What's Ahead for Immigrant Health Coverage in PA: Changes Start October 1
Beginning October 1, 2026, the federal law known as HR1 will change which immigrants can qualify for Medicaid, also known as Medical Assistance (MA) in Pennsylvania. Many immigrants who are eligible today will not be eligible after that date. Understanding what's changing now — and taking steps early to prepare — can make a real difference for those affected.
Who stays eligible
Many people will stay eligible for Medicaid/MA after October 1. The rules aren't changing for children under 21 or for adults who are pregnant or within 12 months postpartum — if you qualify today and fall into one of these groups, your coverage should continue past October 1, 2026. To ensure your coverage is not disrupted, make sure the CAO knows the ages of kids and about any pregnancies in your family.
Even if you expect to stay eligible, it's worth making sure your local County Assistance Office (CAO) has accurate, up-to-date information about your household. If you have a green card, confirm the CAO has a copy — they may not know you have one, which could lead to an incorrect cut-off. Make sure the CAO also has current information about the ages of children in your home and any pregnancies.
Watch for letters from the CAO
Starting this summer, CAOs will begin mailing letters asking certain enrollees to verify their immigration status. If you receive MA for yourself and you have an eligible immigration status, you will need to respond to these letters to keep your Medicaid/MA in October 2026.
If you do not receive Medicaid/MA for yourself or if you receive coverage to treat and emergency medical condition only, the CAO should never ask you about your immigration status, and you never have to tell them anything about your status.
Appeal mistakes right away
These rules are complex, and errors happen often. If you receive a notice cutting off your Medicaid/MA and you believe it's a mistake, file an appeal as soon as possible. Appealing is almost always the best way to fix an error, and acting quickly helps protect your coverage while the issue is reviewed.
Learn more
New Fact Sheet from CLS: CLS has published a plain-language fact sheet that walks through exactly what's changing and the steps immigrants can take to protect their coverage. Download the CLS fact sheet here.
Upcoming Trainings: As these new policies take effect, PHLP is partnering with Community Legal Services (CLS), Pennsylvania Health Access Network (PHAN), and Clarifi to offer a series of educational trainings for statewide organizations. This series is for organizations and staff looking to learn more about public benefits eligibility, upcoming policy changes, and how to get involved to protect access to benefits programs in Pennsylvania.
The next training, Immigrant Access to Medical Assistance Programs Under HR1, takes place Wednesday, July 8, 2026. CLS attorneys Maripat Pileggi and Lauren Davis will explain which immigrants may be at risk of losing Medicaid/MA starting October 1, 2026. They will also share updates about the letters DHS will begin sending this summer about HR1's new restrictions on immigrant access to Medicaid/MA, along with tips for how to respond.
This article provides general legal information, not legal advice. Every situation is different. If you have questions about how the law applies to you, please call PHLP's Helpline at 1-800-274-3258 or email staff@phlp.org.