26,000 Allegheny County Residents to Lose Medicaid Coverage Next Year

Published on August 05, 2026

26,000 Allegheny County Residents to Lose Medicaid Coverage Next Year Due to Congressional Cuts 

County Executive leads effort to mitigate impact of Congressional cuts on county residents and healthcare system 

PITTSBURGH – Allegheny County Executive Sara Innamorato shared an update on how the looming cuts to Medicaid passed by Congress in 2025 will affect Allegheny County. The Medicaid cuts are expected to leave many county residents without health coverage and to create significant budget challenges for the region’s healthcare system. 

“Healthcare is not a luxury; it is a lifeline. Federal cuts to Medicaid will have real consequences for families across Allegheny County, forcing thousands of people to lose coverage not because they are ineligible, but because of new administrative barriers,” said County Executive Sara Innamorato. “In Allegheny County, we will continue standing up for our residents and are working with healthcare providers to minimize the harm of these cuts.” 

New Burdens for Recipients and Hospitals 

Beginning on January 1, 2027, some adult Medicaid recipients will be required to regularly document that they are either employed or engaged in other activities, such as education, to retain coverage. Models estimate that this will result in approximately 10% of Allegheny County’s Medicaid population, or nearly 26,000 Allegheny County residents, losing coverage due to paperwork requirements. Many of those 26,000 people are employed and eligible but will face hurdles with additional administrative barriers. The estimated losses in Allegheny County are part of more than three million Medicaid recipients expected to lose coverage nationwide. Changes to eligibility rules for noncitizens will start on October 1, 2026. Many lawfully present noncitizens, such as refugees and asylees, may lose their current coverage. 

The new requirements were enacted as part of the federal budget package passed in 2025, H.R. 1, also referred to as the One Big Beautiful Bill Act. 

In addition to the direct impact on the individuals and families losing coverage, these cuts will negatively affect healthcare providers. The loss of Medicaid coverage is expected to drive a large increase in the amount of uncompensated care that hospitals and human services agencies will have to provide to uninsured people requiring emergency assistance. In addition, reduced Medicaid enrollment will result in a comparable reduction in federal funding to local behavioral health providers, estimated to total more than $20 million next year. 

County Working to Mitigate Impact 

With the cuts set to take effect in January, the County has taken several recent steps to mitigate the negative impact on residents and healthcare providers. 

  • Last week, the County filed an official comment on a newly proposed rule issued by the U.S. Department of Health and Human Services that would exacerbate the impact of the new requirements by making it harder for medically frail individuals to receive waivers of work requirements. County officials expressed concern that "new administrative burdens created by H.R. 1 will cause Medicaid recipients to lose access to life-saving care, even if they qualify for it... many will delay care until they are in crisis, showing up in emergency rooms instead of getting the ongoing treatment they need...this means that thousands of Allegheny County residents who are sick, disabled, or in crisis will lose their health coverage because the process to prove eligibility has become too complex to navigate. The result will be fewer people getting the mental health and substance use treatment they need, more people showing up in crisis, and a local safety net that cannot keep pace.” 

  • Last week, Allegheny County Department of Human Services Interim Director Alex Jutca sent an email to its full provider network urging them to help spread the word about the need for enrollees to take action to maintain their coverage. DHS provided providers with posters, flyers, social media posts and other materials they can use to spread the word, with the campaign headlined “Stay Informed: Changes Are Coming.” Local businesses and community spaces are encouraged to display the campaign materials. Download materials at qr.alleghenycounty.us/HR1Toolkit 

  • Additionally, DHS announced they will bolster existing outreach to Medicaid recipients through trusted messengers such as homeless shelters, mental health and substance use providers, and immigrant-serving providers in the community; and directly via text messaging.  

“Working with the County Executive and partners from across the healthcare and human services system, DHS is doing everything we can to make sure that eligible people are not cut off from coverage because of reporting requirements,” Jutca said. “Even with these efforts, the federal cutbacks will create a major strain on our ability to provide life-saving care. That’s why we are investing proactively in solutions to reduce the scope of the damage.” 

 

Media inquiries may be directed to the Communications Office.
For contact information, including email addresses and telephone numbers, visit the office website.

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