Report: Ranks of uninsured Pa. kids dropped during pandemic | Tuesday Morning Coffee

It’s already been shown that enhanced Medicaid coverage was a crucial lifeline for millions of people during the darkest days of the COVID-19 pandemic.

And as the federal government eyes winding down the public health emergency (PHE) sometime next year, as many as 18 million people could lose that coverage, data shows. And among those who could be particularly impacted are children. The ranks of Pennsylvania’s uninsured children dropped between 2019 and 2021, from 4.6 percent to 4.4 percent, according to newly released research by the advocacy group Pennsylvania Partnerships for Children. That’s lower than the nationwide average of 5.4 percent, but still higher than surrounding states, according to the report.

The current PHE is in effect until Jan. 11, 2023, according to the Kaiser Family Foundation. The Biden administration has said it will give states 60 days’ notice before ending it. And since the feds didn’t give notice last month (to make the math work) it’s likely the declaration will be extended again, according to Kaiser.

In a statement, the advocacy group called Medicaid, which is jointly funded by states and the federal government, an “essential source of coverage” for children living with disabilities; for those who live in low-income families, and for those living in, and aging out of, foster care.

Child enrollment in Medicaid increased by 20 percent during the pandemic, with more than 1.4 million children in the state relying on Medicaid as their source of health coverage, the research showed.

“We are cautiously optimistic about the improvement in our child uninsured rate in Pennsylvania,” Kari King, the group’s president and CEO, said in the statement.

But even with those improvements, “the number of uninsured children in the state totals the populations of Harrisburg and Scranton combined,” King continued, adding that “hundreds of thousands of children are at risk of losing … coverage when the public health emergency ends and the state begins to unwind the disenrollment freeze and resume pre-pandemic operations.”

Some background there: At the start of the pandemic, Congress approved the Families First Coronavirus Response Act (FFCRA), which included a requirement that, in exchange for enhanced federal funding, state Medicaid programs keep people continuously enrolled through the end of the public health emergency, according to the Kaiser Family Foundation.

At 126,000 uninsured children, Pennsylvania currently has the 8th highest number of kids without coverage in the nation, according to the new state-level data.

Pointing to an analysis by the state Department of Human Services, the report asserts that as 1 in 4 kids now enrolled in Medicaid could lose coverage when the public health emergency ends, and the process to redetermine eligibility begins.

The advocacy group’s research found that such factors as race and ethnicity, poverty level and geographic region impacted children’s access to health insurance.

According to the report:

• “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.
• “5.5 percent of children in PA who qualify for no-cost or reduced-cost health insurance through Medicaid, CHIP, or [the state’s health exchange] Pennie do not have health insurance.
• “The uninsured rates improved in 38 counties and worsened in 29 counties over the last two years,” its authors wrote.

The document also urges the state Department of Human Services to:

• “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,” its authors wrote.

“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,” PA Partnerships’ King said.