Guaranteed Medicaid coverage ends; health leaders discuss changes

Pennsylvania Department of Human Services (DHS) Acting Secretary Dr. Val Arkoosh joined leadership from the Independence Blue Cross Foundation for a conversation with regional non-profit health centers and community leaders about Medicaid renewals as COVID-era policy ends.

The meeting was held at the Independence Blue Cross office, 1901 Market St., Philadelphia, on Monday (July 17).

Over the past few months, thousands of Pennsylvanians received Medicaid Redetermination packages in the mail, and many have been unsure what to do with them. During the COVID-19 pandemic, emergency measures allowed enrollees to not lose their Medicaid Continued from Page 1 or CHIP coverage, even if their circumstances changed and they were no longer eligible. The usual redetermination or renewal procedure was paused.

This spring, the federal government officially ended the pandemic as a public health emergency and the Medicaid renewal flexibilities.

As of April 1, Medicaid and CHIP enrollees had to complete renewal requests to stay covered by health insurance. The change in policy could have caused an increase in people losing coverage in the next year.

Arkoosh said, "If a person is found ineligible for coverage, or does not complete their renewal on time, their Medicaid coverage will end. Pennsylvanians who are no longer eligible for Medicaid will be referred to other sources of affordable medical coverage, like CHIP and Pennie, so they have no lapse in coverage." There are four ways to file for Medicaid renewal: by mail (complete and return forms by mail in the provided envelope); online via the COMPASS website (compass. state.pa.us)); by phone (call 1-866-550-4355); or in-person at a local county assistance office.

Varkoosh encouraged Medicaid enrollees who think they might no longer be eligible for the benefit program to complete the renewal paperwork anyway and if they are deemed ineligible, their information will be automatically transferred to Pennie, which provides other sources of affordable medical coverage and would guarantee enrollees no lapse in coverage.

Arkoosh, the former Montgomery County commissioner who was appointed DHS secretary by Gov. Josh Shapiro on June 29, said the Shapiro Administration was working to ensure that people relying on the Medicaid and CHIP programs "keep care, get new care, and find access to care," as the system change unfolds in the following months.

She said, "Listening and collaborating with partners at the local level that work every day to help people through the Medicaid renewal process, helps us understand opportunities to better assist and where we can partner to make sure people are staying connected to Medicaid or other forms of essential coverage." Arkoosh stressed that state outreach and awareness campaigns are highly data-driven, to assure maximum efficiency, and target communities which most need access to information and resources.

Since the change in early April, the first workable statistics have become available. As of June 2023, 3,713,633 Pennsylvanians are enrolled in the Medicaid program. The counties of Delaware and Philadelphia alone total 225,617 and 1,078,579 enrollees (including children), respectively.

Arkoosh said, "At this point, Pennsylvania is the third state with the lowest rate of procedural termination, with only 43 percent, compared to the national average of 76 percent." "Procedural termination" is the term used to define people losing health coverage because they did not renew their Medicaid Redetermination paperwork on time, versus losing the benefits because their circumstances changed so as to make them ineligible.

Arkoosh said the Shapiro Administration wants to see the number decrease further.

She said the data she quoted is publicly available on the DHS website: dhs.pa.gov/staycovered, and she encouraged organizations and individuals seeking to help with community outreach to look at it by zip code, to find out which specific communities might require more resources, more information, or translated information in a particular language.

In a brief Q and A session, Arkoosh fielded questions from the audience which highlighted various problematic aspects of the Medicaid Redetermination system.

People spoke from their experiences - such as helping non-English speaking family members fill out the paperwork, illustrating language barriers - and lack of sufficient turnover time between reception of the renewal packet and submission due date.

Community organizations also reported having trouble assisting Medicaid enrollees through the renewal process since the renewal dates are considered confidential information.

The conversation veered to include more holistic issues of the healthcare system and potential mitigation policies and solutions to respond to the impending increase in the uninsured population.