Strategies in Action

Making sure that everyone is counted in the 2020 Census is critical to securing the federal resources that Philadelphia and other communities in Pennsylvania need to promote optimal health and well-being. Learn more about the importance of 2020 Census advocacy, education, outreach, and assistance in this article from PHP grantee Pennsylvania Health Access Network (PHAN).

December 2018

The 2020 Census is quickly approaching, and Pennsylvania is at significant risk of an undercount for several reasons. First, the overall level of funding for the Census, including the funding for workers who help people complete the questionnaire, has been limited by Congress. Inadequate funding is a particular concern given that this will be the first Census in which people will be expected to fill out the questionnaire online. As a result of the decreased funds and increased operational challenges, the US Government Accountability Office has labeled the 2020 Census at high risk of failure.

The change to online collection of Census data will pose challenges for people in communities throughout Pennsylvania who lack broadband internet access – a category that includes some 800,000 Pennsylvanians according to new research by Penn State University – or who lack the technology skills or English proficiency to fill out the questionnaire online. Lack of access to broadband is not limited to rural areas; in Philadelphia, the rate of broadband penetration was 71.6 percent in 2017, the second-lowest among the 25 largest cities, and Philadelphia was the only large city to record a decline in internet access between 2016 and 2017.

Lastly, a new question added by the Census Bureau that will ask about respondents’ citizenship status is likely to discourage already-hard-to-count immigrant communities and communities of color from participating by stoking fears that the information collected will be used against them. The Census’s own pre-Census field tests conducted in 2017 found that undocumented respondents and members of immigrant communities already had significant confidentiality concerns about the collection of their information and provided incorrect information as a result.

This is supported by our own experience with immigrant communities. According to Jessica Foster, PHAN’s Community Engagement Coordinator who works directly with immigrant communities, people she works with have already expressed increased fear and distrust when accessing public benefits in the current climate. “I believe that a question about citizenship on the Census would lead members of the communities I work with to question why the information is needed and would discourage them from participating in the Census,” she said.

The impact of an undercount could have dire consequences for our state. The state’s population, as counted by the Census, plays a role in calculating federal funds contributed to Pennsylvania for programs such as healthcare, nutrition assistance, transportation, housing, education, childcare, programs for children and parents, and energy assistance. Currently, Pennsylvania receives $26.8 billion in these Census-derived federal funds; 70 percent are related to healthcare, primarily to support Medicaid and CHIP. With more than a quarter of its population living under the federal poverty line, Philadelphia relies heavily on programs such as Medicaid, CHIP, nutrition assistance, and housing programs and would be disproportionately impacted by cuts to federal funds.

These federal funds are determined based on a calculation called the Federal Medical Assistance Percentage (FMAP). If fewer people complete the Census, Pennsylvania’s per-person income appears higher than it actually is, and it loses federal dollars as a result. Nationally, Pennsylvania is the second-most vulnerable state in terms of potentially losing FMAP-calculated funds in the upcoming Census. A one percent undercount could cost Pennsylvania more than $221.8 million each year over ten years.

These FMAP funds support healthcare programs for seniors, children, and people with disabilities, and since these programs are not discretionary, the loss of these funds would drain resources to support other programs and infrastructure priorities important to Pennsylvanians, like nutrition assistance, highways, education, housing, and many more. As PHAN Director Antoinette Kraus explained, “We’re particularly worried about the impact of an undercount on areas of Pennsylvania – such as Philadelphia – that have high concentrations of poverty and populations that rely heavily on the programs that receive federal support. These are often the same areas that will need the most preparation and outreach to prevent an undercount.”

Pennsylvania must take immediate action to avoid the potential loss of critical federal funds. The Commonwealth should begin preparing for the Census by increasing awareness and education in hard-to-count communities (e.g., urban and rural low-income households, communities of color, immigrants, families with young children) and investing in in-person outreach and assistance efforts conducted by the Commonwealth, local governments, and community-based organizations. These investments should include proven interventions such as: designated questionnaire assistance centers where people can fill out questionnaires, employment of census workers from hard-to-count communities, direct outreach by trusted local entities, and targeted media outreach in local communities. PHAN will work in Philadelphia and in other parts of the state to prevent an undercount using our existing enrollment infrastructure and field operations to reach out to hard-to-count communities.

To learn more, read PHAN’s full policy briefing here.