PA will take full year for Medicaid recertification

PA-ACP has strongly urged the Wolf Administration to take a full year to recertify Pennsylvanians currently receiving Medicaid coverage when the federal COVID-related Public Health Emergency (PHE) expires.

The Wolf Administration now says it will take that  12 months to make recertification decisions related to Medicaid coverage, after earlier announcing it would conduct those recertifications in just six months.  In lobbying for a full year effort, the Chapter had argued that such a fast process could result in qualified individuals losing coverage through a lack of information, administrative difficulties or simply lack of time for adequate follow-up by those administrating the program.

That PHE is currently set to expire on January 11, 2023 but we expect it will be extended at least one more time, till April 2023.

Pennsylvania now has 3.4 million citizens enrolled in Medicaid and CHIP programs.  The extensions of these programs will expire at the end of the PHE, most likely in October, 2022.  Estimates are that as many as 600,000 Pennsylvanians will lose their coverage when these temporary pandemic-inspired reforms expire.

The federal Families First Coronavirus Response Act (FFCRA) allowed the commonwealth to  continue Medicaid (MA) coverage for most individuals who were enrolled in the program at the start of the pandemic or who joined after the pandemic began without ongoing means testing.  PA took advantage of this provision with PA-ACP’s urging, and in return secured additional federal MA funding.  At the end of the PHE and continuous MA coverage, states will be required to review MA eligibility for everyone who was automatically kept on Medicaid as part of the program and to recertify all those in MA programs  For most recipients, this now means Medicaid will be reviewed when their Medicaid renewal would normally occur, rather than on an expedited schedule.

The omnibus spending bill currently moving through Congress sets March 31, 2023 as the last day of the continuous Medicaid coverage requirement, regardless of the status of the PHE.  On the bright side, the spending bill would allow states to continue to receive enhanced federal funding, in gradually decreasing amounts, throughout 2023.  Under FFCRA, the increased federal funding states receive in exchange for keeping people on Medicaid would have ended with the continuous Medicaid coverage requirement.

The state has set up a Customer Service Center at 1-877-395-8930 (215-560-7226 in Philadelphia) to answer recipients’ questions.