Sunday, July 16, 2006

Feds relax some citizenship requirements for Medicaid

I mentioned last month how the federal government was requiring all Medicaid recipients to be citizens, and how they backed off that requirement by July 1. What I didn't post, but meant to, was how they came back later in June and made the requirements more stringent than ever!

In order to be a "citizen" as far as Medicaid is concerned, a Medicaid recipient needs a passport, or a birth certificate and a government-issued ID with their picture on it. This has to be presented to a Medicaid analyst when the person's Medicaid is due for renewal. If you don't have proper documentation, you can get by with a statement from two people who do have proper documentation.

Alana supports a lot of elderly people. Many of them don't have birth certificates. At the turn of the 20th century it was common for a "birth certificate" to be an entry in a family bible, particularly if they were born poor or in a small town. She also came across a couple of other people who could not comply with the new regulations. One was a woman who was house bound. She can not drive, does not live in Monroe (so no bus service), can't afford a taxi, and has no friends or family. How is she to get to the Medicaid office to prove her citizenship? Another person had a daughter on Medicaid. The daughter has been in a persistent vegetative state since she was a child, so she has no government issued ID. These are just two of many people who are American citizens but who can not comply with the regulations.

There are thousands of people who are trying to comply but do not have a current birth certificate. They are now rushing to get a certificate, a process that could take many weeks. Alana was put on a pilot project with access to the Vital Records system. This would allow her to look up birth certificates online. Unfortunately, these records have only been compiled electronically from 1985. If an American was born since then, or asked for a certificate since then, are in the system. Most of Alana's clients are not.

With all these problems, and the fears of legitimate Medicaid recipients, the Feds relaxed their requirements on July 7. The new rules show, gasp, common sense! The disabled and the elderly who are already on the system will be "grandfathered" into the system. They won't have to prove citizenship. Anyone else who is making a "good faith" effort to prove citizenship will not lose coverage. If no proof of citizenship exists, a sworn affidavit of the recipient and one other person will suffice.

Alana predicted over a month ago that the government would have to do something like this. It only took them about 6 weeks, and the scaring of a thousands of legitimate citizens — I say "thousands" based on the number of calls Alana's office received on the issue — before they changed the policy.

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