Hundreds of thousands of Pennsylvanians who enrolled in Medicaid during the pandemic could see that health care coverage end later this year due the likely eventual end of a federal emergency declaration. State officials say they are working to make sure as few people as possible lose coverage, though some individuals will likely no longer be Medicaid-eligible and will have to try to shift to different programs.
Enrollment in Medicaid, also known as Medical Assistance in Pennsylvania, has grown during the pandemic, and now covers 3.4 million Pennsylvanians, according to the most recent state statistics.
That’s up by about 600,000 people since February 2020.
Enrollment grew during the pandemic likely due to the economic downturn and early job losses, but also because of a “disenrollment freeze” – a federal rule implemented in March 2020 that said states couldn’t remove people from the program once they were enrolled, except in very limited circumstances.
That requirement will come to an end when the federal government declares the ongoing health emergency over, which many advocates and health policy experts expect will happen this year, likely in July. The White House recently extended the declaration again.
State officials have said they are preparing for the eventual end of the declared emergency, even though they don’t know exactly when it will happen.
“This is very much a moving target,” Zach Sherman, executive director of Pennie, Pennsylvania’s online health insurance marketplace. “And so, we are preparing. We have been working very closely across agencies to get ready and make sure that we do all the things necessary to make sure that those that are transitioning out of Medical Assistance … have a pathway to coverage. I think broadly, we are working towards goals of achieving continuous coverage for those who eventually will lose coverage at the end of the public health emergency.”
Some individuals who have seen an increase in their income during the pandemic might no longer be eligible for Medicaid, but could purchase a plan on the state’s health insurance marketplace and be eligible for subsidies that make coverage more affordable. Some people also might be eligible for employer-based coverage through their job.
Children no longer eligible for Medicaid will be eligible for CHIP, Pennsylvania’s Children’s Health Insurance Program, regardless of income.
The number of people who would lose coverage is unclear but could number in the hundreds of thousands.
According to the state’s Department of Human Services, as of September, there were approximately 400,000 people who would otherwise not be covered were it not for the emergency declaration, and "based on enrollment trends, that could be approximately 500,000 in the next few months.”
“I think that our overarching goal is maintaining and achieving continuity of coverage for everyone who wants it,” Sherman said.
Some advocates fear that people will lose coverage if they aren’t aware they have to apply for a new program, or because of the potential confusion or administrative burdens of applying for different coverage. They’ve also expressed concern about people getting lost in the shuffle due to the sheer volume of renewals.
“This is going to be a huge administrative process for the Commonwealth of Pennsylvania,” said Laura Stephany, health policy manager at the Pittsburgh-based advocacy group Allies for Children.
A report released last month estimated 6.7 million children nationally are at risk of becoming uninsured at least temporarily in this process.
More than half of the children in Allegheny County are insured through either Medicaid or CHIP, Stephany said; about 109,000 on Medicaid and about 11,000 on CHIP.
Children could be particularly vulnerable to losing coverage because they’re often eligible for different coverage than their parents are, said Joan Alker, one of the study’s authors and the executive director and Co-Founder of the Center for Children and Families at Georgetown University.
She and others have expressed concern about people losing coverage for procedural reasons.
“In other words, the family does not successfully complete the renewal process, perhaps simply because the renewal letter got lost in the mail or because the family has trouble completing the paperwork. Now, procedural denials are nothing new. But given that renewals will have been paused for over two years, families have experienced many, many changes during this pandemic … and we are likely to see a record number of these procedural denials as some states move very quickly to reduce Medicaid enrollment.”
People should make sure their contact information with the state is correct and up-to-date, said Inez Titus, deputy secretary for the Office of Income Maintenance in the state’s Department of Human Services.
“If you are no longer eligible for Medical Assistance, there are alternatives for you and your family,” she said.
Contact the Pennsylvania Department of Human Services Customer Service Center at 1-877-395-8930 for assistance.