Editorial: Hurting our own

Tuesday, March 13, 2007 | 7:17 a.m.

A federal law that was supposed to prevent undocumented immigrants from receiving Medicaid benefits also is preventing tens of thousands of U.S. citizens from receiving benefits because they have difficulty presenting the documents needed to obtain coverage.

A handful of states have traced huge declines in Medicaid enrollment to the federal documentation requirement that went into effect last year, The New York Times reported Monday. The 2006 Deficit Reduction Act requires Medicaid applicants who say they are U.S. citizens to provide "satisfactory documentary evidence of citizenship," which can include a passport or the combination of a birth certificate and driver's license.

But officials in some states told the Times that the Bush administration has required that people submit originals of such documents as birth certificates or copies of the documents that have been certified by the agency that issued them. That is hard on low-income families, many of whom lack original documents and may have moved hundreds or thousands of miles away from the original issuer of such documents. And certified copies can cost as much as $30 each. That is a lot of money to someone whose income is low enough to qualify for Medicaid coverage.

As a result, state Medicaid officials told the Times, the people most often rejected under this new policy are Americans, while relatively few undocumented immigrants have been found to be receiving Medicaid. In Florida, nearly all of those rejected from Medicaid because they failed to prove citizenship have been American citizens, officials there said. Georgia officials say that 100,000 children are now among the newly uninsured U.S. citizens of that state.

Proof of U.S. citizenship has always been required for Medicaid enrollment. The 2006 federal law merely took away states' discretion in deciding how that citizenship could be proved.

When the Bush administration first proposed this rule last year, we said it would result in thousands of children from low-income families losing access to medical care. In reality, the result has been much worse than what we had imagined it would be. Congress must repeal this law that places an unfair burden of proof on U.S. citizens.