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    Medicaid Unwinding

    Medicaid Continuous Coverage Unwinding Data

    As Pennsylvania moves through the 12-month unwinding process, the data provided on this page tracks the renewal process by county and zip code.


    Jump to information about:

    Size of the total maintained population:
    this is the total number of individuals who would have been ineligible or did not return a renewal and had their Medicaid coverage maintained between March 2020 and March 2023 under the continuous coverage requirement. The entire Medicaid population will have the opportunity to go through a renewal cycle or make an update to their case information;

    Number and percent determined eligible:
    this is the number and percent of the total maintained population of individuals whose renewals have been processed during the unwinding period and who are still eligible for Medicaid;

    Number and percent closed:
    this is the number and percent of the total maintained population of individuals whose renewals have been processed and have been closed;

    Number and percent closed that are ineligible:
    this is the number and percent of the total closed individuals that have been reviewed and are no longer eligible for Medicaid (such as for financial reasons). These individuals receive information about how to appeal the closure, request reconsideration and are referred to Pennie or reviewed for CHIP;

    Number and percent closed that are failed to return information:
    this is the number and percent of the total closed individuals that have been reviewed and closed because necessary renewal documentation was not returned. These individuals receive information about how to appeal the closure, request reconsideration, and information about Pennie;

    Number and percent remaining to be processed:
    this is the number and percent of the total maintained population of individuals whose renewals must still be reviewed;

    Number and percent opened in CHIP:
    this is the number and percent of the total maintained population of individuals who were determined eligible for CHIP and had cases opened in CHIP;

    Number and percent opened in Pennie®:
    this is the number and percent of individuals of whose cases were closed with Medicaid during the 12-month unwinding period who have since been enrolled in a health plan through Pennie;

    Number and percent that return to Medicaid:
    this is the number and percent of individuals whose cases were closed with Medicaid during the 12-month unwinding period and who have since had their Medicaid reopened within four months of closing.

     

    Monthly Enrollment Status Changes

    The below table provides enrollment data on the entire Medicaid program. The table shows the:

    • Published Enrollment: This is the total number of individuals enrolled in Medicaid at any point during the month. This is the monthly public enrollment number for Medicaid used by the Department.
    • Continuous Enrolled from the last month: This is the number of individuals who were eligible for Medicaid in the previous month who maintained coverage in the current month.
    • Newly Enrolled this month: This is the number of new individuals enrolled into Medicaid during the month
    • Closed during this month: This is the number of persons whose Medicaid case was closed during the month.
      • Closed - Ineligible: This is the number of persons whose renewal was determined ineligible for Medicaid.
      • Closed - Procedural: This is the number of persons whose benefits were discontinued because of a failure to respond.

    Apr-23    		May-23Jun-23Jul-23Aug-23Sep-23Oct-23Nov-23Dec-23Jan-24Feb-24Mar-24Apr-24May-24Jun-24
    Published Enrollment3,708,4053,705,6243,653,3093,596,7593,543,4753,467,4503,406,4953,354,3853,287,6413,245,4433,216,875

    3,089,931

    3,030,603

    0

    Continuously Enrolled From Last Month3,680,0393,672,1233,622,5263,554,0533,494,1653,421,1153,351,4993,299,5513,238,0603,181,6073,161,194

    3,030,349

    2,979,067

    0

    Newly Enrolled This Month28,36633,50130,78342,70649,31046,33554,99654,83449,58163,83655,681

    59,582

    51,536

    0

    Total Closed This Month43,54653,26440,71547,23378,44654,85559,99147,20233,91540,67244,234

    56,935

    31,698

    0

    Closed - Ineligible24,90529,12023,59026,62739,06831,57033,64427,95521,79823,47524,866

    27,956

    17,562

    		 
    Closed - Procedural (did not respond)18,64124,14417,12520,60639,37823,28526,34719,24712,11717,19719,368

    28,979

    14,136

    		 

    NOTE: Because of retroactive eligibility, appeals and reconsiderations the published enrollment number will not directly correlate with the other the other data in the table.
    NOTE: April number has been changed to correspond to data submitted to CMS.

    Continuous Coverage for Pennsylvania's Medicaid Population

    The Total Maintained Populationthe total number of individuals whose Medicaid coverage was maintained under the continuous coverage requirement data tracks the total number of individuals who maintained Medicaid coverage from March 18, 2020 to April 1, 2023, due to the federal continuous coverage requirement.

    How to Use this Interactive Data Tracker:

    This data is available in two formats: heat map and bar chart.
    The data shows the Total Maintained Populationthe total number of individuals whose Medicaid coverage was maintained under the continuous coverage requirement at the county and zip code levels. Areas are ranked by highest to lowest impacted population totals. You can use your mouse to hover or click into specific data areas.

    Users can change the data visualizations to see total population by ZIP Code, by clicking the Switch to ZIP Code View button on the top right side of the tracker.

    *Data caveats

    1. Data for the tracker is aggregated at the county and ZIP Code level
    2. ZIP Code results with fewer than 30 individuals are suppressed for privacy and confidentiality reasons, and will be displayed as white areas with no population detail
    3. County results with fewer than 11 individuals are suppressed for privacy and confidentiality reasons, and will be displayed as white areas with no population detail
    4. Data is refreshed monthly and may affect previous dataset views
    5. Individuals who are currently eligible for CHIP benefits may not be included in the numbers on this tracker

    Continuous Coverage for Medicaid Maintained Population

    *Data caveats

    1. Data for the tracker is aggregated at the county and ZIP Code level
    2. ZIP Code results with fewer than 30 individuals are suppressed for privacy and confidentiality reasons, and metrics may be displayed with no detail
    3. County results with fewer than 11 individuals are suppressed for privacy and confidentiality reasons, and metrics may be displayed with no detail
    4. Percent metrics that are blank within table is expected per design
    5. Data is refreshed monthly and may affect previous dataset views
    6. Individuals who are currently eligible for CHIP benefits may not be included in the numbers on this tracker