Federal Law Will Require Proof Of Citizenship For Healthcare

This is a step in the right direction, although I do understand the concern about displaced people not having proper documentation. I don't understand why this law was "tucked away". People need to know about this, so that they can prepare now and get any necessary documents that they may need. While it may seem discriminatory to target Medicaid recipients, illegals most surely get their healthcare through Medicaid, if they have any at all. It would be a good idea for everyone to have to do this though. It isn't a big deal to carry a copy of your birth certificate in your wallet. However, procedues should be put in place to ensure that doctors are not turned into UNS agents. Anyone, legal or illegal who goes to the ER with a life threatening situation should be treated. Doctors can't turn people away to die. But they should be able to turn people away who show up at the ER with non-life threatening conditions.

By Scott Helman, Globe Staff April 11, 2006

Almost all of the state's poorest residents will have to show proof of US citizenship to continue getting medical care by July 1, under a little-noticed federal law that could endanger coverage for many, as Massachusetts is trying to expand access to healthcare.

Born out of ongoing efforts in Washington to clamp down on illegal immigration, the new federal requirement compels anyone seeking Medicaid coverage to provide a birth certificate, a passport, or another form of identification in order to sign up for benefits or renew them.
No such proof is required now.

The requirement was tucked into the Deficit Reduction Act of 2005, which President Bush signed into law earlier this year.

The measure was part of an effort to limit the skyrocketing growth of federal entitlement programs. It has surfaced as Massachusetts begins to implement its sweeping healthcare plan, which aims to bring health coverage to almost all of the state's uninsured, in part by enrolling those in Medicaid who are eligible but who have not signed up.

Healthcare specialists voiced fear that because many Medicaid recipients -- including the homeless and the mentally disabled -- won't be able to easily produce documentation of their citizenship, they will have difficultly receiving care at community health centers, hospitals, or anywhere else.

''So we've got people in nursing homes, people in the [state Department of Mental Retardation] institutions, we've got the homeless, we've got the . . . mentally ill who now will have to come up with some verification to prove that they're citizens," said Victoria Pulos, health law attorney at the Massachusetts Law Reform Institute. ''It's ironic that this is happening in the state where part of the health reform plan is to make sure that everyone who's eligible for Medicaid is enrolled."

The new federal requirement, which all states have to comply with, would apply to the vast majority of the more than 1 million people on MassHealth, the Massachusetts Medicaid program.

The intent is to prevent undocumented immigrants from posing as citizens and taking advantage of taxpayer-funded healthcare benefits that are afforded only to legal residents. (Under federal law, undocumented immigrants can receive only emergency Medicaid care; Massachusetts has 40,000 on such a program, which is called MassHealth Limited.)

Less than three months before the new citizenship requirement takes effect, though, Massachusetts and other states are waiting for guidance from the federal government on how it will work.

Mary Kahn, a spokeswoman for the federal Centers for Medicare & Medicaid Services, said that the agency is writing the regulations, but that there is no indication of a delay.

Massachusetts already compels Medicaid recipients to verify their incomes, usually through W-2 forms, to ensure that the figure is low enough to qualify for the program. The state Medicaid director, Beth Waldman, played down the difficulty of adding another requirement.

''This shouldn't take away from people's access to healthcare," Waldman said. ''All you need to do is show that you're a citizen."

Waldman said that many of the state's 1,033,000 MassHealth recipients are not likely to have trouble proving citizenship, because they have already had to do so in registering with some other federal program, such as Social Security. (About 478,000 MassHealth members, for example, also get Medicare, Social Security, or welfare benefits, the state says.)

Some healthcare advocates, though, described the new rules as onerous on community health centers and other healthcare providers, but more so on Medicaid recipients, many of whom, they said, may not continue getting care if they cannot provide the paperwork or may have to wait to get treatment until they can locate the right documents.

''We're in the business of trying to make central Dorchester and parts of Mattapan a healthier place," said Bill Walczak, chief executive officer of Dorchester's Codman Square Health Center. ''We didn't create the healthcare centers to become citizenship enforcement centers."

The provision was added to the Deficit Reduction Act by two Republican representatives from Georgia, Charles Norwood and Nathan Deal, who have been outspoken against illegal immigration. Bush signed the legislation two months ago, saying, ''The bill I sign today restrains spending for entitlement programs while ensuring that Americans who rely on Medicare and Medicaid continue to get the care they need."