All states were required to begin implementing a new federal law on July 1 of 2006. This law, a provision of the Deficit Reduction Act of 2005, requires U.S. citizens to present proof of their citizenship and identity when applying for or seeking to renew their Medicaid coverage.
It has been nine months since the law has gone into affect and the reports from states have been shocking. States are saying that they are seeing a dramatic decrease in Medicaid enrollment particularly among low income families. States are also reporting
that they are seeing a significant increase in administrative costs as a direct result of the new requirements.
Kansas Governor Kathleen Sebelius, has recently said that the states enrollment has declined by 18,000 people since the citizenship documentation has taken affect. Sebelius says that many of these people are likely citizens who simply lack the documents and who may now experience a harmful gap in health insurance coverage.
The law states that when applying or renewing for coverage you must be able to provide one of the following documents: U.S. Passport, Certificate of Naturalization, Certificate of Citizenship. If you do not have any of those then you must provide
one document for citizenship and one document for identity. For citizenship you must provide: a birth certificate or birth record, adoption records showing place of birth or military record. For identity you will need one of the following: Drivers License, Federal, State or Local ID, Military ID, Native American Tribal Document.
The law states that everyone who coverage is applied for must show proof of identity and citizenship, to include children. The above lists is fine for citizenship but for identity a minor will need one of the following: School ID, School Records, Licensed or registered daycare documents, Medical records.
With all the new documents being required it has put an overload on an already taxed system. The Kansas Health Policy Authority (KHPA) says that their work load has more than doubled with no assistance being offered from the federal government. On a normal month KHPA's Kansas Family Medical Clearinghouse will receive 23,000 customer service calls. Now since the implementation of the new law the calls have swelled to 49,000. Voicemail has increased from 1,200 to 11,00 and faxes have gone up to 6,000.
The clearinghouse reports that the time to collect, match and verify the documents has more than doubled and is throwing a clog into the system. The system is now back logged by almost four months.
KHPA is taking steps to try to speed the process up. They have instituted and electronic matching for people who are applying and are born in Kansas with the Kansas Department of Vital Statistics. This does not help those who are born out of state. If you are born out of state you must contact that states office of vital statistics. From there you will need to pay a fine for your birth certificate and wait until it arrives in the mail. This process is just another thing adding to the time it takes to reapply.
Megan Ingmier of KHPA says that the clearinghouse is trying to work with applicants as much as it can. She says that if applicants can prove that they are trying to get the required documentation than they will keep your application on hold so you do not have to start all over.
"We encourage people t get their documents before the apply, it is a real benefit to do that," said Ingmier.
Many states are asking the Federal Government to examine this law. States are saying that this law-created by the House of Representatives-i s putting unneeded financial stress on families that are already financially stressed.
Documentation costs money and likely there will be some medical expenses that come up while waiting for approval. These cost will have to be paid out of funds that are used to support the family therefore causing problems in other areas.
KHPA has asked the state government for assistance with the overload of work. They requested $1,000,000 to help fund the hiring of 17 new people for fiscal year 2008.
Ingmier says she hopes to see a decrease in waiting times.
Kansas isn't the only state seeing the affects of the new law. In Virginia there has been a drop of 12,000 children from the Medicaid enrollment. Iowa, New Hampshire, Wisconsin and Louisiana have all shown similar decrease.