WHEREAS, Healthcare in the United States remains the most expensive in the world. Because of the combination of extreme cost and the lack of government guarantee, roughly 28 million Americans are uninsured. The federal Medicaid program provides essential health coverage to hundreds of thousands of the least resourced, most vulnerable Pennsylvanians, enabling low-income individuals, children, older adults, and individuals with disabilities to have access to health services, prescriptions, and long-term care; and
WHEREAS, In July 2025, President Trump signed H.R. 1, the “One Big Beautiful Bill Act,” into law, enacting significant changes to Medicaid, including new barriers to eligibility, additional steps to the enrollment processes, more renewal requirements, and significant reductions in funding; and
WHEREAS, In the Commonwealth of Pennsylvania, nearly 3 million residents rely on the Medicaid program. The City of Philadelphia in particular faces a severe health equity challenge with over 90,000 residents at risk of losing access to Medicaid because of H.R. 1 changes.
WHEREAS, Medicaid changes will take effect on a staggered schedule beginning October 1, 2026. Subsequent changes will take effect January 1, 2027, and February 1, 2027; and,
WHEREAS, Residents primarily impacted by the new requirements are immigrant residents and adults included inthe Medicaid expansion group. The Medicaid expansion group consists of residents who became eligible for Medicaid under the Affordable Care Act of 2010; and
WHEREAS, Refugee residents along with immigrant survivors of crime, domestic violence and human trafficking, that hold U-Visas and T-Visas, will lose Medicaid eligibility if they do not have a green card; and
WHEREAS, The Trump Administration has repeatedly paused the processing for all types of immigration benefits, including applications for legal permanent residency, further exacerbating the challenges for immigrant residents; and
WHEREAS, Changes to Medicaid are expected to increase administrative burdens for recipients, healthcare providers, community-based service organizations, and County Assistance Offices, leading to significant disruptions in health coverage or loss of coverage; and
WHEREAS, Residents who lose access to Medicaid will depend on health centers and emergency rooms for healthcare, putting additional strain on systems that are already overwhelmed, leading to longer wait times forcing residents to wait for essential healthcare services;; and,
WHEREAS, The City of Philadelphia has a responsibility to understand the anticipated impacts of the H.R. 1 changes and ensure Philadelphians and its health systems are prepared for their implementation; and
WHEREAS, Hearings will provide the opportunity for experts and providers to identify gaps in resources and offer insights into strategies to minimize coverage loss, examine other jurisdictions, educate residents about the proposed changes, and identify actions Philadelphia can adopt to prepare residents and providers for the implementation of H.R. 1; now, therefore, be it
RESOLVED, BY THE COUNCIL OF THE CITY OF PHILADELPHIA, That the Committee on Public Health and Human Services is hereby authorized to hold hearings to investigate the impacts of reductions to Medicaid coverage under H.R. 1 on Philadelphians, healthcare providers, and service organizations, and to examine the City of Philadelphia’s strategy and preparedness to address the impacts.
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