Pennsylvania plans to soon forgive unpaid premiums incurred during the pandemic for individuals enrolled in the Medical Assistance for Workers with Disabilities (MAWD) category of Medicaid coverage.
Under the pandemic-era continuous coverage protections, states were generally prevented from terminating Medicaid coverage. These protections prevented cut-offs for non-payment of premiums. The Medicaid continuous coverage protections end April 1st. Pennsylvania was permitted to continue to bill and collect MAWD premiums during the pandemic. Absent narrow exceptions, though, it did not stop coverage for failure to pay MAWD premiums. When the pandemic-era protections end on April 1st, states are not permitted under federal guidance to either (1) terminate coverage for non-payment of premiums incurred during the pandemic or (2) attempt to collect premiums incurred during the pandemic.
As part of its “unwinding” of the continuous coverage protections, Pennsylvania intends to forgive all unpaid MAWD premiums incurred between January 2020 and April 2023, according to state policymakers. Written guidance to the County Assistance Offices is forthcoming.
Beginning in April 2023, payment of MAWD premiums will again become a condition of eligibility and non-payment could result in termination. In certain situations, County Assistance Offices can grant "good cause" to forgive premiums for a short period of time. MAWD recipients should request “good cause” when, for example, they recently lost their job or are unable to work temporarily due to illness or injury.
PHLP will keep readers informed as additional information and updates are released.