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Danger – Red Tape Ahead!

Medicaid Recipients Will Have to Document Citizenship

February 28, 2006—Children and adults who receive Medicaid will soon risk losing their eligibility if they can’t show the correct documents to prove U.S. Citizenship. If they lose eligibility, the federal government will not reimburse any mental health or other Medicaid services provided to them. That means that states and local mental health providers could lose substantial funding.

The danger stems from a change in Medicaid law in the Deficit Reduction Act (Public Law 109-171), enacted last month. As of July 1, 2006, someone who either applies for Medicaid or seeks to be re-certified as eligible will have to provide proof of U.S. citizenship. (Resident aliens are exempt.) The proof must be a birth certificate, passport, certificate of naturalization or another document specified by the Secretary of Health and Human Services (HHS).

Medicaid eligibility is re-certified by states on a regular basis, in some states as often as monthly or quarterly.

Many low-income individuals may be unable to produce a passport or birth certificate. And there is no assurance that HHS will create a rule allowing any other type of document. Medicaid eligibility will be cut off immediately for those who have no proof of citizenship. 

It often takes considerable time to obtain a birth certificate, and can involve a lot of bureaucratic red tape. But four months is time enough if people start now.

• Case managers and other providers should immediately find out whether a child or adult now on Medicaid has valid proof of citizenship.
• If not, the individual or family should be urged to request a copy of the birth certificate from the state where the person was born.
• Low-income individuals not now on Medicaid who are served by a mental health program should also be warned. They will need this documentation if they decide to apply for Medicaid later on.
• Corrections officials need to know about this because jails and prisons that have programs to help offenders establish Medicaid eligibility upon release will now need to help them obtain proof of citizenship.
• State Medicaid agencies should publicize this issue immediately, so people can begin the process of obtaining the required documents.

Four months isn’t so long when it comes to untangling red tape. Please forward this alert to anyone you know who deals with the health or mental health needs of low-income people.