Editorial: Is there another solution for Medicaid and CHIP enrollment?

On April 1, the continuous enrollment in Medicaid and CHIP programs came to an end.

Continuous enrollment came from the Families First Coronavirus Act, a federal measure passed in March 2020 to help Americans cope with the challenges of the covid-19 pandemic. A major factor was making sure people who needed medical coverage had access to it.

This meant children approved for either program had health coverage for 12 continuous months. That might not seem unusual. People who have health insurance through an employer generally work on a similar system. Sign up at the enrollment period, and everything stays the same for a year.

But with the government programs, it is different. If a parent’s income changes, a kid can lose coverage. During the pandemic, that was a problem because some businesses shut down for a time. A parent’s income could fluctuate, affecting a child’s coverage.

Continuous enrollment addressed that. It wasn’t just a good thing for families. It also meant government agencies weren’t on a roller coaster of approval and denial. That’s a smart use of resources.

With pandemic responses coming to an end this year, it was naturally going to change.

However, a Spotlight PA report points to a complication. The state Department of Human Services, like many employers, has staffing shortages. That means the millions of people enrolled in the program — people who now have to deal with ups and downs and reenrollment — have to do so with fewer workers available to handle the load.

DHS has 69 jobs listed on the state’s job website. Many of them say the listing is hiring for multiple positions.

Income maintenance caseworkers are “responsible and accountable for determining eligibility for financial assistance, Medicaid, SNAP, LIHEAP, Nursing Home Care and Waivers as well as any additional programs the Department of Human Services administers.” It’s a civil service job paying $46,318 a year, and the continuous listing has been open since April 23, 2018.

In some areas, including Pittsburgh, the offices are just 86% staffed. DHS’s overall employment has dropped 11% since 2020. That isn’t great with this new onslaught of work that was on pause for years.

“People are getting their requests for documents after (they’re) due. They’re getting their renewal packets after (they’re) due or not at all. There’s problems all over the state with that,” one worker told Spotlight PA.

The state and federal government should take a long look at the way Medicaid and CHIP have operated over the last three years to determine how continuous enrollment worked and whether there is a way to keep its efficiencies while still staying within the requirements of the programs.