Significant Operational Changes in Pennsylvania to CHIP Overlaps with Medicaid Unwinding

Starting April 17, the Pennsylvania Department of Human Services (DHS) DHS will decide who qualifies for the Children’s Health Insurance Program and process all new applications and renewals. The current 130,000 CHIP families—and all new enrollees—must go through DHS instead of their CHIP health insurance plan to determine eligibility.

The transition of eligibility processing and determinations from the CHIP plans to caseworkers in local DHS County Assistance Offices (CAO) is on the heels of the unwinding process of Medicaid continuous coverage that began on April 1st.

CAOs, which already have full workloads with the unprecedented task of Medicaid unwinding, will now be responsible for processing CHIP applications and renewals.

And while the CHIP eligibility transition had been in the works long before the COVID-19 pandemic, the state ultimately was able to determine its timing.

Check out CHIP changes webpage for more details about how this change will impact CHIP families.