JEFFERSON CITY — Parents who no longer qualify for government health care but fail to sign up their children separately are partly to blame for the drop in children's Medicaid coverage, a top legislative budget said Tuesday, much to the chagrin of some lawmakers who blame the agency itself.

State lawmakers and social services officials held a hearing to address continued concerns about the recent dip in children receiving government health insurance. Between January 2018 and December 2019, roughly 100,000 children lost coverage through the program. 

Rep. David Wood, who leads the budget committee on social services, said during the hearing that between 2014 and 2018 the state didn't adequately check whether Medicaid recipients met eligibility requirements.

After heightened efforts beginning in 2018 to purge Medicaid rolls of people who are not eligible, Wood said families began dropping out of the program. He said some didn't reapply for their children to be covered separately, even if their kids likely would have qualified. 

"When those individuals were notified that they were no longer eligible for Medicaid, we can assume that most of them did not go ahead and apply directly for their children to be under Medicaid," the Versailles Republican said. 

Wood said the state needs to do a better job streamlining the application processes, notifying Missourians about changes in the health care coverage and answering participants' questions. But he also said it's ultimately up to parents to fill out the paperwork to ensure their children still have health insurance. 

"There is a certain amount of parent responsibility and individual responsibility to know what is available and fill out those applications," he said. "It's not the government's responsibility to go out and find these people."

Democrats have been raising concerns  for months about the drop in kids covered by Medicaid and continued to rail against the agency's handling of the situation Tuesday. 

"Our default position was to drop these children, remove them from health care coverage, if the custodial parent wasn't covered," Democratic Rep. Deb Lavender, of Kirkwood, told social services officials during the hearing. "We've sent them a verification to say your child is not there. We're placing the blame on parents on not re-signing their kids up."

Democratic Rep. Sarah Unsicker, of Shrewsbury, this year filed legislation to give children continuous 12-month Medicaid coverage in response. In a Monday statement, she said doing so would "prevent kids from falling through the cracks and save the state money by eliminating unnecessary administrative hurdles."

Department of Social Services officials told lawmakers that it's difficult tracking down recipients to verify their eligibility for the program. Deputy Director Patrick Luebbering said the agency must mail letters to correct addresses or risk violating privacy laws, and some Medicaid participants move frequently.

Other reasons cited by Social Services for the drop in covered children include an improved economy and decreased unemployment. 

Luebbering said anyone dropped from Medicaid who still qualifies can receive retroactive coverage. That means any eligible health expenses from the past three months will be covered.