300,000 people + no birth certificate = no Medicaid

[dragonlady]

On the NPR newscast today I heard that 300,000 people can't get approved or re-enrolled for Medicaid because although they would be eligible they don't have birth certificates to prove that they're citizens. This comes about because of a law passed last year that restricts Medicaid to citizens (more below about that).

A disturbing thought: This proves that a lot of people can't come up with a birth certificate even when their health care and perhaps their life is at stake. If the Real ID with its document requirements isn't repealed by next year, how many people won't get a driver's license and will fall into the spiral of fines for driving without one and then jail and job loss? And how many then won't have the photo ID that Republicans keep pushing in order to prevent "voter fraud"? Their argument is that bringing in a photo ID is simple ("you need one to rent a movie") so what's the big deal? The 300,000 people who can't qualify for basic health care from their government show that things aren't always as simple as they seem.

Back to the Medicaid problem: This law, part of the Deficit Reduction Act signed February 8, 2006, is another monstrosity created by the Republican-controlled Congress and affects 50 million people. Here are some choice tidbits from a report written at the time:

Once they took effect on July 1, 2006, these new requirements would apply to all applications or redeterminations of eligibility that occurred after that date, without any exceptions even for people who are extremely old or have severe physical or mental impairments, such as Alzheimer’s disease. In the following six to twelve months after July 1, 2006, states would have to check citizenship documents for more than 50 million beneficiaries. This would constitute a significant new administrative burden for state and local agencies. ...

Birth certificates may have been lost over the years in which people move from one home to another; in some cases, as explained below, individuals may have been born outside a hospital and no birth certificate may have been issued. Those who may be harmed include:
People who have a sudden emergency and need Medicaid coverage immediately but cannot get these documents quickly (some states take a month or longer to provide a duplicate birth certificate when one is requested);
Those who are homeless, mentally ill, or suffering from senility or a disease such as Alzheimer’s, and who may not be able to secure a birth certificate (or even to recall where they were born);
People who are in nursing homes or are severely disabled, and would have difficulty getting access to their birth certificates; and
Those affected by disasters like Hurricanes Katrina or Wilma who have lost most of their possessions and records....

In some cases, people may have never been issued a birth certificate because they were born at home and their birth was not officially registered. A particular problem exists for a large number of elderly African Americans because they were born in a time when racial discrimination in hospital admissions, especially in the South, as well as poverty, kept their mothers from giving birth at a hospital. One study estimated that about one in five African Americans born in the 1939-40 period lack a birth certificate because of these problems. ... Thus, this new provision would exacerbate a historical legacy of discrimination and could lead to a large number of elderly African Americans losing access to health care.

http://www.cbpp.org/1-5-06health.htm

This sounds bad, but hey, we have to reduce the deficit some way, right?