90K Pennsylvanians have lost Medicaid coverage since the end of pandemic-era rule

Since the end of a pandemic-era policy, roughly 20% of Pennsylvanians who had to renew their Medical Assistance coverage have lost it, according to data the state shares with the federal government.

Slightly more than half of those people lost the health insurance coverage because they were no longer eligible, likely because their income was too high to remain in the program. But just under half — more than 40,000 people — were removed from the program for procedural reasons: failure to return paperwork, a problem many advocates have been warning about.

Some who were ineligible for the program have found other coverage through the state’s health insurance marketplace, Pennie. It’s unclear how many children who lost coverage were able to enroll in CHIP, the state’s Children’s Health Insurance Program.

Many of the renewals undertaken in the last two months — more than 100,000 — are still incomplete, so it’s unclear how many people will ultimately lose coverage.

Still, state officials say, while it is early in what will be a year-long process, they aren’t seeing the processing backlogs some had feared.

“I'm pretty pleased with our progress to date,” said Hoa Pham, deputy secretary for the Pennsylvania Department of Human Services Office of Income Maintenance, though she noted “it’s early days.”

Some health care advocates also cautioned it was too early in the process to draw any firm conclusions.

“We're only two months into a yearlong process, with a lot of folks that still need to be determined,” said Antoinette Kraus, executive director of the Pennsylvania Health Access Network.

During the COVID-19 pandemic, people could remain enrolled in Medicaid without having to complete re-enrollment paperwork that normally must be completed every 12 months. Enrollment in the health care program grew considerably during the time; more than 800,000 Pennsylvanians got and stayed enrolled in the program, also known as Medical Assistance. Enrollment swelled to roughly 3.7 million people. But that pandemic-era policy ended April 1, and the state now is in the midst of what many fear will be a burdensome bureaucratic process.

Nationally, more than one million people have been disenrolled in Medicaid since the end of March, according to health policy website KFF, and the Biden administration expressed concern to states earlier this month too many people were losing coverage because of red tape.

One of those at risk of losing his coverage is Allegheny County resident Gary Rush, 67.

He lives on Social Security and a small pension; he’s been told he will no longer qualify for Medicaid because of about $70,000 in retirement savings. He says he doesn’t know what he will do without the coverage; he has diabetes, arthritis, and several other health conditions. He also has Medicare coverage, though noted that was much more costly.

“What am I supposed to do?” Rush asked.

He spoke at an event in Pittsburgh earlier this month with advocacy group Put People First! PA.

Other advocates have also said they are concerned with the number of people who will likely lose coverage.

There’s a “strong likelihood” that the children who lost coverage for procedural reasons are still Medicaid-eligible, according to advocacy organization Pennsylvania Partnerships for Children.

For those individuals whose income is now too high for the program, Pennsylvania officials have said they are striving to connect those people withPennie, the state Affordable Care Act exchange that allows people to purchase insurance plans. More than 3,000 people were successfully connected to coverage through Pennie in April, Pham said.

More information about how to stay covered in CHIP and Medicaid is available here.