nothin Bureaucracy Gone Wild | New Haven Independent

Bureaucracy Gone Wild

New federal regulations requiring those now on Medicaid or applying for the program to show proof of citizenship could create bizarre scenarios that would be funny — if they weren’t threatening to the health care of thousands of people in Connecticut, including children and pregnant women. Gary Spinner, who is both chief operating officer of the Hill Health Center and a physician assistant at the clinic on Columbus Avenue (pictured here with a patient), is one of many health care providers trying to convince the feds to ease up.

The Hill Health Center was one of dozens of Connecticut agencies and organizations that wrote to the government to explain some of the hardships that their patients would face if the new regulations stand. (Even though the effective date of the legislation was July 1, agencies have not implemented the new rules yet because a comment period in which modifications can be proposed just ended Aug. 11.)

According to the new regs, Spinner said, Anybody who applies for Medicaid or is up for redetermination has to provide proof of citizenship. They must show original documentation, either a birth certificate or passport. This was introduced by two Texas Republicans because of the backlash about undocumented people receiving Medicaid fraudulently. But the Government Accountability Office was unable to verify there was any problem of any scope in which the undocumented received Medicaid. In Connecticut, there are no documented cases of undocumented people receiving Medicaid.

The real travesty is that there are many people who receive Medicaid who don’t have an original birth certificate, like some elderly African-Americans who are originally from the South, who may have never gotten one, and many people have never owned a passport. Nonetheless, they are required to produce this documentation. The federal regulations are very strict in saying that failure to do so makes them ineligible for Medicaid until that takes place. The ramifications are huge — pregnant women might have to go without prenatal care; people may experience interruption in medications.” Connecticut Voices for Children says that one in 12 low-income adults born in the U.S. have neither a birth certificate nor a passport.

Many top state officials also criticized the changes, which would affect 300,000 citizens in the state. One letter protesting the changes came from Connecticut Department of Social Services (DSS), the agency responsible for verifying recipients’ or potential recipients’ original documentation.

Medicaid is funded 50/50 by the federal and state governments; states must abide by these regulations passed by Congress in order to receive their 50 percent federal reimbursement.

Theoretically, a lot of the verification could be done on-line, but there are holes in existing computer data bases that make that impracticable right now.

Click here to read a fact sheet from Connecticut Voices for Children that includes some of the outlandish scenarios that could be involved if the regulations stand, such as thousands of people swamping state offices to present their birth certificates or a Medicaid recipient mailing in a driver’s license to prove her identity and then not being able to legally drive until the license is returned.

The new law does not apply to certain eligible legal immigrants, who are already required to document their immigration status.

Advocates for the poor are hoping their suggestions for alternative documentation will be heard in Washington, which will issue final regulations at some date in the future.

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