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PPC Annual Health Care Report Released

Pennsylvania's child uninsured rate improved slightly to 4.4% from 4.6% during the COVID-19 pandemic thanks to the federal continuous coverage provision that prevents states from disenrolling children and families from Medicaid during the public health emergency, according to our recently released 2022 State of Children's Health report.

Even more families turned to Medicaid during the pandemic when child enrollment increased by 20%. More than 1.4 million Pennsylvania children currently have Medicaid as their health insurance.

We are cautiously optimistic about the improvement in our child uninsured rate in Pennsylvania. While we have made progress, Pennsylvania has the 8th highest number of uninsured children in the nation, with 126,000 children who do not have health insurance and don't have regular access to preventive and primary health care.

And hundreds of thousands of children are at risk of losing Medicaid coverage when the public health emergency ends and the state begins to unwind the disenrollment freeze and resume pre-pandemic operations. According to the latest estimates from DHS, 1 in 4 children enrolled in Medicaid could lose coverage when the public health emergency ends and the process to redetermine eligibility begins.

It will be imperative for DHS to implement an unwinding process that does not disconnect the children most at risk of losing coverage, particularly when Pennsylvania's uninsured rate is starting to improve.

We recommend DHS:

• Reaffirm its commitment to using a 12-month unwinding period as recommended by the Centers for Medicare and Medicaid, which most other states plan to use. Using the full 12 months permitted will give Pennsylvania the best chance to minimize inappropriate terminations and disruptions in coverage (churn) that often impact children more than the adult population.
• Immediately expand the 12-month continuous eligibility policy to children ages 4 through 21 in Medicaid when the public health emergency ends to make it more equitable—Pennsylvania already provides 12-month continuous eligibility (regardless of changes in circumstances) in Medicaid for children up to age 4. All Pennsylvania children in CHIP have continuous eligibility for a full year.

According to the report, factors such as race and ethnicity, poverty level and geographic region impact children's access to health insurance. Some additional key findings include the following:

• Hispanic or Latino children, children who identified as Some Other Race, and children who identified as Two or More Races have worse rates now than in 2019, showing they are more likely to be uninsured.
• 5% of children in PA who qualify for no-cost or reduced-cost health insurance through Medicaid, CHIP, or Pennie™ do not have health insurance.
• The uninsured rates improved in 38 counties and worsened in 29 counties over the last two years.

New to this year's report are fact sheets for each of the 67 counties that show the local uninsured rate, race and ethnicity profiles, and public health insurance enrollment data.

Read the latest coverage:

• Pennsylvania Capital-Star
• The Bradford Era
• Keystone State News Connection

New Directors Elected to PPC Board; Thanks to Members Cycling Off

At its final meeting of 2022, our Board of Directors elected the following individuals to serve 3-year terms beginning January 1, 2023:

• Dom Argento, Director, State Government Affairs & Policy, Merck
• Jessica Brubaker, Executive Director, Keystone Kid Space
• Dr. George Dalembert, Attending Physician, Children’s Hospital of Philadelphia
• Marianne Fray, Chief Executive Officer, Maternity Care Coalition
• Greg Rowe, Executive Director, Pennsylvania District Attorneys Association

We welcome these new members and look forward to working with them!

In addition, the following individuals cycled off the board and thus ended their volunteer service with PPC:

• Bob Cicco, Neonatologist (retired), former president, PA Chapter of American Academy of Pediatrics
• Tom Donley, Business Development Manager (retired), The Butz Family of Companies
• Denise Zimmerman, Executive Vice President (retired), Pennsylvania Medical Society

We thank Bob, Denise and Tom for their years of support and service to PPC and wish them well!

Thriving PA Report Highlights WIC Program Community Feedback

Thriving PA's newest report, WIC Participants Encourage Improvements to Remove Barriers to Access, highlights community feedback about the Special Supplemental Nutrition Program for Women, Infants, and Children, commonly referred to as WIC. Over the summer, Thriving PA partnered with several community organizations across the state to hold seven focus sessions with current and former WIC clients to hear directly from their experiences on the strengths and barriers of the WIC program.

The WIC program provides eligible pregnant and postpartum women and infants and children up to age 5 with access to nutritious foods, breastfeeding supports, nutritional education, and health referrals. Unfortunately, participation in PA's WIC program has been declining in recent years, a trend that is happening nationally. From 2018-2022, the PA program saw nearly a 25% decline in participation. The pandemic also impacted these numbers, with Pennsylvania seeing the third largest decrease in participation from February 2020 to February 2022.

To address the declining participation, which impacts the federal funding Pennsylvania receives to administer the program, Thriving PA sought out direct feedback from participants to identify solutions to the WIC program's challenges. Many of the recommendations in the report highlight opportunities to modernize the program and provide greater flexibility for participants. Some recommendations include technology improvements like moving to an online EBT card system and simplifying the application process through system integration with other state application systems like COMPASS. Others include allowing virtual visits to continue and coordinate care between health professionals, so participants do not need to provide the same information to multiple providers.

Thriving PA hopes the incoming administration and WIC Advisory, a stakeholder group formed earlier this year, will consider the recommendations from WIC clients to help improve the WIC program and increase participation statewide.

Friday Deadline Looms on Passing Federal Budget Bill; MIECHV Reauthorization Included in Recent Language 

MIECHV reauthorization is included in just-released language to provide for the FFY 2023 budget. Last week, Congress passed a one-week extension to the budgetary Continuing Resolution, funding the federal government through this Friday, December 23rd. A vote on the full budget is expected in the coming days.

The language mirrors what was included in the Jackie Walorski Maternal and Child Home Visiting Reauthorization Act of 2022, which passed the House in November and includes:

• Reauthorization of the program through 2027
• An initial increase in funding of $100 million, bringing the program's full appropriation to $500 million
• Subsquent funding increases of $50 million annually (except for a $150 million increase in 2027)
• Establishing a publicly available dashboard that reports program outcomes
• Requiring activities to reduce unnecessary data collection, reporting, and other administrative requirements of the program
• Allowing for virtual home visits

Look for a full recap the federal budget provisions and what it means for kids in our next e-news edition, provided the legislation does pass this week.

You can stay up-to-date on MIECHV reauthorization by checking out Childhood Begins at Home on Twitter.

Data Did You Know?

In Case You Missed It...

• Join us on our social media channels for our #12DaysofData! We'll highlight some of our fantastic work this year and, of course, give you all the data points you know and expect from us. If you don't already, follow us on Twitter, Facebook, Instagram and LinkedIn.
•  The power struggle between PA House Democrats and House Republicans is intensifying. Rep. Joanna McClinton was recently sworn in as Majority Leader in an unannounced ceremony and swiftly scheduled special elections for February 7 to fill the seats vacated by DeLuca, Davis and Lee. Former House Speaker Bryan Cutler and House Republicans filed suit to block the three special elections, claiming McClinton lacks the authority to schedule them. Last Monday, Cutler was sworn into the House early, claiming Majority Leadership in another unannounced ceremony. While majority control remains in limbo, the special elections can occur no later than the May primary, according to state law. The Department of State disagrees with delaying the elections.
• PDE and OCDEL are holding regional meetings for eligible applicants interested in applying for the next 5-year grant cycle of the PA Pre-K Counts program. In addition to regional meetings, several webinars were held, with two additional webinars remaining, including one for family engagement and fiscal responsibilities. Recordings of the prior webinars are also available. Registration is required to attend a regional meeting, and participation is highly encouraged.
• WESA writes about the CHIP program turning 30: Program traces roots back to insuring kids of out-of-work Pittsburgh steelworkers. Broad definitions of neglect often lead to the over-reporting of families to the child welfare system for non-abuse issues. A human rights advocate shares how the system often targets families in poverty, and the data shows alarming rates of racial and ethnic disparities.
• IRRC, Pennsylvania's regulatory review body, approved rules promulgated by the PA Human Relations Commission to formalize discrimination protections for LGBTQ students, workers and tenants. Also included are protections for individuals with traits associated with race, including hair textures and protective styles such as braids, locks and twists. The language in the rule was included in the CROWN Act (last session's HB 1066) by House Democratic Leader Joanna McClinton (D-Philadelphia).