FOR IMMEDIATE RELEASE: November 2023
CONTACT:
Zachary Hershman | zacharyhershman@gmail.com | (267) 571-9503
Put People First! PA | putpeoplefirstpa.org
New data indicates 99% of all Medicaid redetermination appeals denied by DHS
Pennsylvania residents cut from Medicaid face significant health and safety challenges
PENNSYLVANIA – Put People First! PA, a grassroots organization focused on the human right to healthcare, is ramping up support for residents engaged in Medicaid redetermination appeals after new data reveals that over 99% of all appeals are denied by DHS. Multiple Pennsylvania residents have reached out to Put People First! PA indicating they or their family are facing danger from Medicaid cutoffs that threaten their safety and wellbeing.
After hosting the ‘Nonviolent Medicaid Army: Week of Action’, a national mobilization led by chapters of the Nonviolent Medicaid Army Medicaid in Wyoming, Texas, Wisconsin, Indiana, New York, Georgia, Maryland, Vermont and Pennsylvania, which concluded on September 20th with a press conference and presentation of the Medicaid Stories Quilt in Harrisburg, PA, Put People First! PA has been fielding many additional requests from Pennsylvania residents for support in their Medicaid cutoff redetermination and appeal process.
Medicaid continuous coverage requirements were ended via a bipartisan agreement included in the December 2022 omnibus spending bill signed by President Biden. Already over 260,000 people have been disenrolled from Medicaid in Pennsylvania, according to PA DHS, including over 60,000 children.
As Put People First! PA continues to organize health screenings and benefit sign ups at free People’s Clinics around the State to raise awareness about the cut-offs, residents from across Pennsylvania have been reaching out with stories of families driven into crisis by denial of healthcare, as the redetermination process is increasingly marked by poor bureaucracy, late notice and arcane requirements.
Sadly, even those PA residents who are able to collect their paperwork and file for an appeal before the deadline are almost uniformly denied; according to new information released to Put People First! PA by DHS, of the 19,849 total MA appeals filed from 4/1/23 – 9/21/23, only 55 were decided in part or in full for the appellant, a denial rate of over 99% (these numbers include both appeals from redeterminations and initial applications).
The overwhelming number of denials indicates a broken appeals process that was intentionally designed to remove Pennsylvania residents from Medicaid, regardless of the consequences to their health and safety. It is for this reason that Put People First! PA is helping residents file their appeals and hosting demonstrations outside of appeal hearings, to provide as much support as possible for residents as they make their way through a process that is clearly stacked against them. DHS has also committed to putting the appeal denial rate on their Medicaid Continuous Coverage Unwinding Data Tracker [1].
It was reported in the Inquirer on Nov. 13th that the State of Pennsylvania is in the process of restoring Medicaid coverage for 105,000 residents who lost their government-funded health insurance benefits this year because they did not return a form on time or for some other procedural reasons. [2]
These are some of the stories we are hearing from Pennsylvania residents who are going through the appeals process with the support of Put People First! PA:
[All names are withheld to protect the individuals currently undergoing appeal. Please reach out for further information.]
P, from Berwick, never received her renewal paperwork in the mail, so she is being cut from Medicaid for an unknown reason at this time. She is a single mother of two children, both of whom receive mental healthcare through Medicaid; now that she has been cut off both children will need to find new therapists. She fears a disruption in her children’s treatment will impact their mental health and stability. Her appeals hearing is scheduled for November 17th.
P states, “Medicaid is important to me because as a single mom with one income, in today’s economy just basic living expenses are hard to pay. Combine that with a child with disabilities who is on 3 to 5 different medications and required doctor visits, it’s unbearable. When the cost of employer provided healthcare is more than half my paycheck, Medicaid is an absolute necessity to be able to provide for my child.”
“Losing Medicaid because I exceeded some arbitrary number that does not take most expenses into account was a hard blow. The cost of my son’s therapy, meds and doctor’s appointments are well over $1000 a month for someone barely getting by. This appeal process and working with PPF-PA has made me feel like I have a voice. I have the ability to fight back and fight for the rights that every person should be given.”
M, from Philadelphia, has leukemia. He is being cut from Medicaid for having too much income, despite his life threatening cancer diagnosis. DHS did not inform him that he could potentially qualify for MAWD (Medical Assistance for Workers with Disabilities), and was content to simply leave him without insurance, but Put People First! PA informed him of his rights under MAWD and is supporting his appeal.
C, from Manheim, is being cut from the Medicaid rolls because her husband’s income is too high, but received no paperwork in the mail informing her. She only discovered this when taking her children to a doctor’s appointment and realizing she was uninsured, causing her to delay much needed care.
E, from Montgomery County, is being cut from Medicaid because her income has risen above the limit. Under Medicaid, even if you exceed the limit by 1$ you are removed from the program, whether or not it is sufficient. If she loses her appeal, she will lose access to mental healthcare, which is unaffordable through private insurance.
C, from Scranton, is a multiple skin cancer survivor who is on disability and is surviving on a fixed income with her husband’s SSA benefits. She has been cut from Medicaid for possessing too many resources; after she loses her Medicaid, she will have to start paying for Medicare.
“Our current system tells us that only some of us deserve help. We think that’s wrong, and we see how it harms people every day.” said Jacob Hope, a Put People First! PA member who has been assisting residents with the appeals process.
“We know that the money is there to get everybody the healthcare that they need, but instead the State makes us jump through hoops to prove that we deserve assistance. Instead of being focused on healing, we are worried about making a dollar over the limit or missing a single piece of mail that could throw our entire life into chaos.”
If you or a loved one is in danger of being cut from Medicaid, contact info@putpeoplefirstpa.org for support and information.
#
Put People First! PA (PPF-PA) is a statewide, multi-racial, grassroots, volunteer organization with five regional Healthcare Rights Committees located across Pennsylvania.
[1] https://www.dhs.pa.gov/PHE/Pages/Unwinding-Progress-Tracker.aspx [2] https://www.inquirer.com/health/pennsylvania-medicaid-redetermination-ex-parte-20231113.html