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Thousands At Risk Of Losing Medicaid

Federal Law Now Requires Proof Of Citizenship; State Under Pressure To Comply

March 20, 2007
By ANN MARIE SOMMA, Courant Staff Writer

Maria Villasenor is a sickly 2-year-old who could lose her health care coverage if her mother doesn't find her birth certificate.

Under new rules imposed by a federal law meant to block illegal immigrants from receiving Medicaid benefits, U.S. citizens are now required to produce birth certificates proving their citizenship before they can access benefits.

Maria's mother, Sandra Romero, 25, of Meriden, said she enrolled her three children in the state's Medicaid/HUSKY program in 2004. This month, when she went to renew their benefits through the state Department of Social Services, she learned she needed a certified copy of Maria's birth certificate from Texas, where she was born. Romero has the birth certificates for her two other children, born in Meriden.

Romero said obtaining her daughter's birth certificate from Texas has been difficult and time-consuming. Houston's bureau of vital statistics is the largest registration district in Texas. It receives 4,000 calls for birth certificates per month and 3,000 mail requests per month, according to the bureau.

A birth certificate request takes about six to eight weeks to process. A birth certificate sent via Federal Express costs $45. Only walk-in customers are issued certificates the same day.

Romero said she has thought about going to Texas but can't make the trip.

"I've tried to get my family in Texas to get me the birth certificate. I would like to go to Texas, but it takes three days of travel. My daughter has allergies and breathing problems. She is always seeing a doctor," Romero said.

The DSS says there are 10,000 Medicaid recipients like Maria in the state who are at risk of losing their health care coverage because of the new federal mandate.

Another 3,387 people who've applied for Medicaid coverage for the first time won't receive benefits until they produce the correct documents.

Presently, the state is not terminating benefits as long as applicants are trying to get the necessary documents, but state officials say thousands will lose their benefits in the months to come.

"DSS' main goal is to help clients meet the documentation verification requirements," Matthew Barrett, a spokesman for the agency, said. "Connecticut faces disenrolling thousands of cases in the next several months. ... However, the federal law is clear and noncompliance is not an option over time."

Some states, such as Wisconsin and Ohio, have terminated Medicaid coverage for those who don't comply with the new federal rule, which took effect July 1 under the federal Deficit Reduction Act of 2005.

DSS began experiencing a steady backlog of Medicaid applications shortly after the rule went into effect in July.

The number of overdue pending applications increased from 1,566 in June 2006 to 3,387 in February, according to the state agency.

For applicants renewing their benefits, the number increased from 7,336 to 17,521 during the same period.

The agency has taken several steps to stem the tide of backlogged cases, but the numbers continue to increase.

DSS Commissioner Michael P. Starkowski recently asked that pending applications in Bridgeport and Waterbury be reviewed to determine the barriers clients are experiencing.

DSS is also mailing brochures explaining the new requirement to Medicaid recipients one month prior to their renewal date.

DSS and the state Department of Public Health are trying to develop a system to verify citizenship for Medicaid recipients born since 1988. Gov. M. Jodi Rell's proposed budget for DSS calls for six additional workers to deal with the backlog of applications.

The federal law mandates that states require applicants to present proof of their citizenship when they apply for federal benefits. Prior to the law, U.S. citizens applying for benefits were permitted to attest to their citizenship.

"We haven't found a high rate of denials because people are faking their citizenship. It's a solution to a problem that doesn't exist," said Sue Greeno, access to care director at Community Health Center in Middletown.

Democratic Sen. Toni Harp, D-New Haven, said the citizenship requirement is an added burden to a system that's already overwhelmed.

"We didn't have adequate staff before this requirement," Harp said.