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Close General Election Leads to a Split Party-Control Congress; Democrats Take State House Majority

Following the 2022 mid-term elections, Democrats retained the U.S. Senate, with John Fetterman defeating Mehmet Oz for Senator Pat Toomey's seat by a margin of 51-46%. This race and holds in Arizona and Nevada have secured a Democratic Senate majority for the next two years, despite the need for a run-off election in Georgia next month. In the U.S. House, Republicans gained majority control, securing 218 seats thus far with several races still to be called. None of the House seats in Pennsylvania have flipped, resulting in a split of 9 Democrats and 8 Republicans. Following the 2020 Census, Pennsylvania lost one seat in the House due to reapportionment. Current Rep. Fred Keller (R-Snyder) retired with redistricting.

Democrat Josh Shapiro defeated Republican Doug Mastriano in the governor's race by more than 14%. Shapiro's Lieutenant Governor, current House member Austin Davis (D-Allegheny), will become the first black Lieutenant Governor in the state's history. Shapiro, at age 49, will be the youngest governor in office since Mark Schweiker in the early 2000s. Mastriano, a senator from Franklin County, remains in the Senate with his race not up for re-election until 2024.

Republicans will retain control of the state Senate. Only one seat flipped, with Democrat Nick Miller defeating Republican Dean Browning for the seat vacated by Independent John Yudichak. This seat moved form the Northeast part of the state to the Lehigh Valley in redistricting. The partisan majority in the Senate stands to be 28 Republicans and 22 Democrats. Last week, both the Senate Republican and Senate Democratic caucuses voted on their leadership slate. On the Republican side, Kim Ward (R-Westmoreland) replaces Jake Corman as President Pro Tempore; Joe Pittman (R-Indiana) replaces Kim Ward as Leader; Ryan Aument (R-Lancaster) replaces John Gordner as Whip, while Scott Martin (R-Lancaster) replaces Pat Browne as the Chair of Appropriations. For the Democrats, leadership remains the same (Jay Costa as Minority Leader and Vince Hughes as Minority Appropriations Chair) except for Tina Tartaglione (D-Philadelphia), who replaces Tony Williams as Whip.

In perhaps the surprise of the election, the State House flipped to Democratic majority control. With razor-thin races in Bucks and Montgomery Counties called just late last week, the party split will be 102 Democrats to 101 Republicans. This is the first time since 2010 Democrats will control the chamber. Due to unresolved races, House Republicans held leadership elections today with current House Majority Leader Kerry Benninghoff (R-Centre) announcing he would not seek a spot in leadership in the caucus. Current House Speaker Bryan Cutler (R-Lancaster) remains in leadership, being elected House Minority Leader while Seth Grove (R-York) becomes the Minority Appropriations Chair. On the Democrat side, assumptions are that current Minority Leader Joanna McClinton (D-Philadelphia) will become House Speaker while current Minority Appropriations Chair Matt Bradford (D-Montgomery) will become Majority Leader and current whip Jordan Harris (D-Philadelphia) will become the Majority Appropriations Chair.

The operating majority in the House is still somewhat tenuous for the immediate future, as three seats of the Democratic caucus either are or will soon-to-be vacant: Tony DeLuca (D-Allegheny) passed away in October but still won re-election while Summer Lee (D-Allegheny) won her election to Congress and will need to resign from her House seat. The same is true for Austin Davis (D-Allegheny) who won his election as Lieutenant Governor but will need to resign his House seat. The timing and protocol of the special elections is creating uncertainty on whether Republicans will have a voting majority of 101-99 at least until these elections are held.

COVID-19 Public Health Emergency to Stay in Place through Winter Months

Since the COVID-19 pandemic began in early 2020, a federal public health emergency was declared and extended every 90 days.

The Biden Administration has promised to provide 60-days' notice to states before it plans to end the public health emergency when states begin unwinding the continuous coverage provision in Medicaid. The end of the public health emergency will also trigger other actions, such as expiring regulatory flexibilities and rolling back the enhanced Medicaid funding for states.

Given the impact this would have on Pennsylvanians who rely on Medicaid for their health insurance—40% of whom are children—we have been closely watching as we come to each important milestone date. With no 60-day ending announcement occurring in mid-November, the Biden Administration plans to renew the PHE again in mid-January. The public health emergency life cycle of 90 days would now run through mid-April 2023.

The extension provides much relief that the unwinding activities will not coincide with gubernatorial and legislative transitions in January and during uncertainty around a possible winter surge of COVID cases.

PPC and health advocacy partners will continue to regularly meet with DHS officials to provide input on their unwinding plans to return to regular enrollment operations. Of great importance when eligibility redeterminations occur is to ensure children who are Medicaid eligible remain enrolled or those no longer eligible are smoothly transitioned to the Children's Health Insurance Program or Pennie™ to keep them connected to health coverage.

Child Care Aware of America Report Shows Pennsylvania Child Care Costs Continue to be a Barrier for Families

Child Care Aware of America released Price of Care: 2021 Child Care Affordability, an annual report that estimates the price of child care for each state, including both a child age group and provider type cost analysis. States provided data through a survey sent in February 2022, in which oversight agencies reported the annual price of child care in 2021. For those that did not complete the survey, data was collected from the most recent market rate survey and adjusted for inflation.

The data shows that child care prices slightly outpaced inflation with an average cost of $10,600 annually, representing 10% of a married couple's average annual income and 35% of a single parent's average annual income. The report also found child care was the most expensive household expense, including housing and health care, in every region of the country.

The report also breaks the cost of care down by states, with Pennsylvania-specific data showing the average price of child care for an infant in a center-based child care program to be $12,152 annually and $11,557 per year for a toddler in the same program. Compared to the median income for single-parent and married couples, center-based child care for an infant would use 40% and 11% of annual household income, respectively.

The cost of child care continues to be a barrier for many families due to increasing costs each year, which directly impacts our economy and workforce. PPC is a partner in the Start Strong PA campaign that seeks to ensure every child has the opportunity to attend affordable, high-quality child care.

March of Dimes Releases 2022 Report Card on Maternal and Infant Health Across States  

The March of Dimes just released its 2022 Report Card that examines several maternal and infant health indicators across the country. The results show the maternal and infant health crisis is worsening. Overall, the U.S. received a D+ grade and had a preterm birth rate of 10.5%, an increase from prior years and nearly a total percent increase from 2011. Further, the report highlights the inequities in maternal and infant health, with Black women representing a 52% higher preterm birth rate than all other women.

In Pennsylvania, the overall grade for preterm birth is a C, with a 9.8% preterm birth rate, slightly lower than the national average but an increase from our prior year's rate of 9.6%. In addition, our infant mortality rate is 5.5 per 1,000 births, slightly higher than the national average of 5.4%. The preterm birth rate among Black women in the state is 56% higher than among other women, which is also higher than the national average.

Thriving PA, a statewide advocacy campaign focused on maternal and child health, is working to help combat the maternal and health crisis the state is facing. This year, Thriving PA advocated for extending postpartum Medicaid coverage for women up to a full year, which took effect on April 1^st. In addition, the campaign is working to allow doulas to be reimbursed by Medicaid and increase the use of validated screening tools for maternal mood and anxiety disorders.

Data Did You Know?

In Case You Missed It...

• The U.S. Supreme Court heard oral arguments on November 8th in a case that could decide whether Medicaid beneficiaries can sue the federal government if their rights are violated.
• DHS announced the Low-Income Home Energy Assistance Program (LIHEAP) applications are now available for the 2022-23 season. LIHEAP provides assistance with home heating bills for Pennsylvanians that meet eligibility and income guidelines. Applications will remain open until April 28, 2023.
• We are asking our U.S. Senators to prioritize reauthorizing the MIECHV Program. This is urgently needed as Congress negotiates an end-of-year budget package to fund federal programs. If the MIECHV Program expires, thousands of Pennsylvania families could lose home visiting services. Please join us in emailing Senators Casey and Toomey to prioritize reauthorization and increased funding for MIECHV as they negotiate next year’s budget.