Last year, 17 states increased access to health coverage through expansions or changes in Medicaid and the State Children’s Health Insurance Program, according to a survey from the Kaiser Commission on Medicaid and the Uninsured. In fact, the survey found that for the first time in four years, none of the states cut income eligibility in either program.
However, even though Hawaii, Illinois, and Massachusetts launched major expansions to cover children, and other states took more incremental approaches, the survey signaled a warning. Progress on covering the uninsured could be undercut by provisions of the Deficit Reduction Act of 2005 that established proof-of-citizenship requirements for Medicaid applicants. The survey reported that, since the law took effect in July 2006, several states, including Iowa, Louisiana, New Hampshire, Virginia, and Wisconsin, have reported declining enrollments and processing backlogs in their Medicaid programs. State health officials say it is U.S. citizens and legal immigrants--not undocumented immigrants, for whom the law was intended--who are falling off Medicaid rolls.
“There is no evidence that the [enrollment] decline is due to undocumented aliens leaving the program. Rather, we believe that these new requirements are keeping otherwise eligible citizens from receiving Medicaid because they cannot provide the documents required to prove their citizenship or identity,” Anita Smith, chief of the Bureau of Medical Supports in the Iowa Department of Human Services, said in the survey. Jeff Nelligan, a CMS spokesman, told the Associated Press that the agency has given states flexibility to help applicants establish citizenship and is not aware of substantial enrollment barriers. Read the report.
