Becky Ludwick foresees a spike in the number of Pennsylvanians without health insurance if a bill passed by the U.S. House this week moves forward.

House committees have spent months developing the 1,000-plus-page legislation. It outlines a variety of House Republican priorities, including tax cuts for individuals and businesses and work requirements to receive food assistance.

One of the most significant changes proposed in the bill is a nearly $700 million cut to the Medicaid program.

“(The bill) has the largest Medicaid cuts in the program’s history,” said Ludwick, vice president of public policy for nonprofit Pennsylvania Partnerships for Children.

“It’s really trying to achieve savings by taking health care away from millions of people, including children.”

Impact on families, hospitals predicted

The 30-year-old child advocacy organization lobbies for public policy benefiting early and K-12 education, child welfare and maternal and child health.

More than 1.3 million Pennsylvania children — about 40% of the state’s youth population — are enrolled in Medicaid to cover costs associated with wellness visits, immunizations, dental appointments and early intervention and mental health services, Ludwick said.

The proposed Medicaid cuts could be devastating to children and families statewide, she said.

Antoinette Kraus, executive director of nonprofit Pennsylvania Health Access Network, estimates the bill would cut nearly 320,000 people from the Medicaid program.

One in three working adults could lose coverage due to paperwork challenges, Kraus said, as the bill would require Medicaid users to refile for program coverage every six months.

The bill could also place one in four of the state’s hospitals at financial risk due to providing care to uninsured patients, Kraus said.

The Pennsylvania Health Access Network identified several Western Pa. hospitals in a list of 50 statewide that would be most impacted by the Medicaid cuts. This includes AHN’s Hempfield Neighborhoods Hospital, Penn Highlands Connellsville Hospital and six UPMC facilities — Magee-Womens, Mercy, McKeesport, Hamot, Jameson and Greene hospitals.

“Uncompensated care is going to cause financial stress on hospitals, so you might have to wait longer to get a procedure,” Kraus said. “We’re seeing a lot of hospital closures and consolidations in Pennsylvania, so it could stress an already stressed system.”

Bill would add barriers to health insurance

About 30% of Pennsylvanians enrolled in Pennie — the state’s health insurance marketplace established under the Affordable Care Act — could lose health care coverage, Executive Director Devon Trolley said.

“The amount of change and cost increases and new barriers are really something we have not seen ever in the marketplace program here at Pennie,” Trolley said. “We strive to make coverage easy to enroll in, and we make every effort to help people find an affordable plan.

“These changes make that extremely challenging because we will be required to put in many more steps before someone can enroll.”

Tax credits that reduce health insurance costs have been in place for about five years, Trolley said. If the federal government opts not to continue the tax credits this year, Pennie customers would have to pay about 82% more for health insurance, she said.

“This bill was one option (where) they could have extended (the tax credits), and they did not,” she said. “We don’t really have any indication that they are going to extend them at this point.”

Pennsylvania has the fifth-highest population of children without health care nationwide, Ludwick said. The cuts to Medicaid and added paperwork requirements proposed in the bill would only increase that number, she said.

“The loss in health insurance will mean that children will not be getting those early screenings and detection services that help treat developmental delays or behavioral issues or even health challenges like asthma,” she said. “Children who have chronic diseases will not be able to get medication or be able to get the care that they need to treat that in an ongoing manner that’s needed. …

”Pennsylvania is a pretty rural state, and Medicaid is really a lifeline for children who live in rural communities.”

But Ludwick is optimistic the bill will not be signed into law as-is.

“We’re hopeful that families of children who are enrolled in Medicaid will continue to speak up and speak out about how Medicaid is helpful — not only to their families, but really how Medicaid has been impactful to the health providers and systems within their communities.”

Kraus encourages Pennsylvanians relying on Medicaid or Pennie not to panic.

“Still go to your doctor’s appointments,” she said, “and submit your paperwork — all of that stuff that goes along with having access to these health care programs.”

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