With monumental Medicaid changes looming, Pennsylvania braces for healthcare coverage losses
90.5 WESA |
By
Kate Giammarise
Published August 10, 2026 at 5:31 AM EDT
David A. Lieb
/
AP
With a wave of increased paperwork requirements starting in a few months, many public officials and health advocacy groups are warning of likely coverage losses next year for potentially hundreds of thousands of Pennsylvanians enrolled in the state’s Medicaid program
The slew of administrative changes that will happen, starting in January, are from the Trump administration’s budget reconciliation bill passed last summer, often referred to by President Trump as the “Big Beautiful Bill.”
Medicaid is a joint federal-state program that provides health insurance for many low-income and disabled individuals
Two major changes are set to soon hit many working-age adults in the program: they will have to complete paperwork to renew their coverage every six months (rather than once a year), and they will have to complete additional paperwork to prove they are working, attending school, a training program, or participating in a “community engagement” activity
Though the new rules won’t take effect until January, state human service officials plan to begin notifying people about the upcoming changes later this monthbecause they are expected to be so disruptive
The state estimates that roughly 310,000 Pennsylvanians will lose their Medicaid coverage as a result of a combination of these changes — including some people who are likely still eligible for the program
The increased volume of paperwork for so many people will lead to coverage losses for likely hundreds of thousands of people, state officials have said
That projection is based on data tied to work requirements for various public assistance programs in other states and the enforcement of work requirements in Pennsylvania’s SNAP program, said Hoa Pham, a deputy secretary for the state’s Department of Human Services
“These work requirements do very little to promote better economic opportunities for public assistance recipients,” Pham said. “What they do drive is loss in eligibility, more often than not for failure to work through the administrative processes, and not because they were necessarily failing to meet the actual working component or the job training component.”
‘Caught up in the logjams’
Even though the new requirements are only supposed to apply to certain adults, “families and children, seniors and people with disabilities will end up losing coverage because they’re going to get caught up in the logjams and backlogs that result from this additional work,” said Patrick Keenan, policy director for advocacy group the Pennsylvania Health Access Network
Roughly 2.8 million Pennsylvanians currently receive their healthcare through the Medicaid program, also called Medical Assistance. More than 200,000 people in Allegheny County are covered through Medicaid
“Historically whenever changes have been made programmatically to increase those barriers to enrollment, we see people who are eligible fall out of the program,” said Becky Ludwick, vice president of public policy at advocacy group Pennsylvania Partnerships for Children
A White House press release from shortly before the Big Beautiful Bill was signed into law states there will be “no cuts to Medicaid,” and said the law’s changes strengthen the program “while eliminating waste, fraud, and abuse.”
But healthcare advocates are pointing to similar changes that have already been rolled out in the Supplemental <a href="https://healthylife7.com/slimfast-pivots-to-functional-nutrition-with-5m-relaunch/” title=”SlimFast pivots to functional nutrition with £5m relaunch”>Nutrition Assistance Program, also called SNAP or food stamps, that have led to many people losing their food assistance
Since the reconciliation bill was signed into law last year, more than 200,000 Pennsylvanians have lost SNAP, Kennan said. “One in four of those who have lost SNAP are children. And half of the people who lost SNAP were not the people specifically targeted by the changes in H.R. 1,” he said
Ludwick said whatever happens to parents and caregivers tends to trickle down to kids – even if children are not the intended target of the changes
“So when we see parents lose coverage, we often see that even if the child in the household or the children in the household are still eligible, there’s a much larger risk of them losing their coverage too,” she said
In Allegheny County, human service officials cited a state estimate that roughly 26,000 people — or 10% of the people on Medicaid in the county — will lose coverage due to the new requirements
County officials said last week they will bolster their outreach to Medicaid enrollees as well as spread the word to their network of provider organizations that people must take action to stay enrolled in the program
State officials have also said they are working hard on outreach to people who will be impacted, but acknowledged they do not have a budget for paid advertisements about the major changes
Pham said the state is also working very closely with other organizations — community groups, healthcare providers, hospital groups, and others — to help spread the word about what people need to do to prepare for the changes
Costs
The state is also in the midst of major computer system updates due to the upcoming changes. The state budget for the fiscal year that started July 1 includes $7.8 million in additional funding to update IT systems
But Pham said it would be difficult to calculate the cost in staff time in recent months preparing for the coming changes
“That’s sort of a hidden cost number that I think is really, really hard to quantify,” she said
Additionally, the most recent state budget includes funding to fill what are roughly 400 vacant caseworker positions statewide across county assistance offices (which are run by the state)
It can take up to 12 months to fully train a caseworker because various program requirements are so complex, so new caseworkers hired now will not necessarily be able to help people starting in January
Like many public sector employers, the Department of Human Services has struggled to fill such vacancies since the pandemic, said Steve Catanese, president of the Service Employees International Union Local 668, which represents those workers
Catanese said he has met with state officials about how to handle the coming influx of increased paperwork and renewals
“The positions that are open need to be filled,” Catanese said, and the state must make efforts to keep the trained and experienced workers it has
“They absolutely need to make sure they’re staffed up as much as they can,” he said
