Medicaid Citizenship Documentation Requirement Has Devastating Effects, According to George Washington University Study

The citizenship documentation requirement for recipients of Medicaid has now caused enormous harm to America’s Medicaid population. The requirement has resulted in delays and outright denials of coverage for U.S. citizens applying for Medicaid and the loss of Medicaid coverage for U.S. citizens enrolled in the program.

These are the findings of a study based on a recent nationwide survey of federally qualified health centers conducted by the George Washington University’s School of Public Health and Health Services. According to the study, entitled An Initial Assessment of the Effects of Medicaid Documentation Requirements on Health Centers and Their Patients, more than 90 percent of all health centers report increased enrollment difficulties with Medicaid, and “more than one-third report that they have had to increase the amount of staff time available to assist patients with their applications.” This has severely limited Medicaid beneficiaries’ access to quality, efficient medical care, the study says.

The study conservatively estimates that between 2.2 percent and 6.7 percent of the Medicaid population (between 105,100 and 319,500 Medicaid beneficiaries) will lose their health coverage as a direct result of the citizenship documentation requirement. The study also outlines how, as a result of the citizenship documentation requirement, the number of uninsured citizens and the amount of uncompensated care provided by hospitals and other health care providers to low-income individuals will balloon.

The citizenship documentation requirement came about after President Bush in February 2006 signed into law the Deficit Reduction Act of 2005—a scheme to save $40 billion over five years from mandatory spending programs. The U.S. Department of Health and Human Services instituted a new regulation requiring most Medicaid applicants and recipients who claim to be U.S. citizens to prove their citizenship with passports, birth certificates, and other special documents or lose their public health coverage.

The study is available online here. A webcast about the study hosted by the George Washington University School of Public Health and Health Services is available online at the Kaiser Family Foundation’s website, here.