New federal requirements could cost Medicaid beneficiaries their insurance

Governor addresses U.S. Department of Health and Human Services

[JUNE 29, 2006]  CHICAGO -- In a letter Wednesday to Mike Leavitt, secretary of the U.S. Department of Health and Human Services, Gov. Rod R. Blagojevich presented his concerns regarding the new federal rules requiring proof of citizenship for Medicaid beneficiaries. The new guidance issued by federal Central Management Services on June 9 strictly requires Medicaid participants to show documentation of both identity and citizenship, effective July 1.

"I have made protecting, preserving and expanding access to affordable health care my top priority," Blagojevich said. "The new federal rules regarding proof of citizenship could result in senior citizens, children and working adults who meet Medicaid's eligibility criteria losing their health care. I am sure there is a way to meet the goals of the federal government without unnecessarily and unduly punishing those who need and merit access to affordable health care."

Over the past 2 1/2 years, the Blagojevich administration has worked to expand health care coverage for low-income working parents and their children. As a result of the governor's expansions to the state's health care programs, 400,000 more children and parents in Illinois have received coverage, and Illinois is now ranked by the Kaiser Family Foundation as the second-best state in the nation for providing health care to children who need it and first in the nation for providing health care to adults who need it.

The text of the governor's letter follows:

Dear Secretary Leavitt:

As Governor of the State of Illinois, I have made protecting, preserving and expanding access to affordable health care my top priority. I am writing to you today because I am concerned that the new federal rules regarding proof of citizenship could result in senior citizens, children, and working adults who meet Medicaid's eligibility criteria losing their health care nonetheless. That is something we cannot allow here in Illinois, and one I am sure you don't want to see occur anywhere in the United States.

The new guidance issued by federal Central Management Services on June 9, 2006, requires Medicaid participants to show documentation of both identity and citizenship. While I agree that only persons who qualify for Medicaid should receive its benefits, there is little evidence that people are being dishonest about being citizens of the United States when they apply. But there is ample evidence that the new federal rules will result in many people in Illinois losing access to affordable health care for no good reason.

The Department of Homeland Security estimates that approximately 60 million Americans, or just over 20 percent of Americans, have passports, and the prevalence is likely much lower for those in Medicaid. Many people do not have actual birth certificates, but only a commemorative certificate from the hospital. Many senior citizens, particularly African-Americans, were born at home and do not have a birth certificate. Still others may have been issued a birth certificate but lost it over the decades. I am sure there is a way to meet the goals of the federal government without unnecessarily and unduly punishing those who need and merit access to affordable health care.

We would like to work with you to devise a responsible, safe plan that will address those who falsely claim U.S. citizenship without penalizing those who are U.S. citizens but do not have the documents you now require. Possible solutions include a new time frame for implementing the rules, ways to develop and use new forms of electronic documentation, and other methods to give people a chance to prove their citizenship without losing their health care.

In the meantime, I trust you will understand that I cannot justify denying or canceling Illinoisans from Medicaid coverage solely for failing to produce documents proving their citizenship.

Thank you for your time and consideration.

Sincerely,

Rod R. Blagojevich
Governor

[News release from the governor's office]