Medicaid Documentation Requirement

MEDICAID DOCUMENTATION REQUIREMENT -- (Senate - June 29, 2006)

Mr. DURBIN. Madam President, it has been less than 4 months since passage of the Deficit Reduction Act. That bill cut Medicaid health benefits for our Nation's low-income children, seniors, pregnant women, and people with disabilities.

One provision of the bill requires Medicaid beneficiaries to present a passport or birth certificate as proof of citizenship before they are eligible for benefits or to renew their benefits.

All States had the legal authority to require beneficiaries to furnish these documents before we passed the Federal law. However, 47 States have made the decision not to require that identification of Medicaid recipients.

Many low-income Americans don't have these documents, and most States have decided that requiring them would create a hardship and a barrier to health care for some of the poorest people in America.

Instead, States allowed written self-declaration of citizenship and had what are called prudent person policies in place if State personnel were suspicious and wanted further proof.

The inspector general of the Department of Health and Human Services conducted a review of these self-declaration policies and found that most States that conducted post-eligibility quality control measures have not found any problems with self-declaration of citizenship. The system was working.

Nevertheless, Congress passed the documentation requirement which will go into effect on Saturday, only 3 weeks after the Department of Health and Human Services sent guidelines out to the States. That is hardly adequate time to implement a very difficult provision.

This is going to hurt a lot of vulnerable Americans. Foster children who met citizenship requirements to enter the foster care system will have to go out and prove that they are Americans.

The 850,000 Alzheimer's patients on Medicaid will have to somehow locate these documents or run the risk of losing Medicaid protection.

Nursing home residents, 75 percent of whom have some cognitive impairments, such as Alzheimer's or Parkinson's or dementia, are going to have to come up with citizenship documents or be cut off from Medicaid.

For example, Kevin Harris, who lives in Chicago, is blind and mentally impaired. Kevin does not have a birth certificate, and his legal guardian does not know where to begin looking because Kevin doesn't remember where he was born. As of Saturday, Kevin will have to find his birthplace or he will become ineligible for health benefits when it comes time to renew.

At the very least, States should have more time to work with these unfortunate individuals who are struggling with serious medical illnesses. Throwing these paperwork requirements at people who are struggling to live day to day is not right.

The Akaka bill, sponsored by the Senator from Hawaii, which I am proud to cosponsor, will allow States to delay implementation of this rule until January 31 of next year. It will give them an additional 6 months to at least get this in place. That will give all of those involved time to figure out how to avoid letting people like Kevin Harris lose health care protection in America.

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