Medicaid Monitor
Policy Intelligence
Medicaid Monitor
Policy Intelligence
Updated 6:49 AM MT
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State Policy·PA·August 31, 2026

Pennsylvania Governor Race Centers on Medicaid Work Rules, Fraud Enforcement, and Expansion Coverage

Pennsylvania's 2026 gubernatorial race between Democratic Gov. Josh Shapiro and Republican Treasurer Stacy Garrity focuses heavily on Medicaid policy, particularly implementation of 2025 federal budget law changes affecting 2.9 million enrollees. The federal law imposes work requirements and semi-annual eligibility reviews for Medicaid expansion adults, with Pennsylvania estimating over 310,000 will lose coverage due to administrative barriers. Shapiro joined a multi-state lawsuit challenging CMS work requirement exceptions and opposes the federal cuts, while Garrity supports implementing the law's fraud provisions and requiring independent performance audits of state Medicaid programs. The candidates also differ on abortion coverage under Medicaid and false claims whistleblower legislation.

Why it matters

Pennsylvania's next governor will determine how the state implements federal Medicaid work requirements affecting hundreds of thousands of expansion enrollees, and whether the state pursues additional fraud enforcement mechanisms that could reshape program administration and oversight.

Managed Care · Finance

Read the full article at spotlightpa.org

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