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Bill

HB 268

An Act amending the act of June 13, 1967 (P.L.31, No.21), known as the Human Services Code, in public assistance, further providing for the medically needy and determination of eligibility.

2025-2026 Regular Session Introduced by Missy Cerrato and 17 co-sponsors

HB 268 modifies Pennsylvania's medically needy eligibility rules, potentially affecting Medicaid access for low-income residents with significant medical expenses.

Referred to Human Services
0
WeVote Research Nonpartisan
Bill Summary · HB 268

Legislative bill overview

HB 268 amends Pennsylvania's Human Services Code to modify provisions related to medical assistance for the "medically needy" population and how eligibility is determined for this program. The bill specifically targets rules governing who qualifies for Medicaid coverage based on medical expenses that exceed income thresholds.

Why is this important

The medically needy program allows individuals whose income exceeds normal Medicaid limits to still qualify by "spending down" excess income on medical expenses. Changes to eligibility determination could affect thousands of Pennsylvania residents with chronic illnesses, disabilities, or high medical costs who rely on this safety net for healthcare coverage.

Potential points of contention

  • Scope unclear without specific amendments: The bill's actual language isn't provided, making it difficult to assess whether changes expand or restrict eligibility, which will significantly affect stakeholder positions
  • Cost implications: Expanding eligibility increases state Medicaid spending; restricting it may shift costs to hospitals, providers, or beneficiaries—creating budget vs. access tensions
  • Administrative complexity: Changes to eligibility determination mechanisms could create implementation challenges and may require caseworker retraining across counties

Compiled from official sources — confirm details with the bill’s official record.

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