State human service officials are asking the federal government to allow Pennsylvania to make several changes to its Medical Assistance program to make health care more accessible — things like helping people leaving incarceration more easily enroll in the program, keeping children under age 6 continuously enrolled without required annual renewal paperwork, and, in certain instances, allowing Medicaid funds to help people pay their rent.
State officials say their proposals aim to address unmet social needs, such as housing and food insecurity.
“The things that people need to stay healthy, like access to safe, clean housing, access to healthy food — particularly if you have a condition like diabetes or if you're pregnant — making sure that you have access to health care and some of the other pieces that enable you to access that care, these are things that as a physician, I can tell you, are critical to maintaining a person's health,” said Val Arkoosh, the state’s Secretary of Human Services.
Medicaid, a health insurance program that covers low-income individuals, is jointly funded by the state and federal government. More than 3.3 million Pennsylvanians are enrolled in the program also known in Pennsylvania as Medical Assistance.
The proposals are currently in a public comment period through Jan. 2, and will be formally submitted to the federal Centers for Medicare and Medicaid Services next year to be approved or denied by federal regulators. Health care advocates said similar policy changes have been approved in other states, and Pennsylvania’s proposals stand a good chance of being approved and enacted.
The state is proposing four main areas of change:
- Reentry supports for people leaving incarceration, such as helping people apply for Medicaid prior to release so they are on it by the time they leave prison, providing a 30-day supply of prescriptions on release, and maintaining coverage for a year following release.
- Housing supports targeting people who are homeless and have certain chronic or serious health conditions, such as connecting people to housing and short-term help paying rent in some cases.
- Food and nutrition support such as meals or groceries for people with diet-sensitive conditions.
- Continuous Medicaid coverage for children up to age six, without requiring annual renewal paperwork.
“So often a person gets a diagnosis, let's say, of diabetes. And if you don't have stable housing, if you don't have a refrigerator to put your insulin in, if you don't have access to healthy, fresh food, it is extremely hard to manage your diabetes and avoid hospitalizations,” Arkoosh said. “But with these very simple, straightforward supports, we know that we can reduce hospitalizations and help keep people healthy.”
Arkoosh said state officials were still calculating estimates of how much changes might cost.
If approved by federal officials, the changes would likely be phased in in 2025 and 2026.
The proposals have lots of support from health care advocacy groups.
“People may ask the question, well, what does housing have to do with health care or … what do paperwork errors have to do with health care or … why should we do reentry?” said Patrick Keenan, director of policy and partnerships for the Pennsylvania Health Access Network. “And it's because, all of the populations that are being targeted by this, you know, have serious physical and behavioral health needs that have gone unmet. And this is a way where we can actually meet those needs.”
Allowing continuous coverage for children has been the goal of some advocates for a long time, as it eases a major paperwork burden for families and can prevent children from losing coverage due to changes in income or bureaucratic mistakes.
“The goal of it really is to make sure that children don't have any unintended gaps in coverage, especially during their early years in this important developmental period,” said Becky Ludwick, vice president of public policy at Pennsylvania Partnerships for Children.
During the pandemic, federal rules allowed continuous coverage for everyone on Medicaid, but that policy ended earlier this year.
More information about the proposal is available here: Keystones of Health (pa.gov). You can leave a public comment here. The public comment period ends Jan. 2.
