As Pennsylvania braces for stricter Medicaid rules to go into effect, one health system wants to help patients keep their insurance coverage.
Guthrie, a nonprofit with facilities in Pennsylvania and New York, is expanding its volunteer program to help patients who may need to meet the new 80-hour monthly community engagement requirement, which can be fulfilled through school, work, training, or volunteering.
The new Medicaid requirements, which take effect in January, were approved as part of President Donald Trump’s “big, beautiful” budget bill in July 2025. The community engagement rule applies to some adults who do not have dependent children younger than 14.
About 2.8 million people in Pennsylvania — 22% — are covered by Medicaid, according to state data. Pennsylvania officials estimate that 310,000 people could lose Medicaid benefits due to the upcoming changes. Additionally, the state Department of Human Services anticipates a $20 billion loss in federal funding over 10 years, starting in 2028. An infusion of $193 million into the state from the federal Rural Health Transformation Program won’t offset those deep cuts, experts say.
About 70% of Guthrie’s patients are covered by government-funded insurance, which reimburses at lower rates than private plans and hasn’t kept up with inflation. Of those, 16% rely on Medicaid, according to Chief Operating Officer Paul VerValin.
The health system stands to lose as much as $38 million in net revenue because of federal Medicaid changes, VerValin told Spotlight PA.
Guthrie regularly evaluates how to reduce costs with the least amount of impact to patients and caregivers, VerValin said. The health system has no plans to discontinue any services, he added.
“The challenge is our Medicaid recipients,” he said. “Of course, we got something from them. And now, we will not, so we have to pivot and figure out how we are going to deal with that.”
Because hospitals must provide care regardless of someone’s ability to pay, officials fear that an uptick in uninsured patients will lead to more uncompensated care, “especially in rural hospitals which rely heavily on Medicaid revenue, and further strain Pennsylvania’s already-overwhelmed health system,” Pennsylvania Department of Human Services Secretary Val Arkoosh told Spotlight PA in a statement.
With the expansion of its volunteer program, Guthrie offers Medicaid patients a way to keep their insurance so the health system’s hospitals can still get reimbursed for the care they provide.
Patients could volunteer by greeting visitors, working in the gift shop or at special events, delivering flowers, running errands, and more. There’s a process for determining where someone’s skills would fit, VerValin said. Program details and how to apply are available online.
He told Spotlight PA that Guthrie is directly reaching out to Medicaid recipients to walk them through the new policies and how to stay enrolled, offering its volunteer program as an avenue.
Partnership “is essential” to helping people navigate the changes, Arkoosh said, applauding Guthrie for being “a trusted resource that will help people meet the new requirements and stay covered.”
Lisa Davis, director of the Pennsylvania Office of Rural Health, toured one of Guthrie’s facilities earlier this year and called the volunteer program “a really creative way” to help Medicaid patients and the health system’s bottom line.
“It is a service to the patient. It’s a service to the community, and it is also a service to the hospital,” Davis told Spotlight PA.