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Medicaid Matters Panelists:

James J. Cook, FACHE, Executive Director, Cambria Residential Services

Rosalie Danchanko, Executive Director, Highlands Health Clinic

Jeannine McMillan, Executive Director, Center for Population Health

Karen Struble Myers, President & CEO, United Way of the Southern Alleghenies

Jason Rilogio, Certified Community Health Worker & Advocate for mental health and substance use recovery

Moderated by Chip Minemyer, Publisher, The Tribune-Democrat

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Some Medicaid benefits are required by federal law, and others are optional.

States must provide certain mandatory benefits listed in the Social Security Act. These include things like hospital care and doctor visits.

States can also choose to offer optional benefits, like dental or vision care, by adding them to their state Medicaid plan.

What does Medicaid cover?

Family planning services
Midwife services
Certified pediatric and family nurse practitioner services
Freestanding birth center services (when licensed or otherwise recognized by the state)
Transportation to medical care
Tobacco cessation counseling for pregnant women

Inpatient hospital services
Outpatient hospital services
EPSDT: Early and Periodic Screening, Diagnostic, and Treatment Services
Nursing Facility Services
Home health services
Physician services
Rural health clinic services
Federally qualified health center services
Laboratory and X-ray services

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Coverage	Cambria	Somerset
Medicaid Coverage	27%	22%
Medicare Coverage	23%	23%
Uninsured	6%	8%

Demographics	Cambria	Somerset
Aging Population (65+)	23.12%	23.08%
Poverty Rate	16.8%	14.3%
Children in Poverty	18%	16%
Disability Diagnosis	18.26%	16.88%

Demographics

Today, about 750,000 Pennsylvanians get health care because of Medicaid Expansion and since 2015, more than 2.5 million have received coverage

at some point because of

Medicaid Expansion.

Since March 2023 when the Medicaid continuous enrollment provision that paused disenrollments during the COVID-19 pandemic ended, Pennsylvania has disenrolled 879,785 people from the program, including about 33% of people who have completed their renewal forms.

*US:

16.84%

*PA:

11.8%

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What is a Community Health Needs Assessment?

It’s a report that hospitals and health systems create every few years to identify the biggest health issues in the communities they serve and plan how to address them.

Conemaugh Health System, 1889 Foundation, Center for Pop Health, United Way of SA

Physical Health
Socioeconomics/Job Training
Social Determinant of Health Needs/Healthcare
Mental/Behavioral Health
Substance Use
Early Childhood
Violence/Abuse/Safety

Focus Areas for Cambria and Somerset Counties:

Community Health Needs Assessment (CHNA)

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Physical Health

Hospitals and Federally Qualified Health Centers/Community Health Centers could face significant losses or closures if decreased funding proposals are enacted.
There’s already a shortage of healthcare providers in the region, and if Medicaid reimbursement isn’t adequate, that shortage could grow even worse.

Primary Care Physicians in Cambria County: 1 provider for every 1,440 individuals
Primary Care Physicians in Somerset County: 1 provider for every 2,730 individuals

State ratio 1 :1,260, National ratio 1:1,330

Dentists in Cambria County: 1 provider for every 1,440 individuals
Dentists in Somerset County: 1 provider for every 3,350 individuals

State ratio: 1:1,400, National 1:1,360

IUP planned expansion with new osteopathic medical school could see negative impact.
Home and community-based services that help people with disabilities live, learn, work, and participate in their communities could be impacted.
Early intervention for young children, school-based therapies, and equipment and technologies are often excluded by private insurance.

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Disabilities & Medicaid

In Pennsylvania, a significant portion of adults with intellectual disabilities rely on Medicaid for support. Specifically, 92% of residents with intellectual and developmental disabilities (I/DD) in the state receive long-term supports and services through Medicaid-funded waivers.

Nearly half of Medicaid enrollees with a disability (47%) report having difficulty with self-care or independent living, disabilities that frequently require long-term care. Medicaid is the primary payer of long-term care because it is generally not covered by Medicare or private health insurance.

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Socioeconomics/Job Training

Declining incomes in both counties with Cambria County at 46% of the population living on less than $50K annually, and Somerset County with 43%

Unemployment rates in both Cambria and Somerset are 5.4%, higher than the state (4.4%) and national (3.7%) averages

Pennsylvania could lose over 61,000 jobs if the Affordable Care Act’s Medicaid Expansion were eliminated, including nearly 28,000 jobs in healthcare and 33,000 jobs in other sectors.

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Social Determinant of Health Needs/Healthcare

The Medical Assistance Transportation Program (MATP) is funded 50% by the federal government and 50% by the state through Medicaid. Cuts to MATP would seriously impact patients, hospitals, and caregivers. Each month, MATP provides about 3,500 trips in Cambria County and 3,200 trips in Somerset County for people who rely on it to access care.

Food insecurity is worsening in the region.

In 2023, 38,805 households used Cambria County Food Pantries and the Somerset Mobile Food Bank; in 2024, that number rose to 41,559 households—an increase of 2,755.

SNAP is a lifeline for 20% of Cambria and 15% of Somerset residents, compared to 14.1% in PA and 12.5% nationally. Meanwhile, WIC and SNAP face potential funding cuts, and the USDA has ended local food purchasing programs that supported schools.

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Mental Health & Substance Use Disorders

There is already a significant shortage of mental health providers in the region, and this could worsen without adequate Medicaid reimbursement.

Cambria County has just 1 provider for every 440 people
Somerset County has 1 provider for every 710 people
This is compared to 1:370 statewide and 1:320 nationally

Medicaid plays a critical role in addressing the opioid and fentanyl crisis.

Nearly 90% of treatment for opioid and fentanyl addiction in the U.S. is funded at least in part by Medicaid
Increased funding has led to positive local outcomes in substance use disorder (SUD) treatment and support programs

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Early Childhood

Children in Cambria (22%) and Somerset (19%) counties experience poverty at significantly higher rates than the state (15%) and national (16%) averages.

Beyond CHIP coverage, proposed cuts to early childhood education, pre-K programs, and school lunch funding risk deepening this crisis—potentially driving child poverty rates even higher.

Reductions in funding for vital human service programs like WIC, SNAP, and other local supports would further threaten the well-being of young children and families in our region.

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The health of our communities depends on all of us.

Medicaid plays a critical role in ensuring access to healthcare, mental health services, and long-term support for children, seniors, people with disabilities, and low-income families. But it doesn’t stop there—Medicaid strengthens our entire public health system, reduces strain on emergency services, and supports a healthier, more stable community for everyone. When we invest in Medicaid, we invest in the well-being, resilience, and future of our region.

Your support is needed!

Call or email your state and federal legislators and urge them to protect Medicaid.
Rally to Defend Medicaid on Saturday, April 26 at Central Park in Johnstown at 1:00 PM

Visit lfgpa.org for more information about Locals For Good and how YOU can get involved!