Since the end of a COVID-era federal policy, more than 184,000 Pennsylvanians have lost their Medicaid coverage, according to state statistics.
During the pandemic, people could remain enrolled in Medicaid — which provides health insurance to people with disabilities and those with low incomes — without having to complete annual re-enrollment paperwork. Along with other COVID aid programs, that policy has ended, and since April, the state has begun processing renewal paperwork for the more than 3 million Pennsylvanians enrolled in the program.
Health care advocates are especially concerned about the more than 80,000 people — 44% of those who have lost coverage — who could still be eligible for Medicaid, but are being disenrolled from the program for paperwork-related reasons.
“Some people just didn't really know what they were supposed to do,” said Bobby Karlavage, a staff attorney at Neighborhood Legal Services in Pittsburgh, who specializes in cases involving public benefits such as Medicaid, which is also known as Medical Assistance in Pennsylvania.
“A lot of other times… people have moved and they did not update addresses with their county assistance office. So they didn't get the renewal,” Karlavage said. “They didn't know they were supposed to renew until it was too late — until, you know, benefits were cut off.”
Getting the word out
In an effort to get the word out about changes, state human service officials have made television appearances and held press and community events statewide. The state is also running a paid media campaign about the Medical Assistance changes in both traditional outlets and social media sites.
Officials have said they are “optimistic” about their overall progress thus far, citing the fact that most cases are being closed due to ineligibility, rather than paperwork problems, and a number of other states have much higher rates of procedural closures.
Of those who have lost Medicaid coverage in Pennsylvania, over half — more than 104,000 people — are no longer eligible for the program, most likely because their income is now too high. State officials say more than 12,000 of these individuals have found other health coverage through the state’s health insurance marketplace, Pennie.
But health care advocates have been worried about bureaucratic problems in part because, before the pandemic, so many eligible people lost their Medical Assistance regularly due to problems with their renewal paperwork. They worried this issue would only be heightened with the unprecedented volume of renewals the state is processing.
“We are and will continue to monitor renewal processing very closely. …The best thing a person can do to stay covered remains keeping their contact information up to date with DHS through [state social services portal] COMPASS and completing their renewal on time when it is their turn,” said Brandon Cwalina, press secretary for Pennsylvania’s Department of Human Services.
‘There are options’
If you’re enrolled in Medical Assistance, keeping your contact information up-to-date is key, agreed Joanna Rosenhein, consumer engagement manager for the Pennsylvania Health Access Network (PHAN).
If you’re terminated from Medicaid, “there are options,” advises Rosenhein, who helps run PHAN’s statewide hotline, where people can enroll in coverage.
“You can appeal the decision if you think you still qualify. And it's really important to do that within 15 days of the notice, because then you can maintain your coverage until the appeal hearing.”
If you are no longer eligible, it’s often possible to obtain low-cost coverage through Pennie, she said.
Pennsylvania has disenrolled about 33% of people who have completed their renewal forms. That’s slightly below the national average of 37%, said Bradley Corallo, a senior policy analyst at KFF, which conducts independent research and polling on health policy.
More than 5.5 million people have been disenrolled nationally since the process began earlier this year.
“Pennsylvania appears to be doing pretty well based on the publicly available data that we have,” Corrallo said, though he noted there are a large number of renewals that are still pending, and the outcome of those is unclear.
Andrea Szabad, 52, who lives in Berks County, said she’s been told she’ll lose her Medical Assistance due to having money from an old workers’ comp settlement, but is appealing her case. She is partially paralyzed and has a number of other medical issues.
“I just don't know what I'm going to do. I don't have anywhere to turn,” she said.
Children’s issues
It’s unclear how many children who have lost coverage were able to enroll in CHIP, the state’s Children’s Health Insurance Program. CHIP covers kids whose parents’ income is too high for Medicaid. There is no income limit for CHIP, though some higher-income families have co-pays, and any child in Pennsylvania is eligible for the coverage.
State officials have said it’s not clear how many children who were disenrolled from Medicaid were able to get coverage through CHIP. But overall enrollment in that program has increased from 125,169 kids in April to 139,586 children by July.
Coverage for children has been of particular concern for advocates in the state and nationally, because kids are often eligible for different coverage than their parents.
“When you have an adult who … knows they're not eligible anymore, they're assuming that their three kids aren't,” said Carolyn Myers, of advocacy group Pennsylvania Partnerships for Children.
The lack of data on this aspect of the Medicaid transition is due to an IT issue involving CHIP unrelated to the Medicaid changes and is very frustrating, Myers said.
“We want to reduce the uninsured rate for children by keeping kids covered in Medicaid or CHIP,” she said. “And we don't know if that's happening.”
For more information on Medicaid changes and to check your renewal date or submit your information online, go to the DHS website.
