As Pa. slashes Medicaid rolls, advocates cry foul

Pennsylvania has cut more than 130,000 people from its Medicaid rolls since July, more than a third of them children. The state says it has been targeting waste, fraud and abuse, but advocates say those who have a legitimate claim on health insurance are getting the ax.

In July, lawmakers gave the head of the Department of Public Welfare what some called “unprecedented” power to cut $400 million from the department’s budget. In October, the agency announced it purged more than 100,000 people from the Medicaid rolls after analyzing backlogged cases.

Now, as enrollment continues to shrink even in a down economy, advocates say many of those who are losing coverage shouldn’t be.

“From what we can tell, for the vast majority of these families, their children are still eligible,” said Colleen McCauley, health policy director at Public Citizens for Children and Youth. Recently, her organization’s helpline has been bombarded by calls from parents who are confused about why their kids no longer have insurance.

“These kids are going to go without care, they’re going to defer care and perhaps their medical problems escalate because of that,” McCauley said. “We’re just making things worse.”

Over the summer, officials ordered caseworkers to scrutinize every Medicaid case that was past due for its eligibility renewal. That amounted to more than 150,000 cases.

Often, the department just didn’t get renewal paperwork back, according to Lourdes Padilla of the Department of Public Welfare.

“Because we were not able to complete a thorough review of their eligibility, because the parent did not follow through with the renewal, we don’t know whether they have insurance, we don’t know if they’re income-eligible, we just don’t know,” Padilla said.

McCauley and other advocates suspect something else happened, that when renewal applications rolled in, county assistance offices lacked the staff to process the paperwork before deadlines automatically kicked people off their insurance. The state says that theory is wrong.

Tricia Brooks, with the Georgetown University Center for Children and Families, said in most other states, enrollment rates are holding steady or increasing.

“We are not seeing the kinds of precipitous drop-offs in enrollment in Medicaid in any other state that matches what we’re seeing in Pennsylvania,” Brooks said.