Bar on Unauthorized Immigrants Prevents U.S. Citizens from Obtaining Medicaid

Under a 2006 federal law, known as the Deficit Reduction Act, those applying for Medicaid benefits must prove that they are U.S. citizens.  Applicants can demonstrate proof of citizenship by providing a passport or the combination of a birth certificate and driver’s license.  While this law was intended to prevent illegal immigrants from receiving Medicaid benefits, many U.S. citizens have been inhibited from receiving Medicaid.  

States including Florida , Iowa , Kansas , Louisiana , New Mexico , Ohio and Virginia have all reported declines in Medicaid enrollment, and have traced the declines to the new law.  Medicaid officials across the U.S. have reported that they have denied thousands of applications due to failure to provide adequate documentation of U.S. citizenship.   

In Florida , the number of children receiving Medicaid dropped by 63,000, to 1.2 million, between July 2006 to January 2007.  In Iowa , the number of Medicaid recipients dropped by 5,700 in the second half of 2006.  Ohio reports the number of people receiving Medicaid declined by 39,000 to 1.3 million.  

In addition to the difficulty some applicants are having in providing this documentation, Medicaid officials also say that the new requirement causes review of applications to take longer, thus delaying issuance of coverage and causing many to go without needed medical care.  Georgia reported that many of its 100,000 newly uninsured U.S. citizen children of low-income families missed immunizations and preventive health visits due to application delays.  The state also found that many U.S. citizen children were admitted to hospitals and intensive care units for conditions that normally would have been treated in a doctor's office.   Officials across the U.S. have found that many pregnant women are going without prenatal care and some parents have been postponing checkups for their children because they do not have the necessary coverage.  

Washington state is suing the U.S. Department of Health and Human Services in U.S. District Court over the law, which has made it harder to get medical coverage for infants born in the U.S. to illegal immigrants.  The state is arguing that the regulation is nonsensical since every child born in the U.S. is automatically considered to be a U.S. citizen.  Requiring the state to determine citizenship, and therefore eligibility for Medicaid coverage, has added to the state’s health care costs.  

Until passage of the 2006 law, states had some say in deciding how to verify U.S. citizenship. Applicants had to declare in writing, under penalty of perjury, whether they were citizens.  Most states required documentation, such as birth certificates, only if the other evidence suggested that an applicant was falsely claiming to be a citizen.

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