Pennsylvaina to Take Full Year to Unwind Medicaid Continuous Coverage Protection

The federal COVID-related Public Health Emergency (PHE) currently set to expire on January 11, 2023 is expected to be extended once more, possibly for the last time, to April 2023.   

During the PHE, Pennsylvania has allowed continued Medicaid (Medical Assistance) coverage for most individuals who were enrolled in Medicaid at the start of the pandemic or who joined Medicaid since the pandemic began. This continuous Medicaid coverage is required by the federal Families First Coronavirus Response Act (FFCRA) in exchange for increased federal Medicaid funding to Pennsylvania.  Under FFCRA, Medicaid coverage must continue until the end of the month in which the PHE ends.  For example, if the PHE were to end on April 11, the last day of the continuous Medicaid coverage requirement would be April 30, 2023.  

However, the continuous Medicaid coverage requirements’ connection to the PHE may soon be severed.  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.   

When the continuous Medicaid coverage requirement ends, Pennsylvania’s Department of Human Services (DHS) will review Medicaid eligibility for everyone who was kept on Medicaid despite being ineligible or not successfully renewing coverage.  DHS will also process normally-scheduled Medicaid renewals.  Originally, Pennsylvania’s “unwinding” of continuous Medicaid coverage was set to take place over a six month time period, which alarmed advocates who believed the short time frame would lead to renewal logjams and result in a crisis-level number of individuals losing Medicaid, and therefore access to healthcare, despite being eligible.  However, in November, DHS shared that it now intends to take a full twelve months to review eligibility for all Pennsylvanians on Medicaid.  For most, this means Medicaid will be reviewed when their Medicaid renewal would normally occur.   

PHLP would like to remind readers that if you are enrolled in Medicaid, it is critical to ensure your contact information with the County Assistance Office (CAO) is up to date so you can receive Medicaid-related correspondence, including your renewal packet. You can update your contact information on the COMPASS website, on the myCOMPASS PA mobile app, or by calling the Statewide Customer Service Center at 1-877-395-8930 (in Philadelphia, call 215-560-7226). You will also have the option to sign up for text alerts related to your benefits renewal.   

PHLP will continue to keep consumers informed of any updates around the end of continuous Medicaid coverage as we learn them.