Pennsylvania’s governor, Josh Shapiro, has raised concerns over proposed cuts to Medicaid health care being considered by Congress. He warned that these cuts could result in billions of dollars in lost federal aid for Pennsylvania, leading to hundreds of thousands of people losing access to the health insurance program.
Key Points
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State Funding Crisis: Shapiro emphasized, "There are no dollars available at the state level. We can’t just magically make up for what we’re losing."
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Impact on Low-Income Families: The proposed cuts have faced opposition from lawmakers and healthcare advocates, who argue that they would disproportionately affect low-income individuals and families who rely on Medicaid for their healthcare needs.
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Medicaid Overview: Medicaid is a joint federal-state program providing health insurance coverage to millions of low-income individuals and families across the United States. In Pennsylvania, over 3 million people depend on Medicaid.
Proposed Changes
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The cuts would be implemented through changes to the funding formula that determines how much money states receive from the federal government based on Medicaid enrollment.
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Currently, states receive an enhanced match rate, meaning they get more money per person enrolled, as long as they expand their programs under the Affordable Care Act.
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If Congress alters or eliminates this formula, states like Pennsylvania could lose billions in funding annually, which could severely impact rural hospitals that rely heavily on Medicaid.
Consequences for Rural Hospitals
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Shapiro warned that accelerated funding losses could force some rural hospitals out of business within months or even weeks after the cuts are implemented.
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The closure of these facilities would have far-reaching consequences, affecting local economies where these hospitals operate.
Broader Concerns
- Shapiro is not alone in his concerns; many lawmakers and healthcare advocates have voiced opposition to the proposed cuts, arguing they would harm vulnerable populations reliant on Medicaid.
Pennsylvania’s Budget Response
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In contrast to the proposed cuts, Pennsylvania’s budget seeks an additional $2.5 billion for Medicaid due to higher-than-expected costs associated with patients remaining on Medicaid rolls after the COVID-19 pandemic surge.
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The state currently has a reserve fund totaling $10 billion, resulting from increased tax revenue and federal COVID relief funds. This reserve could help offset potential losses from congressional actions.
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However, Shapiro stated he cannot afford to make up the difference himself, citing a lack of available funds at the state level.

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