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Shift On Medicaid Documentation Rule Helps Some, But Leaves Millions At Risk

WASHINGTON, DC--Ten days after a class action lawsuit was filed against the federal government over its new requirement that Medicaid recipients must prove they are U.S. citizens, the government has announced that some groups would be exempt from the rule. But an advocacy group representing the plaintiffs says it's not nearly enough.

The U.S. Department of Health and Human Services recently changed its rules to conform with a federal law passed earlier this year designed to make sure that only legal citizens receive benefits through Medicaid, the joint state-federal healthcare program for people on low incomes. The new policy, which went into effect July 1, requires Medicaid recipients to either prove their citizenship through passports, birth certificates and other documentation, or lose their benefits.

Nine people who say they are citizens, but cannot prove it, sued the government on June 28, claiming the new rule violates their due process rights guaranteed under the 5th Amendment to the Constitution.

According to the Chicago-based Sargent Shriver National Center on Poverty Law, which is one group representing the plaintiffs, millions of low-income Americans would likely lose their benefits, with those at greatest risk being "seniors in nursing homes, people with mental or physical disabilities, disaster victims, and people not born in hospitals (sometimes due to racial discrimination, especially in the South) who never had birth certificates."

One plaintiff is a 72-year-old Missouri woman, now on dialysis, who has no birth certificate and was raised by a relative that is no longer alive. Another is a 95-year-old woman who was born in Arkansas before birth certificates were kept there.

The suit asked a federal district court to declare the government's new law unconstitutional and stop it from being implemented.

In Louisiana, health officials told the Times-Picayune that the new policy could present particular problems for thousands of people whose birth certificates and other documentation were lost during Hurricanes Katrina and Rita.

Last Friday, HHS officials announced that low-income seniors and people with disabilities who receive Supplemental Security Income (SSI) would not have to prove they are U.S. citizens to keep or begin receiving Medicaid benefits. Additionally, seniors receiving Medicare as their primary form of insurance could still receive Medicaid as a secondary source of insurance. The federal agency said these groups have already met certain documentation requirements.

The policy shift also means that states would be allowed to document citizenship by matching people's identities through state databases.

The Shriver Center noted that while the policy change would help about 8 million people, there are still about 40 million who stand to lose their benefits.

"Citizenship Suit Challenges New Law Requiring 50 Million People in Medicaid to Document Citizenship" (Sargent Shriver National Center on Poverty Law)
"9 file lawsuit over new Medicaid law" (Times-Picayune)

"Policy change gives disabled, aged some help" (Naples News)

Copyright 2006 Inonit Publishing
Article reproduced here under special arrangement with Inclusion Daily Express international disability rights news service. Please do not reprint, republish or forward without permission.

I understand the claims involved here. They all seem valid to me. It seems to me if the country is to blame for the individual not being able to prove they were born here (such as in the case of missing birth cert.), then they ought to be able to wrap the regulations around that.

While I understand that some people are going to slip through the cracks here, I also believe it's very important for people to be documented citizens before being eligible for programs like this. Even if that documentation is that they are here for asylum (for whatever reason) that is a million times better than not knowing who's getting the benefit, or if they maybe shouldn't be in some cases.

I think it is a dual issue, because while it may prevent people from receiving a service they need, it's also a better way of ensuring that people need the service and are contributing, in some way, to it's cost.

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