Tension eases over new Medicaid law

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By MARK ANDERSEN / Lincoln Journal Star

Fears have begun easing that a new a rule requiring proof of citizenship in order to receive Medicaid will have a great effect on the poor and clinics that serve them.

Intended to keep illegal immigrants from receiving Medicaid, the primary insurance for the poor, the rule has been widely attacked for possibly harming American citizens who are Katrina victims, mentally ill, have Alzheimer’s disease or  who never received birth documents. The rule becomes effective July 1.

Initially, it appeared all Medicaid recipients would need to show a birth certificate and state-issued photo identification card.

The Medicaid requirement for citizenship isn’t new, said Adolph Falcon, vice president for science and policy at the National Alliance for Hispanic Health in Washington, D.C.

“People always had to be a legal resident in order to get Medicaid.”

The change was that Medicaid would now require paper proof.

Because of the challenges of documenting citizenship, people who claimed citizenship were seldom challenged.

At People’s Health Center in Lincoln, where one quarter of the clientele is Hispanic, the rule appeared to threaten finances, said Cecelia Creighton, center director.

The clinic provides care to many poor pregnant women, she said. After birth, Medicaid paid for their care.

Before, the clinic charged the women a minimum $15 medical fee. After, Medicaid paid the clinic $116 per visit.

“I don’t know where we’ll be able to recoup (that lost $101 per visit),” Creighton said. She didn’t know how many of the clinic’s patients would be affected by the rule.

But it appears the Centers for Medicare and Medicaid Services is having second thoughts about enforcement.

Due to the concerns about the hardship on legitimate citizens, Falcon said, the Centers for Medicare and Medicaid Services is being flexible within the constraints of the law.

A Nebraska Health and Human Services spokesman said last week that officials are still awaiting guidelines that the federal agency promised to deliver two weeks ago.

Originally, the Congressional Budget Office estimated the rule change would affect 35,000 of the many millions enrolled in Medicaid nationwide, Falcon said.

The Office of The Inspector General, meanwhile, estimated that many of those 35,000 could legitimately receive Medicaid.

“There was not widespread fraud,” she said.

Many of the 35,000 would, however, encounter difficulty in finding or obtaining a birth certificate, due to poverty, dementia, hurricane displacement or simply because they were born at home and never issued one.

Reach Mark Andersen at 473-7238 or mandersen@journalstar.com.