5 Fast Facts about Medicaid in Pennsylvania

April 29, 2025

By Cameron Brown, HAP policy analyst

Medicaid is a cornerstone of our commonwealth’s health care system, providing essential assistance to more than 3.3 million Pennsylvanians. With recent policy developments at the federal level driving fears of significant cuts to Medicaid, understanding the scope, impact, and misconceptions of this program in Pennsylvania is key to shaping informed health care strategies, strengthening access, and advancing health equity across Pennsylvania.

Here are five important things to know about Medicaid in Pennsylvania:

1. Medicaid covers more Pennsylvanians than you think

While often associated with unemployment, Medicaid supports 1 in 4 Pennsylvanians. Most adult recipients––nearly two-thirds of them––are employed but earn low wages and lack access to affordable, private coverage. The program also protects pregnant women, seniors, and individuals living with disabilities. Almost 40 percent of children in Pennsylvania are Medicaid recipients.

2. Medicaid is essential to hospital sustainability

Medicaid helps sustain access to care by reimbursing hospitals for services provided to low-income patients. In FY 2022–2023, Pennsylvania hospitals received more than $7 billion in Medicaid payments. These funds support critical services, emergency care, and community-based programs across the state.

3. Coverage includes more than primary care

Medicaid benefits extend beyond doctor visits. The program covers behavioral health, dental care, vision services, long-term care services, and prescription medications. This comprehensive coverage prevents cost-related care, reduces avoidable hospitalizations, supports thousands of health care jobs, and injects funds into local economies. This program especially strengthens infrastructure in areas that need it most—our rural communities.

4. Medicaid supports Pennsylvania’s workforce and economy

Medicaid is one of the largest sources of federal funding in the state budget. The program not only improves public health outcomes but also generates jobs and supports health care infrastructure. In many rural and underserved communities, Medicaid funding is a lifeline for local providers.

5. Coverage losses are climbing due to eligibility redetermination

Since the end of the pandemic-era continuous coverage requirement, Pennsylvania has resumed regular eligibility checks for Medicaid enrollers. Over 600,000 residents have already lost coverage, often due to avoidable issues such as incomplete paperwork or outdated contact information.

The bottom line:  Medicaid isn’t just a safety net—it’s a public health pillar, an economic stabilizer, and a lifeline for millions of Pennsylvanians. It remains a vital source of health coverage for millions of Pennsylvanians and a critical element of the state’s health care delivery system. As the state navigates renewal challenges and risks to the program from the federal government, protecting and strengthening Medicaid in Pennsylvania is critical for advancing health quality, equity, and access statewide.

For more information and resources on Medicaid policy in Pennsylvania, visit HAP’s Medicaid fact sheet.