End of Public Health Emergency Could Reverse Progress
HARRISBURG (Monday, Dec. 12) — The number of uninsured children in Pennsylvania improved during the COVID-19 pandemic thanks to the federal continuous coverage provision that prevents states from disenrolling children and families from Medicaid during the public health emergency, according to the State of Children’s Health report by Pennsylvania Partnerships for Children.
Pennsylvania’s child uninsured rate improved to 4.4% from 4.6% between 2019 and 2021 as families weathered the pandemic storm under the umbrella of public health coverage, with Medicaid enrollees having uninterrupted access to health insurance that connects them to doctor visits, immunizations, and well-visits that screen for physical and mental health.
The report found Medicaid is an essential source of coverage for Pennsylvania children with disabilities, living in low-income families, and those living in and aging out of foster care. It became even more so during the pandemic when child enrollment increased by 20%. More than 1.4 million Pennsylvania children currently have Medicaid as their health insurance.
“We are cautiously optimistic about the improvement in our child uninsured rate in Pennsylvania,” said Kari King, president and CEO of Pennsylvania Partnerships for Children. “While we have made progress, the number of uninsured children in the state totals the populations of Harrisburg and Scranton combined. And hundreds of thousands of children are at risk of losing Medicaid coverage when the public health emergency ends and the state begins to unwind the disenrollment freeze and resume pre-pandemic operations.”
Pennsylvania has the 8th highest number of uninsured children in the nation, with 126,000 children who do not have health insurance and don’t have regular access to preventive and primary health care. According to the latest estimates from the Department of Human Services, 1 in 4 children enrolled in Medicaid could lose coverage when the public health emergency ends and the process to redetermine eligibility begins.
“It will be imperative for DHS to implement an unwinding process that does not disconnect the children most at risk of losing coverage, particularly when Pennsylvania’s uninsured rate is starting to improve,” King said.
The report recommends the Department of Human Services:
- Reaffirm its commitment to using a 12-month unwinding period as recommended by the Centers for Medicare and Medicaid, which most other states plan to use. Using the full 12 months permitted will give Pennsylvania the best chance to minimize inappropriate terminations and disruptions in coverage (churn) that often impact children more than the adult population.
- Immediately expand the 12-month continuous eligibility policy to children ages 4 through 21 in Medicaid when the public health emergency ends to make it more equitable—Pennsylvania already provides 12-month continuous eligibility (regardless of changes in circumstances) in Medicaid for children up to age 4. All Pennsylvania children in CHIP have continuous eligibility for a full year.
According to the report, factors such as race and ethnicity, poverty level and geographic region impact children’s access to health insurance. Some additional key findings include the following:
- Hispanic or Latino children, children who identified as Some Other Race, and children who identified as Two or More Races have worse rates now than in 2019, showing they are more likely to be uninsured.
- 5% of children in PA who qualify for no-cost or reduced-cost health insurance through Medicaid, CHIP, or Pennie™ do not have health insurance.
- The uninsured rates improved in 38 counties and worsened in 29 counties over the last two years.
King said her organization this year offers fact sheets for each of the 67 counties that show the local uninsured rate, race and ethnicity profiles, and public health insurance enrollment data.
For more information on enrollment for children’s health care coverage, visit: