Medicaid and state marketplace cover almost half of PA kids

But disenrollment looms

By ANNEMARIE SCHUETZ
Posted 12/1/21

HARRISBURG, PA — Partly due to a national freeze that prohibits kicking enrollees off Medicaid during the pandemic, partly due to job losses and the need to buy health insurance, Medicaid and …

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Medicaid and state marketplace cover almost half of PA kids

But disenrollment looms

Posted

HARRISBURG, PA — Partly due to a national freeze that prohibits kicking enrollees off Medicaid during the pandemic, partly due to job losses and the need to buy health insurance, Medicaid and Pennie, the PA health insurance marketplace, have seen increased enrollments.

However, an estimated 500,000 people stand to lose coverage once the emergency ends and routine Medicaid operations resume, said an advocacy group, if Pennsylvania does not carefully plan.

“We found that families have weathered the pandemic storm under the umbrella of public health coverage because enrollment increased in the last year,” said Kari King, president/CEO of Pennsylvania Partnerships for Children (PPC), in a statement.

Together, Medicaid, the Children’s Health Insurance Program, and Pennie, the state-based marketplace, account for 45.9 percent of children covered in Pennsylvania. Statewide, Medicaid and CHIP have enrolled 10 percent more children since the beginning of the pandemic, and every county has seen an increase.

Medicaid is the single largest health insurer for Pennsylvania children, covering 41 percent of all kids. King said a key factor affecting the increase is the disenrollment freeze implemented in the Families First Coronavirus Response Act in March of 2020, which will be in place for as long as the federal public health emergency (PHE) is in effect.

The PHE began in January 2020, according to the Center for Medicare and Medicaid Services, and is renewed every 90 days. It was last renewed October 15.

Normally, a person can be disenrolled from Medicaid because they made too much money, they moved to a different state with different rules, a pregnancy ended, or they aged out of the family’s Medicaid. (There are other rules, depending on the state.) But currently, “[s]tates may not disenroll any beneficiary who was enrolled in Medicaid as of March 18, 2020, or anyone who newly enrolls, until after the national emergency declaration has been lifted,” according to Tricia Brooks, in a post for the Georgetown University Health Policy Institute. “In essence, it provides continuous eligibility to ALL current beneficiaries and new enrollees in Medicaid unless they move out-of-state or request voluntary termination.”

“Threats to safety net programs existed before the pandemic,” said King. “We cannot [overstate] the importance of ensuring that every eligible child and pregnant or postpartum individual does not unnecessarily lose coverage.”

PPC recommends that those with existing coverage be able to stay connected without unnecessary gaps in coverage through auto-renewal strategies, updating current mailing addresses and through more extended time frames.

In addition, data in a report by PPC shows, King said, that the pandemic disproportionally hit people depending on their race and ethnicity, and whether there were children in the family. Larger percentages of Black and brown children enrolled in Medicaid during the pandemic in Pennsylvania than did their white counterparts.

The report also covers the impact of the pandemic on routine immunizations that protect from 17 childhood diseases. Overall, Pennsylvania had a five percent decline in vaccination coverage. The early part of 2021 shows vaccination gaps continued among children, particularly preschool and young school-age children ages four to 10. Ensuring kids are up to date on routine immunizations is necessary for community health and helps keep them healthy enough to stay in school.

For more information on the report or on PPC, visit https://www.papartnerships.org.

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