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DSS attributes drop in child Medicaid coverage to rising incomes

South Dakota Department of Social Services officials take questions from lawmakers on the Joint Appropriations Committee Tuesday morning.
Lee Strubinger
/
SDPB
South Dakota Department of Social Services officials take questions from lawmakers on the Joint Appropriations Committee Tuesday morning.

South Dakota Department of Social Services officials say the causes behind a 27 percent drop in Medicaid coverage for South Dakota children are two-fold.

They point to rising incomes and unwinding Medicaid rolls following the federal COVID public health emergency expiration last year.

The decline in child Medicaid enrollees is tied for worst in the nation. It drew the attention of federal officials who flagged the drop off and are urging the state to adopt flexible policies to help and keep children enrolled.

Alex Mayer, chief of children and family services for DSS, said the department is following federal guidance for disenrolling children.

“I would agree that it is a substantial amount of children. I would also say that we’re at an unprecedented time when it comes to the program level of enrollment and the number of individuals that are on the program," Mayer said in front of Joint Appropriations Tuesday morning. “All I can do is assure you the conversations we’ve had with CMS—their review of our policies and procedures—has solidified the fact that what we’re doing is accurate and consistent.”

DSS officials say overall Medicaid enrollment and utilization are down. Some worry that’s due to individuals not knowing they qualify for the program.

Democratic Rep. Linda Duba wants to see department data the underlying data behind the children losing Medicaid coverage.

“What I’d like to see is the actual raw numbers behind the 20,000 children that were removed from the rolls. What are those reasons and what are we doing to mitigate the losses? Are there things that we can do to bring some of them back on the program,” Duba said. “But, without the data and the actual reasons, statements saying I can assure you we’re following policy… not good enough.”

DSS Secretary Matt Althoff declined SDPB’s request for an interview. Althoff took the job of DSS secretary just over a year ago and has overseen the scrubbing of Medicaid rolls as the public health emergency expired and implementing Medicaid expansion.

DSS is scheduled to go before a state legislative committee to talk about how it’s handling Medicaid on Feb. 12.

Lee Strubinger is SDPB’s Rapid City-based news and political reporter. A former reporter for Fort Lupton Press (CO) and Colorado Public Radio, Lee holds a master’s in public affairs reporting from the University of Illinois-Springfield.
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