Sunday, June 11, 2006 | 7:31 a.m.
CARSON CITY - Thousands of low-income Nevadans could lose or be denied free medical care under a federal law that becomes effective July 1.
This law, says state Welfare Administrator Nancy Ford, "could have a devastating effect."
Under the federal Deficit Reduction Act passed earlier this year, people applying for Medicaid must show their birth certificates or U.S. passports to be eligible for the benefits.
Medicaid is a state-federal program that provides medical care to low-income citizens. It currently covers about 172,000 people in Nevada.
Most affected will be the elderly in long-term nursing homes, American Indians and low-income blacks who were born in the southeastern United States without a birth certificate, says Jon Sasser, statewide advocacy coordinator for Nevada Legal Services.
The new law is aimed at stopping illegal immigrants from receiving government-sponsored health care.
Richard Arnold, executive director of the Las Vegas Indian Center, finds it ironic that the burden of proof should fall so heavily on Indians. Many are now eligible for Medicaid, particularly those born in remote areas, would not have been issued a birth certificate.
"For those that weren't born in hospitals, they may have a delayed birth certificate or they may have some records that were kept through either their separate tribes or the Bureau of Indian Affairs," said Arnold, a Southern Paiute.
"Sometimes it is accepted, and other times it's not, depending on the agencies and the programs."
There are more than 20,000 Indians in Clark County, the most in any Nevada county. Arnold estimates that at least 25 percent are senior citizens on, or eligible for, Medicaid.
The welfare Division will not remove people from the program en masse, and those already on Medicaid will have more time to provide the required documentation than those applying for initial benefits, according to the Welfare Division.
Janice Stenson, program specialist for the Welfare Division, said those already enrolled won't have to supply identification until their yearly re-enrollment date. Each person receiving Medicaid must be recertified annually .
Stenson said the division is preparing to send letters to current recipients to advise them of the need to provide proof of citizenship.
The division plans to help people obtain birth certificates, and the state Office of Vital Statistics is gearing up for increased birth certificate requests, she said.
Arnold found it hard to believe that with less than a month until the law takes effect, this issue is just now being addressed.
He said that it sometimes takes years to obtain a delayed birth certificate because verification of the facts surrounding birth is required, and that can be difficult for many older residents.
Those applying for the first time will have to show proof of citizenship beginning next month.
Deborah Moore, of the Nevada AARP office in Las Vegas, called the change disturbing.
"In general, anything that makes it more difficult for people to have access to care from existing programs is a concern," Moore said. "These are our most vulnerable citizens."
There are two bills in Congress to repeal the birth certificate/passport requirement, and Ford has asked for support from Nevada's congressional delegation.
The new law, Welfare Administrator Ford said, "is pretty far-reaching. This will have an adverse effect on a very needy population."
Medicaid pays for a large number of the state's nursing home patients. Sasser and Ford both said they are concerned how the incapacitated will find or be able to come up with their birth certificates.
In addition, it could affect those on Medicaid in mental institutions.
"Our hope is Congress will change this in time or the secretary of Health and Human Services will lighten the load on states" though regulations, Legal Services' Sasser said.
"The law is pretty onerous."
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