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New Medicaid Documentation Requirements (Deficit Reduction Act)

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Previously, states were required to get a written declaration, under penalty of perjury, stating whether an individual was a citizen or U.S. national for that individual to be eligible for Medicaid. If an individual declared that he or she is a citizen or national, the state was not required to obtain additional documentary evidence.

Under the Deficit Reduction Act, states must now require all current and new Medicaid beneficiaries applying as citizens to provide proof of identity and their citizenship through a birth certificate or passport. Participants would also have to produce identification, such as a driver’s license.

New Medicaid Documentation Requirements as of 07/01/06
All new Medicaid applicants and all current Medicaid beneficiaries who have not previously proved their citizenship status or identification must produce acceptable documentation.

Now exempt from these rules are those receiving or who have received SSI benefits, those receiving Medicare, those applying for or receiving BadgerCare Prenatal Program benefits, and those applying for or receiving Emergency MA.
Acceptable Documentation of Proof of Identity & U.S. Citizenship Status

Any one of the following will be accepted:
• U.S. Passport
• Certificate of Naturalization
• Certificate of U.S. Citizenship
OR
Any one of the following will be accepted:
• Birth Certificate in the U.S.
• Certification of Birth Abroad
• U.S. Citizen ID Card
• Report of Birth Abroad
Plus
• Additional Personal ID (e.g., a driver’s license in states that require proof of citizenship)
• Other documentation the HHS Secretary specifies

Minors can use school I.D. cards with photos. For children under 16, identity can be proven through the use of a signed Statement of Identity for Children Under 16 Years of Age.
Fact Sheets & Forms
WI Medicaid and BadgerCare Citizenship and Identity

Statement of Identity for Minors

Statement of Citizenship and/or Identity for Special Populations

US Citizenship Documentation Requirements Letter
US Citizenship Documentation Requirements Letter - Spanish

DHFS DRA Operations Memo 06-32

DHFS DRA Operations Memo 06-36
To obtain documentation and a copy of your birth certificate, contact your County's Register of Deeds.

If you were born outside of Wisconsin, please contact the National Center for Health Statistics to get a copy of your birth certificate.
Who it impacts: There are an estimated 885,000 citizens in Wisconsin who are enrolled in Medicaid over the course of a year and thus will be required to produce these documents.

To date, a total of 14,034 individuals have been terminated or denied Medicaid and BadgerCare participation solely because of the federal documentation requirements. DHFS data shows that 69% of the denials and terminations were solely because of failure/inability to provide identity documentation.

DHFS has stated that they've budgeted $1.8 million in excess funding to comply with new requirements.
Other Organizations Addressing New Documentation Requirements and Reports Analyzing DRA's Impact

WI Covering Kids & Families
WI Council on Children & Families
Center on Budget & Policy Priorities

George Washington University School of Public Health and Health Services
Legislative Proposals to Address DRA
H.R. 210 would exempt all children born to women on Medicaid from the citizenship documentation requirement during their first year of life.

H.R. 1238 would have the effect of permanently exempting all children born to women on Medicaid form teh citizenship documentation requirement by allowing a state's own Medicaid records to serve as proof of citizenship in cases where a child's birth is paid for by the program.

H.R. 1328 would require additional documentation options for federally recognized Indian tribes.
S. 751 would required deemed eligibility and separate identification numbers for children born to noncitizen mothers on emergency Medicaid. It would also permanently exempt all children who are deemed eligible for an automatic year of coverage from the citizenship documentation requirement and allow states to provide retroactive eligibility for newborns who were previously denied.

H.R. 1535, S. 895, and S. 909 would make Medicaid citizenship documentation a state option. They would also permanently exempt all children who are deemed eligible for an automatic year of coverage from the citizenship documentation requirement, allowing states to provide retroactive eligibility for newborns who were previously denied.
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