You lose the right to drive for 270 days.
The answer is you lose your license. Maryland, like all states, is an implied consent jurisdiction, meaning that if you drive on the roadways in Maryland, you agree to give a breath sample to officers on demand. If you refuse that request, you lose your license, for an initial refusal, for 270 days. Now, it is possible to apply to the MVA for what is sometimes called a hardship license or restricted license, under which you can drive to work or potentially to school or medical appointments. In order to do that, you have to also place an ignition interlock device on your car.