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Saturday, April 15, 2006

Medicaid recipients must prove they are U.S. citizens

New I.D. requirement for medicaid coverage starts July 1, 2006

The Deficit Reduction Act, which was signed by the President on February 8th, contains a provision that will require most new applicants, as well as most current beneficiaries at re-determinations, to document their citizenship (only aliens who are Medicare enrollees and SSI beneficiaries would be exempt). Documentation includes a U.S. passport, birth certificate or driver’s license from a state that verifies social security numbers.

What is the problem with our entitlement programs?

The biggest challenge to the budget is mandatory spending - or entitlement programs like Medicare, Medicaid, and Social Security. Together, these programs are now growing faster than the economy and the population - and nearly three times the rate of inflation. By 2030, spending for Medicare, Medicaid, and Social Security alone will be almost 60 percent of the entire Federal budget. The annual growth of entitlement programs needs to be slowed to affordable levels, but these programs do not need to be cut. Through reforms that will reduce the annual growth of mandatory spending, the Deficit Reduction Act saves taxpayers nearly $40 billion over the next five years - about $300 per taxpayer.

According to a report by the National Policy Institute citing Center for Immigration Studies, illegal aliens receive more than $26.3 billion in federal services while paying only $16 billion in federal taxes, creating a net fiscal deficit of about $10.3 billion. The figures for 2002 are from a report published by the Center for Immigration Studies in 2004. ( Steven A. Camarota, The High Cost of Cheap Labor: Illegal Immigration and the Federal Budget, Center For Immigration Studies, August 2004.)

Using the California figure ($3,823 per immigrant household) as a proxy for the national average, the National Policy Institute estimated that the state and local deficit attributable to illegal aliens is approximately $15 billion (3.8 million households X $3,823 per household.) The total (federal, state, and local) deficit attributable to illegal aliens is therefore $25-$10 billion (federal) and $15 billion (state and local).

What is the current system in place?

Most states currently allow citizen applicants to self-attest, under penalty of perjury, that they are citizens. States are allowed to ask for proof of citizenship if they have any reason to question the applicant’s truthfulness, but, statistical data is not available as the the frequency that proof of citizenship requests occur.

What does this mean for current and future entitlement recipients?

It is imparative that recipients get thier documents in order. If one is currently enrolled, or is going to enroll for entitlements in the future, one will need either a passport or birth certificate (or in the cases of states that verify social security numbers, a drivers license). Perhaps it is time for national security card as proof of citizenship.

The new requirements will be imposed on all citizens who apply for or are already receiving entitlements. At present, there appears to be no exceptions, regardless of an individual’s physical or mental condition.

Are there potential problems asking for proof of citizenship?

Congressional Budget Office (CBO) estimates that this provision would result in a loss of coverage for 35,000 Medicaid enrollees. Many low-income Americans do not have such documentation in their possession and may find their Medicaid coverage delayed or denied altogether while they attempt to obtain it from the state agency that maintains vital records. Birth certificates may have been lost over the years in which people move from one home to another; in some cases individuals may have been born outside a hospital and no birth certificate may have been issued.

Those who potentially may be harmed by the proof of citizenship requirement include:

People who have a sudden emergency;

Those who are homeless, mentally ill, or suffering from senility or a disease such as Alzheimer’s, and who may not be able to secure a birth certificate (or even to recall where they were born);

People who are in nursing homes or are severely disabled; and

Those affected by disasters like Hurricanes Katrina or Wilma who have lost most of their possessions, documents, and records.

One can only hope that the government will allow alternative methods of proof for those affected. The main point of this legilation is to provide\deficit reduction and to weed illegals out of the budget. It is shocking that it has taken this long to start regaining control of a broken system.


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