Thursday, June 08, 2006

Feds require proof of citizenship for Medicaid by July

Alana spent a good deal of time today going through files at the Medicaid office where she works to see which of her clients have submitted proof of citizenship. This is due to a federal government mandate. By July 1, all Medicare and Medicaid recipients must have proof of citizenship. Acceptable proof is a birth certificate or a passport.

At first blush this sounds like a good idea. There are, however, problems...
  • A lot of Alana's clients are elderly. Many of them don't have birth certificates, either because they were lost (and they didn't see the need for replacing it), or because they weren't issued one. There are citizens of this state around 100 years old. For many, the only real proof of citizenship they have is a page from a family bible, a very common occurrence around the turn of the 20th century.

  • Many elderly don't have close relatives to help them with this, and there are those who aren't mentally competent. If they were born in another state, proving it could be difficult, or at least time consuming.

  • There is currently a four month wait to get a birth certificate from the Bureau of Vital Statistics. That's before this government mandate.

  • You can get birth certificates online. It costs the individual, or the government department, $1 per person to verify this. Imagine how expensive this could get for people who have to verify the citizenship of entire families.

The feds decided this was important, so they rushed it through so that it goes into effect July 1. The order is coming from the Center for Medicaid and Medicare Services (CMS). Although the states heard it was rumored to be in the works, the deadline of July 1 was given to the state Medicaid offices last week.

If someone on Medicaid or Medicare does not have acceptable proof of citizenship they can be denied coverage. They have until July 1, less than a month, to prove it. Many of them don't know they need to prove it, and won't until the letters arrive early next week.

I didn't mention that most of Alana's clients have some sort of Social Security benefit. The Social Security Administration requires proof of citizenship before they can give out benefits. The Social Security Administration okaying someone is not good enough; Medicare must have proof themselves.

Obviously this is the decree of someone in the federal government who wants to show they are doing something about the illegal immigrant problem. The cynic in me thinks the timing was deliberately set for July 1 so that it wouldn't look like an election year ploy.

Alana suspects that within a couple of months the stupidity of the situation will reach the highest levels of the bureaucracy and something will change. Perhaps they will grandfather anyone of a certain age, or anyone who received benefits at a certain time. Maybe they will extend the list of documents they will accept as proof of citizenship.

For now, a lot of elderly people across the country are getting scary letters telling them they must send in proof of citizenship. Instead of giving these people reasonable time to get the proper documentation (say, by the end of the year), the government is giving them less than a month. Why do I get the feeling that fewer illegals will be denied coverage than those legitimately entitled to it?

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