Posted on June 6, 2006

Medicaid Recipients Will Need Citizenship

Kevin Freking, AP, June 5, 2006

WASHINGTON — 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.

Health analysts say they fear the provision could prevent some citizens from getting health care.


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.

The inspector general’s report did not address to what extent there is a problem with illegal immigrants accessing Medicaid, only that the potential exists.

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.