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Groups challenge Medicaid citizenship law
Wed Jun 28, 2006 3:24pm ET

By Kim Dixon

CHICAGO (Reuters) - Low-income citizens backed by anti-poverty groups filed a proposed class action on Wednesday, challenging a federal law requiring proof of citizenship in exchange for benefits under the government's Medicaid health insurance program for the poor.

Critics say the law, set to go into effect July 1, will hurt the vulnerable who may be unable to provide original documents like birth certificates. Those most in jeopardy are those in nursing homes, with mental and physical disabilities, and the victims of natural disasters, the critics contend.

The proposed class-action lawsuit, filed in U.S. District Court in Chicago, argues that the law unconstitutionally violates the Fifth Amendment's due-process guarantee by arbitrarily requiring documents and imposing deadlines.


"This law throws out a dragnet and says: 'All of you, all 50 million of you, have to come document your citizenship, whether we think you are a problem or not,'" said John Bouman, a lawyer at the Shriver Center on Poverty Law in Chicago, which filed the lawsuit on behalf of nine people.

The suit names Michael Leavitt, secretary of the U.S. Department of Health and Human Services, as defendant. Mary Kahn, a spokeswoman for the health agency, said the allegations overstate the potential for people to be denied coverage.

She cited a recent government analysis finding "about 35,000 people might be at risk of losing their current benefit. The assertion that there are 50 to 55 million people at risk is grossly overestimated," Kahn said.

She noted the agency's flexibility, including letting states in some circumstances accept sworn affidavits to prove citizenship.

Health and Human Services has no data suggesting the Medicaid system is being abused by illegal immigrants, and Kahn referred questions to the Congressmen who pushed the law.

Plaintiffs want the court to temporarily suspend the law while it considers the suit. They also contend the law puts an onerous burden on states, which must comply to keep federal funds.

"Medicaid coverage will be delayed or denied for many," according to a recent analysis by the nonprofit Kaiser Family Foundation. "Obtaining required documents may be difficult and costly for low-income citizens," the report found.

About 55 million people receive health care benefits under the state-administered Medicaid program.

The consumer group Families USA called the law a political ploy as lawmakers debate potential measures to deal with the 11 million to 12 million illegal immigrants believed to live in the United States.


"There is a political factor in all of this. We are in the middle of a very contentious debate on illegal immigration," said Ron Pollack, executive director of Families USA.

He pointed to a recent analysis by the Center on Budget and Policy Priorities, which found between 3 million and 5 million Medicaid recipients might not be able to produce the proper identification and could lose benefits.

One of the lawsuit's plaintiffs is 95 year-old Ruby Bell, who was born in 1911 in Arkansas and who has no birth certificate.

Bell now lives in a nursing home in Northern Illinois, but the county she came from did not start keeping certificates until 1914 and she might not be able prove citizenship under the law, Bouman said.

Medicaid recipients are now required to be U.S. citizens, but documentation is only required of those under suspicion.