NEW REQUIREMENT FOR BIRTH CERTIFICATES OR PASSPORTS COULD THREATEN MEDICAID COVERAGE FOR VULNERABLE BENEFICIARIES:
A STATE-BY-STATE ANALYSISThe Deficit Reduction Act, which was signed by the President on February 8th, contains a provision that would require all citizens applying for Medicaid or renewing their coverage to produce a passport or birth certificate to prove they are U.S. citizens. There would be no exceptions for any Medicaid applicants or beneficiaries, not even individuals with severe physical or mental impairments such as Alzheimer’s disease.
This new requirement, which a recent study by the Inspector General of the Department of Health and Human Services shows to be unnecessary, would almost certainly create significant enrollment barriers for millions of low-income citizens who meet all Medicaid eligibility requirements. It also would increase Medicaid administrative costs. (For a discussion of these issues, see Leighton Ku and Donna Cohen Ross, “New Medicaid Requirement Is Unnecessary and Could Impede Citizens’ Coverage and Policy Priorities,” revised January 4, 2006.)
This analysis provides estimates of the number of Medicaid beneficiaries in each state who would be required to submit a passport or birth certificate between July 2006 (when the new requirement would take effect) and June 2007, and who would be cut off Medicaid if they are unable to do so.
Analyses of Census data and Medicaid administrative data indicate that about 49 million native-born U.S. citizens and two million naturalized citizens were enrolled in Medicaid over the course of the year in 2003.
(Fewer than 4 million legal immigrants also participated.) Thus, about 49 million people would be required to submit birth certificates or passports or lose their Medicaid coverage. (The two million beneficiaries who are naturalized citizens would be allowed to submit naturalization documents.)<snip>
Large numbers of eligible people could lose coverage because they do not have a birth certificate or passport available at the time they apply or reapply for Medicaid. Low-income individuals on Medicaid usually do not travel abroad and often lack passports. Birth certificates may have been lost over the years in which people move from one home to another; in some cases, as explained below, individuals may have been born outside a hospital and no birth certificate may have been issued. Those who may be harmed include:
* People who have a sudden emergency and need Medicaid coverage immediately but cannot get these documents quickly (some states take a month or longer to provide a duplicate birth certificate when one is requested);
* Those who are homeless, mentally ill, or suffering from senility or a disease such as Alzheimer’s, and who may not be able to secure a birth certificate (or even to recall where they were born);
* People who are in nursing homes or are severely disabled, and would have difficulty getting access to their birth certificates; and
* Those affected by disasters like Hurricanes Katrina or Wilma who have lost most of their possessions and records.
http://www.cbpp.org/1-5-06health.htm
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