Published November 26, 2006
--------------------------------------------------------------------------------

New Medicaid rule hits few

ADAM WILSON

Despite predictions of widespread problems, relatively few people - about 200 - have lost their state health care coverage because of a federal rule requiring them to prove they are Americans.

Critics say the low numbers show the rule wasn't necessary in the first place.

Medicaid, the state's health program for the poor, always has required people to swear they are citizens or permanent legal immigrants. But a law passed by Congress in 2005 requires the nearly 1 million people in Washington who use the program to prove their status with documentation.

"They're really going to be hurting people born in this country," said Tony Lee, advocacy director for the Freemont Public Association.

He and others warned when the law took effect this summer that few illegal immigrants try to sign up with a government program, while many Americans - American Indians or elderly blacks, for example - would have a tough time coming up with a birth certificate, the most common type of proof of citizenship.

"If the question is, 'Is it easy to get onto this program as an immigrant?' the answer is no," Lee said. "Citizens who were trying to get on the program - the department sort of took your word for it. We take these things for granted. How many of us carry our birth certificates with us, or know where they are?"

Politicians' views

Gov. Chris Gregoire blasted the requirement. Other lawmakers, such as Sen. Alex Deccio, the lead Republican on the Senate Health Care Committee, said it was reasonable to demand proof before providing services with tax money.

Doug Porter, who leads the agency in charge of Medicaid, said the proof requirement has not booted off as many clients as he expected, but it has been just as much work.

"We're actually starting to fall behind because we're only up to 22 (additional) staff. I remain convinced that this was a solution in search of a problem," Porter said.

Significantly, the state was able to verify the citizenship of about 400,000 Medicaid clients by checking their information against a Department of Health database of birth certificates, Porter said. The state is processing citizenship verification for 9,000 clients and 2,000 applicants each month, he added.

Catch-up needed

"We've been able to use technology and our relationships with other state agencies to avoid a flood of paperwork and get through this," Porter said. He added that will take a year and $5 million to catch up with the existing clientele.

There are 862,000 Medicaid clients in Washington, two-thirds of them children, plus another 113,000 people receiving family planning services that face the same requirements. About 29,000 people in Thurston County use Medicaid.

The state Medicaid administration decided it would not deny service to people while they looked for missing citizenship documentation, and Porter credited that approach with limiting the dropoffs.

There was no pattern among the 200 people who have lost their Medicaid eligibility, Porter said. He explained they "either weren't interested in taking the trouble, or didn't get back to us" with proof of citizenship.
http://www.theolympian.com/112/story/52589.html