Medicaid patients must show documentation

By Levin Freking, News Channel 21, Oregon

June 6, 2006

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Tens of millions of low-income Americans will soon have to show their birth certificates or U.S. passports if they want to obtain health care through their state Medicaid programs.

The requirement that beneficiaries provide proof of citizenship goes into effect July 1. It's designed to root out cases of illegal immigrants getting their health care paid for by the government. Federal law says only citizens, people granted asylum and legal immigrants who have been in the country at least five years are eligible for Medicaid benefits....

The citizenship requirement was attached to a bill that President Bush signed into law in February spelling out $35 billion in spending cuts over a five-year period. Much of the focus was on slowing the growth in Medicaid.

The provision will save federal taxpayers an estimated $220 million over the next five years, according to the Congressional Budget Office.

Last year, the inspector general for the Department of Health and Human Services found that a majority of states don't verify claims of U.S. citizenship by those seeking Medicaid. The practice creates the potential for illegal immigrants to access the health care program....

Federal law says a person must be a citizen to receive Medicaid benefits. However, emergency care cannot be denied.

States now can accept a signed declaration as proof of U.S. citizenship. Forty-six states do.

Only Montana, New York, New Hampshire and Texas require applicants to submit documents verifying citizenship.

The bill required that Medicaid applicants show a birth certificate or U.S. passport but gives the administration leeway in saying other documents could be acceptable. An example might be a sworn affidavit that describes why documentary evidence does not exist or cannot be obtained.

Directors of community health centers, which specialize in helping the poor access health care, have asked the administration to accept as proof of citizenship report cards, voter registration cards, tribal documents and military ID cards.

The Center on Budget and Policy Priorities, a liberal think tank, said disaster victims and elderly African-Americans may have difficulty accessing records such as birth certificates. Several black lawmakers have signed onto bills that would repeal the proof of citizenship requirement for participating in Medicaid.

The group said many elderly blacks were born in a time when racial discrimination in hospital admissions kept their mothers from giving birth at hospitals, so their births often were not officially registered. The center conducted a survey showing 9 percent of black adults reported they lack a passport or birth certificate, compared to 5.7 percent of all adults surveyed.

The new requirement will apply to all Medicaid applications submitted after July 1, as well as all applications to renew Medicaid coverage.

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