Two Reports Analyze Medicaid Citizenship Requirements

Today Oversight Committee Chairman Waxman released two new analyses that examine the impact of the Medicaid citizenship documentation requirements that went into effect in 2006. A GAO analysis shows that the requirements have caused eligible U.S. citizens to lose Medicaid coverage, and a report by the Committee's majority staff shows that the new requirements have not achieved the goal of saving taxpayers money.

GAO Report: Citizenship Documentation Requirement (pdf) >>

Summary of GAO and Staff Findings (pdf) >>

From the summary, on the majority staff's findings:

The staff analysis finds that the DRA documentation requirements have cost significantly more to implement than they have saved in expenditures by excluding undocumented immigrants from Medicaid coverage. For every $100 spent by federal taxpayers to implement the new requirements in six states, only 14 cents in Medicaid savings can be documented.

From the summary, on the GAO's findings:

" The new requirement is leading to declines in Medicaid coverage for eligible U.S. citizens. Half the states reported declines in Medicaid coverage due to the requirement. According to a majority of these states, the individuals losing coverage appear to be eligible U.S. citizens.

" The total number of eligible U.S. citizens being turned down or losing coverage may be large. Only a few states reporting declines were able to quantify the loss of eligible citizens. One state, in the first seven months of implementation, identified 18,000 individuals whose applications were denied or who lost coverage due to inability to provide the necessary documentation, even though the state believed them to be eligible citizens. Of the 22 states reporting a decline in enrollment, 17 expect the downward trend to continue.

" All states reported increased administrative burdens and costs to implement the requirement. All 44 states reported that additional administrative measures were necessary to comply with the requirement, including training of Medicaid agency staff, community agencies, and providers and expansion of staff capacity. One state reported a 60% increase in phone calls, a 1,000% increase in voice messages, and an 11% increase in the length of calls. For fiscal year 2007, ten states appropriated a total of $28 million to cover the additional administrative costs.

" Fiscal benefits to federal and state governments are unclear. Only one of the 44 states reported potential savings due to reductions in coverage for individuals who were ineligible due to their citizenship status. The remaining states expected no savings or reported that it was too early to know.