City officials are warning that major changes to Medicaid eligibility and requirements are approaching, and hundreds of thousands of residents could be affected in the coming months.
In Philadelphia, 645,000 people are enrolled in Medicaid, and about 180,000 of them are considered at risk of losing coverage under provisions of President Trump’s One Big Beautiful Bill Act.
The city has begun sending letters and is asking media outlets to help inform residents about steps they should take now to avoid disruptions.
The first set of changes begins January 1, 2027, affecting people in the Medicaid expansion population – generally adults ages 19 to 64. Exemptions apply to those who have children under 14, a qualifying disability, or who are pregnant.
Crystal Yates-Gale, the City of Philadelphia’s first deputy managing director, said it is critical for eligible residents to act quickly.
“People that have the ability to stay connected to Medicaid need to do everything they can to do so,” she said.
Beginning in January, Medicaid recipients will need to re-enroll every six months instead of annually.
The window for retroactive Medicaid coverage will shrink from three months to 30 days after an application is submitted. Some recipients will also be required to show proof they are meeting community engagement requirements.
That means, Yates-Gale said, “they have to show that they are working, volunteering, engaged in training or education for 80 hours every month.”
She added that many people in the expansion group already meet those requirements.
“A lot of people that fall in that expansion group are already working. They’re already doing what’s required. The important message that we need to get to them is that they’re now going to have to demonstrate that they are doing so,” she said.
To avoid losing coverage, Yates-Gale said residents should take several steps immediately.
“The biggest thing that a person can do right now is to make sure that you download the Compass app,” she said.
The app will be used to receive important messages and upload proof of work or other required documents.
Residents are also urged to ensure their information is current with the Pennsylvania Department of Human Services and to carefully read any mail sent by DHS.
Another deadline is approaching even sooner. By October 1, certain non-citizens without lawful permanent resident status – including refugees, asylees, and some military-related categories – could lose Medicaid coverage.
Helpful Resources:
PA DHS: 877-883-6383
Update your information on DHS Compass
Call 988 for free confidential support if in distress
CBH member services: 1-888-545-2600
BenePhilly – Free, one-on-one support to apply for public benefits