NCPA - National Center for Policy Analysis


April 19, 2006

The New York Times on Sunday examined a new federal law that will require individuals seeking health care through Medicaid to show proof of U.S. citizenship -- such as a birth certificate, passport or another form of identification -- beginning on July 1.

The requirement was included in the Deficit Reduction Act of 2005, which President Bush signed into law earlier this year. The provision's intent is to prevent undocumented immigrants from claiming to be citizens in order to receive benefits only provided to legal residents. Under federal law, undocumented immigrants can receive only emergency care through Medicaid.

  • The Congressional Budget Office estimates that the requirement will save the federal government $220 million over five years and $735 million over 10 years.
  • CBO says that by 2015, about 35,000 people -- mostly undocumented immigrants -- will lose coverage because of the new requirement.
  • However, the Center on Budget and Policy Priorities estimates that three million to five million low-income citizens could lose Medicaid coverage because they do not have birth certificates or passports.

Critics say the provision is misguided and will serve as a barrier to health care for otherwise eligible United States citizens. They say that many older African-Americans who never received birth certificates and homeless people without access to documentation could lose coverage.

"We are working with states to develop a policy to accommodate the needs of special groups of Americans who may not have traditional government-issued birth certificates," says Mark McClellan of the Centers for Medicaid and Medicaid Services.

Source: Robert Pear, "Medicaid Hurdle for Immigrants May Hurt Others," New York Times, April 16, 2006.

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