Tougher rules on citizenship records curbing Medicaid enrollment

The law is intended to keep undocumented immigrants out of the program, but some state officials say it is hampering lawful residents as well.

By Doug Trapp, AMNews staff. Feb. 12, 2007.

Washington -- At least a handful of states say they are seeing declines in Medicaid enrollment due to identity and citizenship documentation requirements that went into effect July 1, 2006.

The Deficit Reduction Act of 2005 included a provision requiring states to verify the identity and citizenship of people enrolling in Medicaid or applying for a renewal. This can be done using original documents, such as birth certificates, driver's licenses, passports and other government-issued identification.

The measure was intended to curtail Medicaid fraud by undocumented immigrants. Previously, Medicaid applicants in most states could attest to their citizenship on their applications, under penalty of perjury.

Congress has exempted from the requirements children in state foster care systems and people who receive supplemental security income or Social Security disability insurance.

No one has released a nationwide analysis of the law's effects, but a January report found that Iowa, Louisiana, New Hampshire, Virginia and Wisconsin are having some difficulty maintaining Medicaid enrollment or processing applications because of the act's requirements. The report was co-authored by the Center on Budget and Policy Priorities and the Kaiser Family Foundation's Commission on Medicaid and the Uninsured.

The declines raise concerns that Medicaid-eligible citizens will remain part of the 46.6 million uninsured people in America, the report said.