April 2006

What is the most important change in the Medicaid legislation as a result of the Deficit Reduction Act?

There are a large number of changes that have important consequences for both physical and mental health service delivery for children, adolescents and their families. However, the change that most concerns Medicaid Directors is the requirement that all children and adults must present proof of citizenship or demonstrating that they are here legally in this country if they are not citizens. This requirement pertains to both people who are first applying for Medicaid and who are going through eligibility re-determination. All must present one of three documents to satisfy the new rule:

• A non-expired US passport or
• A birth certificate and a current photograph or
• A “Green Card” that demonstrates that they are in this county legally.

The concern is that people will not have these documents immediately available and thus will not be able to apply for the first time or reapply on a timely basis. Medicaid Directors are anticipating that people will fall off the Medicaid program and the number of uninsured individuals will increase in their state as well as nationwide.