PITTSBURGH — Medicaid benefits for Pennsylvania residents are in limbo as temporary protections implemented during the pandemic end for the first time in three years.
A federal rule under a COVID relief package ensured Medicaid recipients stayed enrolled throughout the pandemic. That provision expired March 31, meaning those receiving healthcare under Medicaid must reapply starting this month to ensure they are still eligible to stay in the program.
The unwinding of continuous Medicaid enrollment puts thousands of Pennsylvanians at risk of losing their coverage, especially children and people of color.
• Who receives Medicaid benefits?
Covering one in five Americans, Medicaid is a joint federal-state program and a main source of healthcare coverage for millions of low-income individuals and families across the country.
As of October 2022, over 3.5 million people in Pennsylvania, roughly 21% of the state’s population, were enrolled in Medicaid and/or the Children’s Health Insurance Program, another low-income insurance plan.
According to the state Department of Health Services, more than 300,000 people in Allegheny County are enrolled in Medicaid. The majority of recipients are between the ages 21 and 64. About 52% of Allegheny County recipients are people of color.
Medicaid covers 2 in 5 people with disabilities, and 5 in 8 nursing home residents in Pennsylvania. Of non-elderly Medicaid enrollees in the state, about 46% are people of color.
It’s a critical benefit for parents and kids too, covering three in eight of Pennsylvania children. Last year, 34% of births in the state were funded by Medicaid.
• What happened to Medicaid during the pandemic?
The public health emergency declared in March 2020 required Pennsylvania and other states to temporarily suspend their yearly Medicaid renewal processes in exchange for enhanced federal funding.
This ensured people could continue receiving Medicaid coverage even if they experienced a change in personal circumstances that would have otherwise rendered them ineligible, according to Hoa Pham, deputy secretary in the Pennsylvania Department of Human Services’s Office of Income Maintenance.
“If you were involved in Medicaid or medical assistance sometime over the last three years, you have not had to take any specific actions to keep your coverage,” Ms. Pham said. “That’s known as the continuous coverage requirement.”
Under this requirement, Medicaid recipients did not need to fill out their regular annual paperwork to keep coverage. Though Ms. Pham said the department continued to send out the applications each year to keep people in the habit of completing them.
• What changes are coming to Medicaid?
Since the expiration of the COVID-19 public health emergency, the federal provision that kept Medicaid enrollees from being kicked off the program over their eligibility ended March 31.
