Decreasing Number of Applications for Public Health Benefits During Pandemic

COVID-19 has fueled a surge in unemployment – 2.1 million initial unemployment claims were filed in PA between mid-March and June.  Over 900,000 Pennsylvanians are estimated to be currently unemployed (15% of pre-COVID workforce). 

With so many Pennsylvanians relying on their employment for their health coverage, one would expect that the application numbers for Medicaid (Medical Assistance), CHIP and Marketplace health insurance programs would be rising as well.  Surprisingly, Medicaid applications have not increased to the level expected for such unprecedented job losses.  And, according to the Pennsylvania’s Health Insurance Marketplace (Pennie), there has been only a marginal impact on Marketplace enrollment to date.  This is due, in part, to employer sponsored health insurance (ESI) rate. To date, ESI losses have been low, suggesting that the COVID unemployed had other types of coverage (i.e., part time workers) and the rate of ESI retention amongst those previously covered by ESI is high.  See Pennie Enrollment and Revenue Model Overview Presentation at July 17, 2020 Board Meeting.   

A key reason for low Medicaid enrollment might be the lack of understanding of the Medical Assistance program in Pennsylvania and its variety of coverage options.  Unlike the Federal Health Care Marketplace (i.e., there are no enrollment periods or time frames that must be met to apply. Pennsylvanians can apply for Medical Assistance at any time at or 1-800-692-7462. 

Eligibility for Medical Assistance in Pennsylvania is income-based.  For many unemployed Pennsylvanians, the Federal Pandemic Unemployment Compensation (FPUC) program has been extremely helpful during these uncertain times.  It is important to know that while standard unemployment compensation in Pennsylvania must be reported for Medical Assistance applications, the FPUC is not considered in the income calculations for eligibility.  Thus, during this pandemic, many unemployed Pennsylvanians may incorrectly believe they are over the income limit for Medical Assistance.  

If you have questions about Medical Assistance eligibility or would like more information about coverage options available during the COVID-19 pandemic, please call our Helpline at 1-800-274-3258.