Very UNcool
Indifference to cancer patients sums up why the Maryland Freedom Caucus can't get out of their own way.
There’s a particular kind of political theater that happens when a caucus has absolutely no power but desperately wants you to think otherwise. The Maryland House Freedom Caucus has been performing this show since last January, and last week, they handed us the perfect encapsulation of everything wrong with their strategy.
On February 26, the full House of Delegates voted 129–7 on HB393, a bill requiring health insurers to cover scalp cooling systems, the devices that help chemotherapy patients preserve their hair during treatment. It is a bipartisan bill. It is a compassionate bill. It costs insurers relatively little and means a great deal to people going through the worst experience of their lives. The bill passed with the full complement of Republican delegates except seven.
You won’t be surprised who voted against it. The Maryland Freedom Caucus cast the only seven no votes in the entire 141-member chamber.
The caucus would presumably like you to see this as a principled stand against insurance mandates. What it actually looks like is seven delegates finding themselves to the right of every single Democrat in the chamber on a bill about helping cancer patients not lose their hair. Being the loneliest holdouts in a 129–7 blowout on a health coverage bill isn’t a flex. It’s a diagnosis.
The scalp cooling bill is a carry-over from last session, where it also failed to advance. The technology works by cooling the scalp during chemotherapy infusions, which reduces blood flow to hair follicles and can significantly reduce hair loss. For patients already facing the physical and psychological toll of cancer treatment, keeping their hair can matter enormously. The bill is cosponsored by delegates from both parties. It passed 129–7.
Now, there is an ideological argument against insurance mandates. They drive up premiums by forcing coverage people may not want, and that consumers should have choices rather than have legislatures dictate benefits packages. That is a legitimate policy debate that I sometimes agree with. Insurance mandate skepticism has serious intellectual defenders.
But that argument is significantly harder to make when you are the only seven people in the room making it, and the other 32 Republicans all voted yes. The Freedom Caucus isn’t representing the conservative mainstream of the Maryland House GOP on this vote. They’re representing themselves.
Nawrocki said at the launch that they’re “Americans first, Marylanders second, Republicans third.” What the HB393 vote actually reveals is a caucus that has drifted into a posture where being oppositional feels more important than being consistent with what their own conference is doing. The rest of the Republican caucus found a way to vote for cancer patients who want to keep their hair. The Freedom Caucus found a way not to.
There’s a broader pattern here worth naming. The Capital reported last week that tensions are rising between the Freedom Caucus and the rest of the House Republican leadership over “strategy, attendance, and party direction.” That last word is the operative one.
The Maryland Republican Party is at a crossroads that should be familiar to anyone who has read The Duckpin before. Dan Cox lost the 2022 governor’s race by 32 points which, as I wrote last week, led directly to the MDGOP’s current electoral debacle. The MDGOP’s one consistent path to statewide success has been nominating moderate Republicans with genuine cross-party appeal i.e. Ehrlich in 2002, Hogan in 2014 and 2018. The Freedom Caucus model points in precisely the opposite direction, and that direction is one that leads to Democrat wins, Republican losses, and ultimately higher taxes and runaway spending.
In a state where Harris is the only Republican in federal office, and where Republicans hold 13 of 47 Senate seats and 39 of 141 House seats, the party’s strategic situation requires building coalitions, not performing purity. The Freedom Caucus is not interested in that project. They are interested in being the most “authentically conservative” bloc in Annapolis, affiliated with the national network, generating press releases that play well in MAGA-adjacent media, and occasionally getting Andy Harris to stand next to them. That doesn’t give voters a hell of a lot of reasons to want to support them.
None of that produces a Republican governor in 2026, when Moore is running for re-election without a serious opponent, partly because the MDGOP has been structurally unable to field one. None of it produces more Republican seats in the legislature. It does produce a lot of press releases.
The 129–7 vote on a chemotherapy coverage bill will not go down in Maryland political history as a pivotal moment. But it is a clarifying one.
When your caucus is designed to be a disciplined ideological bloc, and the clearest evidence of that discipline is being the only people in the chamber to vote against helping cancer patients not lose their hair during chemo, you should probably ask whether the posture is serving the purpose. When the Maryland Freedom Caucus launched, they promised to demonstrate success. Over a year in, the most consistent thing they’ve demonstrated is a capacity to find the minority position on bills that everyone else, including the rest of their own conference, has no trouble supporting.
That’s not a voice. That’s an echo chamber with a press operation.
As a sidebar, in addition to everything else the Freedom Caucus has done, they have struggled to get even candidates to agree with them. When Narwocki made a public plea to recruit a primary challenger to Baltimore County Councilman David Marks, not a single person took him up on that.
If that’s not a metaphor for the Maryland Freedom Caucus, I don’t know what is.
As I have said before, some people are more comfortable being losers who “fight” than winners who achieve. Maryland Republican primary voters would be wise to send the Freedom Caucus members home in the Republican Primary, where they can “fight” somewhere else while electing competent Republicans to serve the people.