Medicaid Proof-of-Citizenship Rules Drawing Criticism
Federal rules that require Medicaid beneficiaries and applicants to provide proof of their U.S. citizenship are preventing eligible legal citizens from enrolling in the program because they cannot obtain the proper documents, according to advocates and health officials, the Baltimore Sun reports (Epstein, Baltimore Sun, 6/17).
The Deficit Reduction Act of 2005 includes a provision that requires most Medicaid applicants to provide "satisfactory documentary evidence of citizenship," such as a passport or the combination of a birth certificate and driver's license. According to some state officials, Medicaid applicants are required to submit original documents or copies certified by the agencies that issued them (California Healthline, 5/8).
Supporters of the rules say "it's only fair to ensure that those receiving government help are legally entitled to it," the Sun reports. However, "many states are finding that the law is also a barrier to tens of thousands, and likely hundreds of thousands, of poor citizens on their rolls," including many children, according to the Sun.
For example, the Sun reports that despite efforts by Maryland health officials to match Medicaid beneficiaries with state birth records to avoid "unnecessarily rejecting tens of thousands of applications from lifelong" state residents, enrollment has declined by 6,500 beneficiaries to 501,500 between when the provision took effect and May.
Many of those dropped from the program were unable to provide the type of documentation required by the law, according to state and local health officials. The drop in enrollment is a "pattern similar to that of many other states when officials have expected increases in enrollment instead," according to the Sun.
Sen. Jeff Bingaman (D-N.M.) has sponsored legislation that "would essentially overturn the new restriction" and allow applicants to self-declare citizenship, the Sun reports.
The bill is expected to be offered as an amendment to a larger health care measure this year, "but it's unclear whether Congress would approve a change when immigration is still a major issue heading into the 2008 election," according to the Sun (Baltimore Sun, 6/17).