HARRISBURG, Pa. (AP) — The federal government’s pandemic-era prohibition against kicking people off Medicaid is ending, meaning that hundreds of thousands of people in Pennsylvania face losing the free health insurance in the coming year.

Many people who stand to lose Medicaid coverage don’t know the changes are coming, say officials at advocacy organizations who do outreach to the poor. That could mean people — parents of school-age children, for instance — find out they have no coverage when they go to fill a prescription or see a doctor for a sick child.

Enforcing the eligibility rules will be a massive task that will test the new administration of Gov. Josh Shapiro, and advocates predict that caseworkers will be flooded by questions from confused enrollees who appeal or reapply when they are denied benefits. They are worried.

“Very very worried,” said Allister Chang, co-founder of Fabric Health, which sets up in laundromats in Philadelphia and Pittsburgh to engage people about public benefits. “Not a single person we’ve talked to so far ... knows that this is coming, including the people who will be affected by this.”

All told, state caseworkers must resume enforcing eligibility rules for more than 3.6 million who are on Medicaid, the federal-state partnership that covers medical care, including primary care and surgeries.