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Spotlight PA

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PA 7th District Rivals Split Sharply on Medicaid, ACA Cuts

Spotlight PA compares economic platforms of Rep. Ryan Mackenzie (R) and challenger Bob Brooks (D) in Pennsylvania's competitive 7th Congressional District ahead of the Nov. 3 election. Mackenzie backed the One Big Beautiful Bill Act, which includes roughly $1 trillion in Medicaid cuts over a decade plus new work requirements, more frequent eligibility checks, and higher cost-sharing; he says he continues working across the aisle on affordability measures and voted for a bill to extend enhanced ACA subsidies for three years. Brooks calls the law "God-awful" and wants to restore cuts to Medicaid, SNAP, and ACA subsidies, and supports moving toward universal coverage. The race is rated a toss-up, and the outcome could influence future congressional action on Medicaid financing and eligibility rules.

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State Policy·PA·16d ago

Pennsylvania Families Sue Shapiro Administration Over Medicaid Caregiver, Travel Restrictions

Four Pennsylvanians with intellectual and developmental disabilities filed a class action lawsuit challenging new Medicaid waiver rules that limit paid hours for family caregivers to 40–60 per week and restrict out-of-state travel support. The Shapiro administration imposed the limits through participation agreements after Commonwealth Court struck down nearly identical policies in February 2026 for failing to follow required rulemaking procedures. The administration gave participants an Aug. 6 deadline to sign new agreements or face involuntary service terminations; over 8,300 beneficiaries had signed by early September. Plaintiffs argue the state is bypassing the regulation process and forcing families to choose between uncompensated caregiving or institutional care.

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State Policy·PA·34d ago

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.

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State Policy·PA·34d ago

Pennsylvania Health System Launches Volunteer Program to Help Medicaid Patients Meet Work Requirements

Guthrie health system in Pennsylvania is expanding its volunteer program to help Medicaid patients meet new 80-hour monthly community engagement requirements taking effect in January 2027. The requirements, enacted in July 2025 federal legislation, apply to certain adults without young children and could result in 310,000 Pennsylvania residents losing Medicaid coverage. Pennsylvania expects a $20 billion federal funding reduction over 10 years starting in 2028. Guthrie, which derives 16% of revenue from Medicaid, projects $38 million in net revenue loss and is offering volunteer roles including greeting visitors, working in gift shops, and delivering flowers to help patients maintain eligibility and preserve the system's reimbursement stream.

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State Policy·PA·80d ago

Pennsylvania AG Appeals Commonwealth Court Ruling Striking Down Medicaid Abortion Ban

Pennsylvania Attorney General Dave Sunday has appealed a Commonwealth Court ruling that struck down the state's ban on Medicaid-funded abortions, after the court found 4-3 in April 2026 that the ban violates the state constitution's Equal Rights Amendment. The state Supreme Court agreed in mid-July to hear the case again. Sunday intervened in February 2025 to defend the law after the Department of Human Services, which had initially defended it, reversed position and sided with plaintiffs challenging the ban. Sunday cited the Commonwealth Attorneys Act, which requires attorneys general to defend state statutes absent a controlling court decision, though legal experts disagree on whether that obligation extends to appeals.

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State Policy·PA·83d ago

Pennsylvania Delays $1.3 Billion in Medicaid MCO Payments to Balance Budget

Pennsylvania adopted a $50.8 billion budget that delays $1.3 billion in payments to Medicaid managed care organizations as part of accounting maneuvers to preserve an $8 billion rainy day fund. The legislature passed the budget two weeks late, using delayed MCO payments along with more than $500 million from special funds to close the gap. House Appropriations Chair Jordan Harris told reporters the approach ensures Medicaid enrollees still receive care but shifts the timing of MCO reimbursements. The budget includes $900 million in new education spending but no new revenue sources.

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Federal Policy·88d ago

HHS Postpones Preventive Services Task Force Meetings, Plans August Reboot with Eight New Members

The Department of Health and Human Services will announce eight new members of the U.S. Preventive Services Task Force and schedule the panel's first meeting in 17 months for late August. HHS canceled four prior meetings, removed two vice chairs in May, and allowed the 16-member panel to shrink to eight as terms expired without replacement. The task force grades preventive services that Medicaid expansion programs and most private insurers must cover without cost-sharing when rated A or B. Recommendations on prostate cancer screening, weight loss counseling, cervical cancer screening, perinatal depression, and alcohol abuse await votes or formal publication.

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State Policy·PA·101d ago

Pennsylvania Projects $5.6 Billion Budget Deficit, May Tap $8 Billion Rainy Day Fund

Pennsylvania faces a $5.6 billion budget deficit for fiscal year 2026-27, according to the Independent Fiscal Office. Governor Shapiro's budget proposal projects using $4 billion from the state's rainy day fund, assuming new revenue from legalizing marijuana and taxing skill games. Without new revenue sources, the state will need to drain reserve funds, implement spending cuts, or use accounting maneuvers to balance the budget by the June 30 deadline. Senate Republicans have discussed cutting Medicaid and SNAP spending, though specifics have not been provided. The state has already drawn down $6.6 billion from reserves over the past two fiscal years.

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Federal Policy·102d ago

Trump Administration Holds $2 Billion in HHS Grants Pending White House Review

The Trump administration has instituted a multi-step political review process requiring White House OMB approval for all HHS grant funding opportunities, delaying over $2 billion in congressionally appropriated funds. The process includes AI screening for flagged keywords like "harm reduction" and "gender," followed by political review at multiple levels through HHS Secretary RFK Jr.'s office and OMB. CDC delayed $728 million across 30 grants and SAMHSA held $286 million. State and local health departments, which receive approximately 25% of their funding from federal grants, face service cuts if delays continue. The policy applies to all FY 2026 funding opportunities including 988 suicide hotline expansion, outbreak response, and opioid treatment programs.

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