White House eases Medicaid proof-of-citizenship rule


By Robert Pear
New York Times

WASHINGTON -- The Bush administration said Thursday that it would exempt millions of the most vulnerable Medicaid recipients from a new law that requires them to prove they are U.S. citizens by showing birth certificates, passports or other documents.

The action was apparently intended to pre-empt a ruling by a federal judge who is scheduled to hold a hearing today on a lawsuit challenging the new requirement, which took effect Saturday.

Dr. Mark B. McClellan, administrator of the Centers for Medicare and Medicaid Services, said more than 8 million of the 55 million Medicaid recipients would be "exempt from the new documentation requirements" because they had established their citizenship when they applied successfully for Medicare or Supplemental Security Income.

Medicaid provides health insurance for low-income people, including many in nursing homes. Medicare provides health insurance for people who are 65 and older or disabled. Supplemental Security Income is a cash assistance program for people with very low incomes who are old or disabled. About 6 million people receive Medicare and Medicaid. In most states, people receiving Supplemental Security Income are entitled to Medicaid.

An estimated 800,000 low-income Hoosiers would be affected by the new law, state officials said.

McClellan said the exemption would apply, for example, to "people with mental retardation who have never worked and to many nursing home residents." Critics of the new law had said it would be difficult for many people with mental impairments to produce the documents needed.
Under the law, anyone who has or applies for Medicaid must present "documentary evidence of citizenship." Previously, more than 40 states had accepted the applicants' written statements as proof of citizenship unless the claims seemed questionable.

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