As many as 90,000 Philadelphians could lose Medicaid coverage next year due to new federal work requirements and eligibility changes taking effect in January, according to city health leaders. The loss would disrupt access to behavioral health care, particularly for vulnerable populations with limited alternatives.
Beginning January 1, adults on Medicaid will need to prove they work or volunteer at least 80 hours per month to maintain coverage. This requirement applies to roughly 750,000 people in Pennsylvania, including more than 183,000 Philadelphians in the state’s Medicaid expansion population. Additionally, states will reassess Medicaid eligibility every six months instead of annually, requiring participants to submit more frequent income documentation and other paperwork.
City health leaders estimate that at minimum, about 73,000 people are at risk of losing coverage, though the actual number could reach as high as 90,000, according to Donna Bailey, chief executive officer of Community Behavioral Health. The losses will include people already meeting work requirements who may be kicked off due to missing documentation or eligibility paperwork issues.
Philadelphia city officials are implementing a three-part strategy to mitigate the impact: mitigation efforts, continuity of care for those who lose coverage, and an equity focus. Community Behavioral Health is using existing client data to identify at-risk individuals and working with mental health providers to proactively reach out to them. Public service announcements and awareness campaigns will target residents, beginning with outreach events starting June 13 in partnership with local community service providers.
The changes will also affect provider organizations, with more than 810 community behavioral health jobs in Philadelphia potentially at risk due to expected Medicaid enrollment losses and reduced reimbursement revenue. City agencies are partnering with schools, faith-based institutions, and community centers to expand enrollment support locations and reduce coverage disruption.
This article is an AI-assisted summary. All facts and figures are drawn from the original report: https://whyy.org/articles/medicaid-reuirements-eligibility-philadelphians-mental-health-care/