But change is coming to the federal insurance plan, which (along with the state plan CHIP) covers two in five Pennsylvania children. Here’s what you can do to prepare.
But change is coming to the federal insurance plan, which covers two in five Pennsylvania children. Here’s what you can do to prepare.“Another month without insurance,” our patient’s mother sighed. She had brought her 18-month old to all his doctor’s appointments in his first year.
Then his Medicaid coverage was cut off, and she had no idea why. She tried multiple times to contact Medicaid, but couldn’t get through, and assumed incorrectly that this must be due to changes in the state-federal insurance program she had heard about on the news. She spent a week’s wages on care so her baby would not fall behind on his recommended visits, but wondered if she could afford future appointments. What would happen if he needed emergency care?Fortunately, there was positive news to share with our patient that we wanted to share with everyone: Medicaid has not changedJanuary 2026: Premium tax credits expired. These tax credits helped low- and middle-income people without affordable employer insurance pay for Affordable Care Act marketplace coverage, based on a sliding scale. October 2026: Many legally residing immigrants previously eligible for Medicaid will lose coverage, including refugees, asylum-seekers, and victims of trafficking. January 2027: Certain adults will have work requirements and need to prove Medicaid eligibility every six months rather than annually. This will apply to adults who are not pregnant, disabled, or the parents or caregiver for a child under 14 or foster youth under age 26. Six month redetermination will also apply to moderate-income Pennsylvanians who became eligible underwill likely remain eligible, and you must show they’re eligible annually, not every six months. .This is important as research shows that If your child is on Medicaid or CHIP, make sure your address and contact information are up to date with theBe prepared for longer wait times. If you have trouble reaching your caseworker, you can ask for a supervisor or contact the In this changing policy landscape, pediatricians aren’t just clinicians — we’re essential partners in keeping children covered and cared for. We will always want to hear from you. So, tell your pediatrician about any insurance struggles. If you have questions or are confused by information you hear, visitwhat topics you’d like to learn more about. Because we will always advocate for health insurance that covers all children and gives them a healthy future. Elizabeth Salazar and Diana Montoya-Williams are attending neonatologists at the Children’s Hospital of Philadelphia , Assistant Professors of Pediatrics at 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