End of PHE Could Cut Kids From PA Medicaid Rolls
When the formal COVID-19 public health emergency ends, as many as one out of every four Pennsylvania children enrolled in Medicaid could lose their state-sponsored health insurance, according to new research by the Pennsylvania Partnership for Children.
During the PHE, the number of uninsured children in the state fell from 4.6 percent to 4.4 percent, but some of that improvement could be reversed as the state begins to redetermine the eligibility of more than 3.5 million people currently on the state’s Medicaid rolls after a more than two-year hiatus in eligibility reviews. Today, more than 1.4 million children in Pennsylvania are enrolled in Medicaid or CHIP.
Even with the PHE-inspired improvements, 5.5 percent of children in the state who qualify for some kind of free or subsidized health insurance remain uninsured, according to the research.
Uninsured children, like the uninsured population at large, are far more likely than not to be treated by Pennsylvania’s safety-net hospitals such as those that belong to the Safety-Net Association of Pennsylvania (SNAP). As a result, any reduction in the rate of uninsured children would have a correspondingly damaging effect on the financial health of those safety-net hospitals – and potentially, on the residents of the medically vulnerable communities those hospitals serve.
Learn more about how the end of the PHE may affect health care coverage for Pennsylvania children in the Pennsylvania Capital-Star article “Report: Ranks of uninsured Pa. kids dropped during pandemic.”
Pennsylvania Act 2, passed earlier this year, appropriates $225 million in federal money and the state has earmarked a portion of that money for hospitals based on how many beds they have. Hospitals that serve especially high proportions of Medicaid patients, however, will receive funding over and above the amount targeted to them based on bed count alone.
Because of the manner in which the COVID-19 pandemic affected hospital admissions, some hospitals that have been eligible to participate in the 340B program could lose that eligibility for what is, in effect, a one-year anomaly. The proposed bills would temporarily enable current 340B participants to retain their eligibility for the program until hospitals’ inpatient volume returns to normal and they can demonstrate whether they still meet the criteria to continue participating in the program.
The bill also should include additional targeted funding for safety-net hospitals, help with staffing, an extension of the current moratorium on the Medicare sequestration, and forgiveness for safety-net hospitals for loans they received under the Medicare Accelerated and Advance Payment Program.
The Medicaid DSH cut was included in the 2010 health care reform law in anticipation of a great reduction in the number of uninsured people leaving hospitals providing much less uncompensated care and therefore not in need of as much DSH money. The law’s reach has not proven to be as great as anticipated, however, and two developments since the law’s passage have put a damper on the expected rise in the number of insured Americans: a court decision that made it optional for states to expand their Medicaid program and the repeal of the requirement that everyone purchase health insurance.
According to a new study, safety-net, academic, and rural hospitals have enjoyed improved performance under the program since Medicare began organizing hospitals into peer groups based on the proportion of low-income patients they serve rather than simply comparing individual hospital performance to that of all other hospitals.
According to a new study published in Health Affairs,
