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August 08, 2023

At least 137,000 Pennsylvanians have lost Medicaid coverage since post-pandemic rules took effect

A return to pre-COVID eligibility and paperwork requirements has put a dent in the state's enrollment numbers

Health Insurance Medicaid

More than 137,000 people have been cut from Pennsylvania's Medicaid program due to ineligibility or missing paperwork since a pandemic-era continuous enrollment policy was lifted in March.

Pennsylvanians are losing health coverage by the tens of thousands as the state experiences a post-pandemic drop-off in Medicaid enrollment due to a federal policy change. 

More than 137,000 people have been cut from Medicaid statewide in recent months due the end of a pandemic-era rule that allowed people to stay enrolled in the low-income health coverage program without having to file renewal paperwork or meet its usual eligibility requirements, WHYY reported. 

More Pennsylvania residents also are expected to lose Medicaid coverage as the state verifies the eligibility of the 3.7 million resident enrolled in the program, either because they no longer meet the program's income requirements or because they failed to file the renewal paperwork on time, if at all.  

In many cases, Medicaid recipients are being cut because they were simply unaware of the need to re-enroll, which has not been required for the last three years. During that time, Medicaid coverage rolls expanded significantly due to shifts in employment and public health demands during the COVID-19 pandemic.    

Pennsylvania saw an unusually high 13.7% increase in Medicaid enrollments during the first year of the pandemic alone, according to data from the state's Department of Human Services. By early 2021, an estimated 257,000 residents were enrolled in Medicaid that otherwise would not be eligible for the program. 

Nationwide, as many as 15 million people could lose their health coverage as a result of the policy change, according to federal government estimates.

The risk of extraneous cuts in Pennsylvania's Medicaid enrollment numbers, especially due to procedural reasons, has been a concern for state public health officials since the continuous enrollment rule was reversed in March. Last month, DHS Secretary Dr. Val Arkoosh said she was "very concerned" about the low rate of Medicaid renewals among the state's residents, and that addressing the issue was her agency's top priority of the year.

"Everything has changed," Arkoosh said. "Now that the pandemic is over, we are required by federal policy to return to our pre-pandemic redetermination process."

To mitigate the risk of unnecessary excess cuts, DHS is streamlining the Medicaid renewal process, educating recipients through expanded outreach, and offering affordable health insurance options through Pennie, the state's health insurance marketplace. 

The state is giving Medicaid recipients up to 90 days to appeal if they believe they were unfairly cut from the program. 

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