State officials: U.S. House budget bill could strip 300,000 Pennsylvanians of Pennie coverage

The budget bill passed by the U.S. House of Representatives on May 22 would impact a number of Pennsylvanians who get their health care through Pennie or Medicaid, according to state officials.

That bill has to be approved by the U.S. Senate to be finalized.

About 270,000 people, or one out of every two Pennie enrollees, could lose marketplace health coverage if the House bill as written becomes law, and if current tax credits that make plans more affordable are not extended by Congress, according to Valerie Arkoosh, secretary of the Pennsylvania Department of Human Services.

An estimated 320,000 working-age adults would lose Medicaid coverage due to restrictive new requirements or reductions in funding, Arkoosh said.

Arkoosh, Devon Trolley, Pennie executive director, and Antoinette Kraus, of the Pennsylvania Health Access Network (PHAN), held a virtual town hall on Tuesday to discuss in greater detail the implications of the House bill.

The bill makes changes to federal rules that would create new barriers to enrolling in Pennie coverage, Trolley said.

Those changes include shortening the Open Enrollment Period, discontinuing automatic enrollment, and no longer allowing lawfully present immigrants to purchase coverage with financial assistance.

"Also, any process that requires somebody to take on the administrative burden of having to do something as complex as determining their eligibility two times instead of one time in a year is going to have a bad outcome for both," Arkoosh said.

Kraus said the legislation would make the largest cuts in history to Medicaid and SNAP, devastate Pennsylvania's state budget and strip away coverage for 320,000 people who rely on Medicaid.

"In total, over half a million Pennsylvanians could lose coverage if this bill becomes law," Kraus said

Proposed cuts to Medicaid funding would force the state to make impossible choices, she said, such as taking away health coverage, reducing services, or drastically increasing state spending to maintain current coverage levels.

Pennsylvania will be particularly hard-hit by the proposal, with at least $1.7 billion in cuts each year to the commonwealth's Medicaid program, Arkoosh said.

To put this into perspective, the state contributes about $14 billion a year to the state Medicaid program and the federal government contributes about $30 billion.

Right now, it does not appear that programs directly benefiting children, including Children's Health Insurance Program or CHIP, are a target of this piece of legislation, Arkoosh said.

The bill is largely targeting the Medicaid expansion population, which are those adults between 19 and 64.

"Meanwhile, there are still a lot of questions about how the bill is written," Arkoosh said. Some of the language regarding Medicaid "is a little vague and could potentially be interpreted more than one way."

This House budget bill was a party-line vote for Pennsylvania's congressional delegation, Kraus said.

"All Pennsylvania Republicans voted for it and congressional Democrats all voted against it," Kraus said. "As it heads to the Senate, (Sen. John) Fetterman said he would vote against it. (Sen. Dave) McCormick said he would vote for it. It will eventually have to go back to the House."

Polls show a majority of the public is not following this debate and doesn't understand how it will make a local impact on Medicaid, SNAP the Affordable Care Act and Pennie, Kraus said.