The reform is rooted in common sense: People who are aging, sick or dying in prison, who pose little to no risk to public safety, should be given a second look. It offers a blueprint for other states.
For decades, Maryland had one of the most restrictive medical and geriatric parole systems in the country. People had to be near death to qualify, and even then the approval process was far from transparent and heavily politicized. Maryland was one of just three states where the governor was required to approve parole for individuals serving life sentences, adding a deeply political layer to what should be a clinical and rehabilitative process. Parole decisions were vulnerable to election year pressures, and governors concerned about appearing “soft on crime” routinely denied parole recommendations even when individuals met all of the criteria.
In 2021, the Maryland General Assembly removed the governor from standard parole decisions but unintentionally left out medical parole. This year’s reform corrected that error, ensuring that decisions are based on evidence and medical necessity, not political calculation.
Across the country, prison populations are aging. Thousands of incarcerated people are growing old behind bars, many of them sick, disabled or decades removed from the conduct or conditions that led them to prison. Yet, in most states there is no accessible process to grant release based on age or medical condition, even when the individual poses no risk to the community.
The cost of inaction is steep. Incarcerating older adults is much more expensive than incarcerating younger people, often costing three times as much due to higher medical needs and more complex facility accommodations. Taxpayer dollars are spent to confine individuals who are often bedridden, nonverbal or dependent on round-the-clock care. There’s no public safety justification for this to continue. It’s also fiscal waste at its worst.
The racial justice implications are just as stark. Black Marylanders make up about 30 percent of the state’s population but account for nearly 70 percent of its prison population, and an even greater share of those serving long sentences. These disparities grow sharper with age. Many older incarcerated people are in prison because they were sentenced during the height of the tough-on-crime era, under cruel and outdated laws that have since changed. Without a viable release mechanism, there is no way out.
While a handful of states, including Colorado, Illinois and Vermont, have also made progress on parole and second-look reforms, Maryland’s new law stands out for its comprehensive scope and clarity. By fully removing political barriers from the medical parole process and aligning policy with medical necessity and public safety, Maryland now ranks among the national leaders. In a 2022 report card from Families Against Mandatory Minimums, only six states received passing grades for their compassionate release policies. With this reform, Maryland offers a practical and humane approach other states can follow.
None of this happened overnight. It took years of sustained advocacy, coalition-building and political pressure to get this legislation over the finish line. Individuals impacted by long sentences were joined by legal advocates, faith leaders and public safety experts who made clear that this was not a radical idea but a practical solution.
Advocacy organizations, including ours, were instrumental in advancing the reform by providing research, coordinating strategy and ensuring that impacted voices remained central. Philanthropic partners played a key role not only by funding the work but by staying committed through multiple legislative sessions and challenges. Their support helped keep the coalition strong through political setbacks and moments of uncertainty, allowing those closest to the issue to lead the way.
States across the country can look to Maryland’s new law as a model: one rooted in evidence, driven by those directly impacted, and grounded in public safety and human dignity.
Jasmine Tyler is the executive director of the Justice Policy Institute, a national nonprofit organization developing workable solutions to problems plaguing juvenile and criminal justice systems. A forthcoming report from the institute will look at how states including Illinois, Iowa and Texas are grappling with the challenges of aging, ailing prison populations and what lessons Maryland’s new approach offers.
Governing’s opinion columns reflect the views of their authors and not necessarily those of Governing’s editors or management.
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