Roughly 26K Allegheny County residents could lose Medicaid coverage next year

The new requirements were enacted as part of the Trump administration’s One Big Beautiful Bill Act, passed in 2025.

By MEGAN TROTTER
TribLive

The Allegheny County Executive’s Office expects new federal Medicaid rules taking effect next year to leave roughly 26,000 Allegheny County residents without health coverage, increasing financial pressure on hospitals and the region’s behavioral health system.

The changes would hit about 10% of the county’s residents — many of whom remain eligible but could lose benefits because of new paperwork requirements, according to county officials.

“Federal cuts to Medicaid will have real consequences for families across Allegheny County, forcing thousands of people to lose coverage not because they are ineligible, but because of new administrative barriers,” said County Executive Sara Innamorato in a news release.

Beginning in January, some adult Medicaid recipients will be required to regularly document employment status or list that they are engaged in other activities, such as education, in order to retain coverage.

Of those 26,000 people, county officials said, many remain employed and eligible but will face hurdles with additional administrative barriers. The estimated losses in Allegheny are part of more than 3 million Medicaid recipients expected to lose coverage nationwide, according to the county.

Changes to eligibility rules for non-citizens will start on Oct. 1. Many lawfully present non-citizens, such as refugees and asylees, may lose their current coverage.

The new requirements were enacted as part of the Trump administration’s One Big Beautiful Bill Act, passed in 2025.

Last week, county officials said they filed an official comment on a newly proposed rule issued by the U.S. Department of Health and Human Services that would exacerbate the impact of the new requirements by making it harder for medically frail individuals to receive waivers of work requirements.

In the letter, Allegheny County officials stated they were concerned over the new administrative burdens, which could lead Medicaid recipients to lose access to lifesaving care, even if they qualify for it. Officials also expect many residents to delay care until they are in crisis, showing up in emergency rooms instead of getting the ongoing treatment needed.

“This means that thousands of Allegheny County residents who are sick, disabled or in crisis will lose their health coverage because the process to prove eligibility has become too complex to navigate,” the letter read.

Who is eligible

Alex Jutca, interim director of Allegheny County Department of Human Services (DHS), said he alerted network providers of the looming change.

Under the new provisions, some adults ages 19 to 64 will need to have their Medicaid renewed every six months instead of every year. Those who do not have a dependent child under 14 years old must also show that they are meeting work and community engagement requirements in their application or renewal, according to the Pennsylvania Department of Human Services.

In an effort to spread the word, the county’s DHS launched the “Stay Informed: Changes Are Coming” campaign and gave providers posters, flyers, social media posts and other materials.

Jutca said the department plans to bolster existing outreach to Medicaid recipients through trusted messengers such as homeless shelters, mental health and substance use providers, and immigrant- serving providers in the community and directly via text messaging.

DHS Manager of Strategic Initiatives Molly Morrill said the county is monitoring engagement from residents.

“I think there is definitely some metrics we can look at around engagement in terms of how many people are clicking on the links that we have, how many people are following QR codes, but ultimately, what we’re interested in is how many people continue to maintain Medicaid coverage,” Morrill said.

Stopping the bleed

The loss of Medicaid coverage is expected to drive a large increase in the amount of uncompensated care that hospitals and human services agencies will have to provide to uninsured people requiring emergency assistance.

Statewide, Pennsylvania hospitals absorbed more than $1.1 billion in uncompensated care in fiscal year 2025, which was a 16.4% increase from the prior year, according to a Financial Analysis 2025 Report conducted by the independent state agency, Pennsylvania Health Care Cost Containment Council.

County officials estimate that reduced Medicaid enrollment will reduce federal funding for local behavioral health providers by more than $20 million next year in Allegheny County.

“That’s a shock to the system, so we need to find additional resources to try to stop the bleed from that section,” Innamorato told TribLive.

In 2025, the statewide nonprofit Pennsylvania Health Access Network, which helps people get and keep affordable health insurance, released a report identifying four Allegheny County hospitals reliant on Medicaid for financial stability and most at-risk.

Among those listed were UPMC Magee-Womens Hospital, UPMC McKeesport, UPMC Mercy and Heritage Valley Kennedy, which officially closed its doors in June 2025.

UPMC spokesman Paul Wood said UPMC is evaluating and preparing for the potential impacts of the One Big Beautiful Bill Act, including reduced federal funding for health care services and the risk that more people will lose coverage.

“We are actively engaged with state and community leaders to leverage our technology, expertise, and programming to ensure that we protect patients and preserve access to care,” Wood said in a statement Wednesday.

Allegheny Health Network officials declined to comment.

A call to the White House press office was not immediately returned.

While Antoinette Kraus, executive director of Pennsylvania Health Access Network, said it is too early to know how many hospitals may have to close due to Medicaid eligibility changes, she expects emergency rooms to see an increase in uninsured patients.

Kraus said that those who lose access to Medicaid will no longer have coverage for more routine healthcare, which overtime will lead to more emergency room visits as well as other more expensive costing healthcare. Kraus said that wait times could also be increased.

“We as a county then are responding by really thinking hard about how we can preserve our resources towards those services that are most critical,” Jutca said. “We know that there are many other worthy instances where individuals who are uninsured might show up for behavioral health services that we simply will not be able to fund.”

Staff writer Brian C. Rittmeyer contributed to this report.