Archive for Tuesday, November 28, 2006

Disabled, needy bear new burden of proof

Citizenship documentation needed to retain coverage

November 28, 2006


— Thousands of low-income and disabled Kansans have lost or been denied health care coverage since new rules took effect that require documented proof of U.S. citizenship, according to state officials.

In addition to the loss of benefits, the federal verification rule is a bureaucratic nightmare, officials said.

"The impact to the consumer has been severe," said John Anzivino, a vice president and project manager for Maximus, the company that provides administrative services to the state for Medicaid and HealthWave.

"From our perspective, this has possibly been the most dramatic change and challenge to the Medicaid program since its inception," Anzivino said in recent testimony to a state legislative committee.

Since this summer when the new rules took effect, the number of beneficiaries in Kansas has dropped from 271,000 to 253,000 - a reduction of 18,000 people.

Officials couldn't provide an exact figure of how much of the reduction was attributed to the citizenship documentation requirement, but they said much of it was.

The requirement was part of last year's federal deficit reduction law. It was seen as a way to prevent illegal immigrants from enrolling in the state's federally funded programs that provide health care to the disabled and needy.

But consumer advocates said many vulnerable people who legitimately were eligible for assistance would lose coverage because they couldn't produce the necessary documentation.

"We expect that many of these that have lost coverage will regain coverage once they have gathered and provided the necessary documentation," said Marcia Nielsen, executive director of the Kansas Health Policy Authority. "They will, however, experience a gap in coverage that could prove to be significant for some."

And, she said, the reduction in caseload caused by the requirement may result "in a shortfall in the estimation of funds necessary to run the program next year."

Each person applying for benefits now must submit one primary document proving citizenship, such as a passport, or two secondary documents: one verifying citizenship, such as a birth certificate, and one verifying identity, such as a driver's license or school identification card.

"As you might imagine, most of our consumers don't have a passport," Anzivino said. "Therefore they are left scrambling to come up with birth certificates and one of the federally accepted identification documents."

The number of customer service calls each month to the Kansas Family Medicaid Clearinghouse has more than doubled from 23,000 to 49,000, the number of voice mails has increased tenfold and faxes have doubled, officials said.

U.S. Rep. Dennis Moore, D-Lenexa, whose district includes eastern Lawrence, said federal officials were aware of states' problems with the new rules and probably would work on it when the new Congress takes office in January.

"I opposed the legislation that included this mandate, which is already adversely affecting thousands of Americans," Moore said. "I am working with my colleagues to address this problem so that we are not excluding those who need our help the most."


6mom 11 years, 6 months ago

I understand the need for this, however my children have been denied health coverage due to a recent move and the inability to locate the birth certificates. Oh, by the way in 2 days. That did not even give me time to order new ones. Then when I tried to call them all I got was a busy signal. This system is a mess.

alm77 11 years, 6 months ago

I wouldn't think getting copies of Birth certs would be that difficult or take that long. Honestly, I'm a huge advocate for helping low income families, and I don't think these requirements are that hard to meet. There are several agencies that would be available to help those who find the requirements "a huge barrier". C'mon people, this isn't too much to ask when you are getting FREE health care. I've been there and I can tell you that if I were still in that situation, these requirements wouldn't stop me from getting my kids the protection they need.

Bobo Fleming 11 years, 6 months ago

Well some of your young urban types might not know this but some of our elderly people were born at home and did not apply for a birth certificate. Things were a little casual then.

KansasKel 11 years, 6 months ago

It actually isn't that easy to get copies of birth certificates - you have to pay about $15 for each one, and it takes several weeks unless you go straight to Topeka and wait for it to be processed in the office. If you're a low-income family, $15 per child isn't easy to come up with (for me, it would cost $60 to have my kids' birth certificates printed). Also, they won't accept Social Security cards as a form of ID, but they will accept immunization records, which doesn't make sense to me because it would be just as easy to forge immunizations as SS cards, probably easier, I would think.

I gathered all their requested paperwork, sent it, then called to verify that they had received it, and still ended up with a lapse in coverage. It took me over three months to get the mess cleared up when I did what they wanted to begin with - it must be a lot harder when you don't have what they want!

I don't know what the solution is. And I agree that when you're getting free or reduced cost health care you should be willing to do whatever is asked...but somehow it needs to be streamlined.

Linda Endicott 11 years, 6 months ago

When I applied for my driver's license (back in the dinosaur days), I didn't have a certified copy of my birth certificate from Topeka. Back then, no one saw the need for one. I did have a copy of my birth certificate from the hospital, and they took that.

But they won't now. You have to have a certified copy or nothing.

When I was on disability, I had an entire $25 to spend on groceries each week. I ate lots and lots of cheap cereal and cheap lunchmeat. $15 for a certified copy of my birth certificate would have really put me in a bind. There was no spare money at the end of the month.

A lot of people act as if people on disability are just living it up on endless money. They give you a pittance, if that much.

skewed_veiw 11 years, 6 months ago

I feel strongly that disabled needy bears should have to show proof of citizenship to receive assistance. We can't have cripple-up, broke-dick, foreign bears coming over here and sucking up all the money we put aside for our own bears.

Godot 11 years, 6 months ago

Why in the world does the State charge to make a copy of a birth certficate? That should be a free service.

skewed_veiw 11 years, 6 months ago

Why should I have to have a birth certificate? I have a belly button, isn't that proof of birth right there?

Katara 11 years, 6 months ago

Why should I have to have a birth certificate? I have a belly button, isn't that proof of birth right there? ~~~~~~~~~~~~~~~~~~~~ Depends. Are you an innie or an outie?

SpeedRacer 11 years, 6 months ago

When I first glanced at this headline, I thought it was a story about a disabled, needy bear.

Linda Endicott 11 years, 6 months ago

I can see where you'd be confused, Speed...

Godot 11 years, 6 months ago

"Why should I have to have a birth certificate? I have a belly button, isn't that proof of birth right there?"

Only if it is stamped in indelible ink with the name of the country of origin.

Sigmund 11 years, 6 months ago

A little bit of whine with that taxpayer provided free cheese?

KS 11 years, 6 months ago

It's about time. This is better than a fence.

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