An unintended consequence?
I received this from Chicago ADAPT. It’s pretty scary!
New Medicaid law is called a threat
Illegal immigrant fraud was target
By Judith Graham
Tribune staff reporter
No one has been able to figure out when Kevin Harris was born or
where. This blind, mentally impaired man has told the Cook County public
guardian he doesn’t know. Public-records searches have come up empty.
Until now, this hasn’t been a problem for Harris, who depends on
Medicaid, the nation’s largest health-care program, for medical care and his
community-based living arrangement.
But come Saturday, Harris’ setup could be jeopardized. That’s
the startup date for a controversial law that requires as many as 50 million
Medicaid recipients to prove they are U.S. citizens by providing passports,
birth certificates, driver’s licenses or other documents to authorities. All
new applicants also have to provide proof of citizenship before their
request to join Medicaid is considered.
As a result of the new law–an effort to keep illegal immigrants
from finding their way onto the Medicaid rolls–consumer advocates warn that
many vulnerable Americans could lose or be denied Medicaid coverage.
Especially at risk, they say, are seniors in nursing homes, the
severely disabled, children in foster care, the homeless, African-Americans
and Native Americans born outside of hospitals and Hurricane Katrina
evacuees who have lost personal records.
Harris, believed to be about 42, doesn’t have any of the papers
the government says it needs to establish citizenship. Efforts to find a
birth certificate in Illinois, where he was adopted, have failed. His state
identification card was stolen years ago. He doesn’t have a passport. And
the public guardian’s office says it knows of no relatives or close
associates who could tell the circumstances of his birth.
“The horrible thing is these people have lived in this country
all their lives, and no one would question that they’re Americans, but they
don’t have the ability to provide the documentation,” said Cook County
Public Guardian Robert Harris.
The controversy over the new Medicaid law is an offshoot of the
national debate over illegal immigration, and it shows how social policy is
being influenced by that discussion.
The intent of the law, signed by President Bush in February, is
to prevent illegal immigrants from obtaining medical care through Medicaid
by falsely claiming to be U.S. citizens, explained John Stone, spokesman for
Rep. Charles Norwood (R-Ga.), a leading sponsor. Only U.S. citizens and some
legal immigrants are eligible to receive Medicaid benefits.
“Medicaid programs across the country face a funding crisis, and
the feedback we’re getting is that a lot of the financial pressure is coming
from illegal immigrants,” Stone said.
Not so, consumer groups counter, citing a June 2005 report from
the U.S. Department of Health and Human Services’s inspector general that
found no evidence of widespread citizenship fraud in Medicaid.
But the potential for fraud exists, the report acknowledged,
because 40 states allow Medicaid applicants to assert they are citizens
without providing any proof. An additional six states often allow similar
assertions. Only Georgia, Montana, New Hampshire and New York have
documentation requirements.
“The problem is, the enforcement of existing regulations has
been almost non-existent,” said Rep. Nathan Deal (R-Ga.), another key
sponsor.
That may argue for vigilance by state Medicaid authorities. But
it doesn’t make sense to subject 50 million current Medicaid members to
burdensome new requirements, said John Bouman, advocacy director at
Chicago’s Sargent Shriver National Center on Poverty Law.
Many states, including Illinois, don’t have adequate staff to
take on new administrative tasks, he argued.
Gov. Rod Blagojevich is concerned about the new federal
regulations and “raised the issue today with the Illinois congressional
delegation,” said spokeswoman Christine Glunz on Tuesday. If states don’t
meet the law’s requirements, the government will cut off financial support
for Medicaid.
What happens next is uncertain. Government guidelines issued
earlier this month indicate that current Medicaid recipients will get some
time to obtain documents, but it’s not clear yet how long that will be.
Consumer advocates had hoped the guidelines would be flexible,
but they’re “incredibly prescriptive and burdensome,” said Stephanie Altman,
policy director with Chicago’s Health & Disability Advocates. Her group and
four others plan to file a legal challenge to the new law Wednesday in U.S.
district court in Chicago.
The new requirements are going to make things hard for another
ward of the Cook County public guardian, Alocia Brown, who officials think
was born in 1930 or 1931 in Arkansas. State officials there have conducted a
statewide search for birth records for Brown, to no avail.
Brown’s driver’s license is expired, and her Social Security
card doesn’t count as proof of citizenship under the new Medicaid law. Brown
has end-stage Alzheimer’s disease, and she won’t have any way to pay for her
nursing home care if her Medicaid application is denied.
This is pretty scary, and shows how innocent folks can get caught up in an unintended legal “sweep”. Hopefully, lawmakers will add some provisions to the bill that will protect people like those in the article. I’ll keep a watch on this.