low reimbursements.