About 300,000 Pennsylvania residents risk losing Medicaid next year when new eligibility rules take effect, and advocates worry that too few people are aware.
More than 100 public health workers, community advocates, and medical providers gathered Thursday to strategize how to spread the word about forthcoming changes to Medicaid.
The nonprofit Community Behavioral Health organized the event at its Center City offices as a first step toward rallying the stakeholders tasked with helping people navigate the new rules in order to maintain access to critical health services. The city contracts with CBH to provide mental and behavioral health services for Philadelphians with Medicaid.
New federal rules taking effect in January 2027 require certain adults to meet work requirements and reapply for Medicaid every six months, instead of the current once a year. The changes were ordered under Republicans’ 2025 spending bill and signed into law by President Donald Trump. They are part of the largest cut in recent history to Medicaid, the publicly funded health coverage program for low-income families and individuals, and people with disabilities.
States will be expected to verify eligibility for millions of people twice as often, a major administrative burden. For now, who will be exempt remains unclear. For instance, the law suggests that “medically frail” individuals will not need to meet work requirements or reapply every six months, without detailing who would qualify.
The federal government expects to release more details in June.
Public health leaders say they cannot wait for the additional guidance to begin talking about the forthcoming changes, in order to minimize the number of people who lose coverage.
“It needs to be consistent and ongoing,” Donna E.M. Bailey, CEO of CBH, said of the group’s outreach efforts. “It really is a Philadelphia responsibility.”
The coming Medicaid changes
Roughly three million Pennsylvania residents are covered by Medicaid. About a quarter of them — roughly 750,000 people, including 180,000 in Philadelphia — qualify because the 2010 Affordable Care Act expanded access to low-income parents and childless adults. This so-called expansion group saw the bulk of the Medicaid cuts in last year’s Republican spending bill.
Beginning next year, most people in this group will need to provide monthly proof that they spent at least 80 hours working, volunteering, or participating in job training. Every six months, they will need to reapply for the program. Some experts have compared this process to filing taxes because of the extensive paperwork and documentation required.
Pennsylvania has estimated that about 300,000 people will lose Medicaid because they cannot navigate the new requirements — even though many remain eligible.
“It’s hard to imagine with all these changes that it’s just going to be smooth,” said Mike Nardone, a former director of Pennsylvania’s Medicaid program, who spoke during the CBH event. “We’re going to have people who lose coverage, and we’re going to have to understand why that happens.”
Starting outreach early
Early and frequent communication is the best strategy for minimizing the number of people who lose Medicaid, public health advocates said at Thursday’s event.
“We need to start now. This isn’t something that can wait,” said Joan Erney, CBH’s former chief executive.
The dozens of medical providers, social workers, and community advocates in attendance were urged to work together to develop strategies for helping people to understand what new steps to take to keep their Medicaid coverage.
“We always need the voice of those of you on the ground,” said Leesa Allen, a former Pennsylvania Medicaid director, who spoke during the panel.
The event was the first in a series planned by CBH, which will expand outreach with similar events throughout Philadelphia designed for families and individuals to ask questions and learn more about the new Medicaid rules.
