8 million exempted from citizenship documentation for Medicaid

WASHINGTON — About 8 million people will be exempted from a new federal requirement that they prove citizenship before receiving health care through Medicaid, federal officials said Thursday.

The requirement calling for proof of citizenship went into effect July 1. It's the subject of at least two lawsuits filed by people who claim that a lack of documentation could cause scores of nursing home residents, the mentally ill and the destitute to lose health coverage.

Those exempted from the documentation requirements often fit into the category of most vulnerable, according to regulations to be issued by the Centers for Medicare and Medicaid Services. They include about 6 million people who qualify for both Medicare and Medicaid, and another 2 million aged and disabled people who get an income supplement, called Supplemental Security Income, that helps them meet basic needs.

Officials said the new law requiring proof of citizenship called for "special treatment" of those beneficiaries.

"In most cases, these individuals have already gone through additional documentation procedures," said Mark McClellan, administrator for CMS.

Citizenship or legal immigration status has always been a requirement for Medicaid eligibility. However, beneficiaries could assert their eligibility simply by checking a box on a form. Congress said that, beginning July 1, documents will be needed to prove identify and citizenship.

"Simply checking a box on a form does not suffice any more," McClellan said.

A passport would meet both criteria. A birth certificate would serve as evidence of citizenship, but a second document would be needed to prove identity. In rare cases, sworn affidavits from two citizens can be accepted, but at least one of the two cannot be related to the applicant.

McClellan said current beneficiaries should not lose benefits during the time they are undertaking a good-faith effort to provide documentation to the state.

Families USA, an advocacy group critical of the documentation requirements, called the new exemptions commendable.

"But numerous other people who need health care the most and can't come up with the required documentation such as foster children, the homeless and people who were victimized by natural disaster may still lose Medicaid coverage and join the ranks of the uninsured, and this should be corrected," said Ron Pollack, the group's executive director.