Medicaid modifications leave many uninsured
Published: Wednesday, January 10, 2007 at 6:01 a.m.
Last Modified: Tuesday, January 9, 2007 at 11:04 p.m.
WASHINGTON — For several years, there has been a steady increase in the number of children enrolling in Virginia's health insurance program for the poor. Beginning July 1, state officials say, an unprecedented slide began.
Over the following five months, about 12,000 children dropped off the state's Medicaid rolls.
"An entire year's growth has been wiped out," said Cynthia Jones, chief deputy director for the state's Department of Medical Assistance Services.
The drop-off, Jones points out, began about the time a new federal law took effect. The law states that U.S. citizens applying for Medicaid or renewing their participation must present proof of their citizenship and identity. The law emerged out of concern that illegal immigrants were obtaining access to health insurance coverage sponsored by the government.
But some officials say that's not who is losing coverage.
Besides Virginia, some other states are also reporting declines in children enrolled in Medicaid or a decline in applications. They include Iowa, Louisiana, New Hampshire and Wisconsin. Health researchers say they don't know if the states are representative of a nationwide pattern.
The states singled out as experiencing enrollment declines were included in a report issued Tuesday by the Kaiser Family Foundation, which conducts health research, and by the Center on Budget and Policy Priorities, a liberal think tank.
The states experiencing declines are adamant that U.S. citizens and certain legal immigrants are dropping off the Medicaid rolls, not illegal immigrants.
"There is no evidence that the decline is due to undocumented aliens leaving the program," said Anita Smith of the Iowa Department of Human Services. "Rather, we believe that these new requirements are keeping otherwise eligible citizens from receiving Medicaid because they cannot provide the documents required to prove their citizenship or identity."
Medicaid is a health insurance program serving about 55 million people that is financed by the federal government and the states. The declines cited would indicate that just a fraction of the people enrolled in the program have dropped out as a result of the documentation requirements, but they do represent vulnerable populations, such as pregnant women and children.
"We've delayed coverage for those children, and if those children need medical care, there's going to be ramifications for them," said Donna Cohen Ross, outreach director for the Center on Budget and Policy Priorities.
After Congress passed the documentation requirements, Medicaid officials released rules that established which documents would suffice in meeting the law.
Primary evidence, namely a U.S. passport or a certificate of U.S. citizenship, is considered the ideal. Secondary evidence or lower-tier evidence must be accompanied by a document showing identity. Such evidence includes birth certificates, insurance records, and written affidavits.
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