New Medi-Cal rules may oust patients
By Nick Casey
May 24, 2007


Health care administrators on the Coastside are expressing confusion about a federal mandate meant to prevent illegal immigrants from receiving state-sponsored treatment.

Starting this summer, new patients applying for Medi-Cal coverage will need to provide proof of U.S. citizenship or other identification showing that they qualify for treatment.

The new rule is aimed at blocking unqualified patients, most notably undocumented immigrants, from applying for treatment under state-run insurance programs that receive federal funding. Approved identification - including passports and Social Security cards - will be required for all new patients.

But beyond that, much is uncertain - including when the new rules will begin and what is to become of patients unable to immediately produce the information. The lack of administrative guidance has left local clinics in the dark.

"We haven't received anything in writing," said Cecilia Murillo, the spokeswoman for the Coastside Family Medical Center. "No word, no consultation."

The clinic, which treats about 8,300 patients on the Coastside, serves more than a third of its patients through Medi-Cal funding. Although only incoming recipients would fall under the new rules, Murillo had misgivings about unintended consequences, even among immigrants currently thought to qualify.

"It's going to put a lot of fear into immigrants and migrant workers," she said. "Just the fact that (the government) is starting to request documentation is enough to worry people. The last thing we need is for people to be scared to go see their own doctor."

Cathy Senderling, a legislative advocate for the County Welfare Directors Association, said her group has been rushing to prepare county health agencies. She said that implementation is expected this summer but she, too, remains unclear about the start date.

The Medi-Cal program provides health insurance benefits to low-income individuals and families. Medicare, a federal program based on age requirements, already requires proof of citizenship and will not be affected by the new laws.

It's not yet certain how many people will be affected by the change. The CWD estimates that 6.5 million people would be required to provide proof of citizenship, a number which experts anticipate will fall by at least two-thirds as counties use internal verification methods, such as previous Social Security records on file, to verify a patient's citizenship.

Still, Senderling foresees that some groups, particularly the elderly Medi-Cal recipients and new patients with mental impairments, may eventually be caught in the red tape.

"Many of these people may be unable to locate the documents to prove their citizenship," she said.

Jennie Loft, the spokeswoman for the San Mateo County Human Service Agency, said the county is also concerned about enforcing the new rules but plans to conform with federal mandates as more information arrives.

For her part, Murillo said the clinic won't be rewriting its policies right away.

"We're not changing our procedures," she said. "Not until we have something in writing."

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