89,000 Pennsylvania Children Lose Medicaid Due to Shortsighted Policies & Bureaucratic Backlogs – Say Ahhh! A Children’s Health Policy Blog

By George Hoover, Pennsylvania Partnerships for Children

Having dedicated my career to making health care coverage
accessible to all Pennsylvanians, I am dismayed over recent actions by the
state that are jeopardizing health care access for children.

The number of Pennsylvania children covered through
Medicaid has plummeted by about 89,000 in recent months, including many kids
with life-threatening medical needs who were hastily — and wrongly — cut from
Medicaid despite meeting the eligibility requirements.

Those wrongly dropped from Medicaid included a 5-year-old
undergoing treatments for leukemia and an infant with congenital heart
deformities. They also include a severely disabled 12-year-old who requires
home health care and a pair of 9-year-old twins — one diagnosed with autism,
the other with a hearing impairment — who rely on Medicaid to provide supports
and services critical to their development and learning.

Many of these children rely on Medicaid not only for
physical health services, but also critical behavioral health services that
help them get by day to day. To understand how this happened and how we can fix
it requires a quick history of the health care coverage crisis that has been
quietly unfolding in Pennsylvania since last summer.

Last August, the Department of Public Welfare began
sending out hundreds of thousands of renewal notices to Pennsylvania families
receiving Medicaid, allowing these families 10 to 15 days to provide
documentation to keep their children enrolled in Medicaid. If DPW did not
receive and process all requested paperwork within this 10 to 15-day deadline,
the child was dropped from Medicaid, even if the deadline was missed due to
DPW’s own bureaucratic backlogs.

Locally, this poorly planned process cut off Medicaid to
more than 2,000 children in Dauphin County, nearly 1,600 in York County and
more than 2,500 in Lancaster County. There’s another troubling aspect to this
story: Families whose children are no longer income eligible for Medicaid are
referred to the Children’s Health Insurance Program, or CHIP, yet we have not seen
an increase in CHIP enrollment that corresponds to the drastic Medicaid
enrollment decline.

In a state with near universal coverage for children,
where have these children gone? ?And what can be done to ensure these children,
and others, are not put at risk due to lack of access to health care?

Part of the solution lies in the Affordable Care Act.
Look beyond the heated political rhetoric and it’s easy to see how the ACA is
helping to keep young Pennsylvanians healthy at a time when our state policies
are putting children’s health care at risk.

More than 1.1 million Pennsylvania children are
benefiting from the ACA’s prohibition on lifetime limits on health care.
Insurance companies can no longer deny coverage for children in Pennsylvania
with pre-existing conditions, and nearly 65,000 young adults can now remain on
a parent’s health insurance coverage up to age 26.

Why should any of this matter to Pennsylvanians who don’t
have kids? Because we all benefit, financially and otherwise, when children are
healthy. Healthy kids grow up to be healthy adults. Families are less likely to
put off medical care for their children and run the risk of needing more costly
and complicated medical treatments later.

Fortunately, Governor Tom Corbett has embraced a critical
aspect of the ACA that state lawmakers should support, too. The state is moving
ahead with plans to create a health insurance exchange, a user-friendly, online
insurance marketplace that will enable all families with children to obtain and
maintain high-quality health insurance in a streamlined way.

If we do it right, Pennsylvania’s exchange will allow
children to have access to the behavioral and physical health benefits they
need to be healthy. The governor and General Assembly should enact necessary legislation
this spring to get the exchange up and running. The commonwealth has been a
national leader in providing affordable, accessible, quality health care
coverage for children through Medicaid, CHIP and Cover All Kids — efforts that
have been supported by governors and lawmakers of both parties for over two

The ACA helps us build on those efforts, and it does so
at a critical time when we have seen children’s access to health care
jeopardized through shortsighted policies at the state level.

Scroll to Top