Proving your citizenship


A little known provision of a new law could result in a denial of health care benefits to an estimated 50 million Medicaid (California’s Medi-Cal) enrollees. This includes hundreds of residents in nursing homes around the Southland.  With President-elect Donald Trump taking office soon, these issues are sure to be raised again.

On February 8, 2006, President George Bush executed a bill into law (the 2005 Deficit Reduction Act) which now requires recipients of Medicaid (Medi-Cal) benefits to provide either an original birth certificate or passport in order to apply for or to continue to receive their health care benefits, commencing July 1, 2006.

The new law was part of Washington’s efforts to clamp down on illegal immigration by preventing undocumented immigrants from claiming to be citizens in order to receive benefits only provided to legal residents.  With the election of Donald Trump as our next president and his focus on immigrant reform, these issues are poised to be raised again.

In general, Medicaid (Medi-Cal) is available only to U.S. citizens and certain “qualified aliens.” Under the current law, there is no requirement to show proof of citizenship. Unless the claims seemed questionable to state eligibility workers, benefits were provided relying only upon a signature of the applicant to certify whether or not they were American citizens.

Under the new law (the Deficit Reduction Act), states cannot receive federal Medicaid (Medi-Cal) money unless they verify citizenship for people who receive or apply for Medicaid (Medi-Cal). “An applicant or recipient who does not cooperate with the requirement to present documentary evidence of citizenship may be denied eligibility or terminated from Medicaid”.

The Center on Budget and Policy Priorities indicates that this provision will affect 49 million US-born citizens and two million naturalized citizens covered by Medicaid over the course of a year, not including new applicants. Many affected will be illegal immigrants, but some will be citizens unable to present the necessary documents. Some Medicaid experts are estimating that millions of citizens could find their health care in jeopardy.

According to Families USA, a consumer advocacy organization, the disabled, the mentally ill, the homeless, the elderly and the chronically ill will unfairly suffer as the result of this new law, as they would have difficulty accessing copies of birth certificates, and would be far less likely to own a U.S. passport. Therefore, they will be unfairly denied necessary health care beginning as early as July 1st.

The law specifies documents that can be used to establish citizenship. This documentation will be required for every new determination of Medicaid once implemented. The following documents are said to meet “satisfactory documentary evidence of citizenship or nationality:”

- A birth certificate from the US

- A US passport

- A Certificate of Naturalization (Form –550 or –570)

- A Certificate of US Citizenship (Form –560 or –561)

- A valid state driver’s license or other state ID document that requires proof of citizenship or a valid Social Security number

- Certification of Birth Abroad (Form FS-545 or Form DS-1350)

- US Citizen Identification Card (Form t-97)

- Report of Birth Abroad of a Citizen of the United States (Form FS-240)

- An identity document as described specifically in the Immigration and Nationality Act

- Another document the Secretary of Health and Human Services (HHS) may specify by regulation that requires proof of US citizenship or nationality and that provides a reliable means of documenting personal identity

But, you might say, “I don’t ever plan to go to a nursing home!” Well, my advice is, find or obtain your birth certificate anyway. You never really know what tomorrow may bring. Maybe your kids will have the time (and/or inclination) to take of you, maybe they won’t.

Even if you stay at home, or perhaps go to an assisted living or retirement home, you can still benefit from Medi-Cal if you are paying several hundreds of dollars or more a month in prescription drugs and medical “co-pays,”. “Say what? I thought Medi-Cal was only for nursing homes?” Not so. You can qualify for and obtain Medi-Cal benefits even if your staying at home. i.e., “community-based” Medi-Cal to pay for prescriptions, procedures, and help with daily activities.

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Elder Law Services of California is proud to announce that attorney Andrew Paranal has joined its trust department.   Mr. Paranal began his career in estate planning in 2013 and has since expanded into asset protection and Medi-Cal planning.  He became interested in Elder Law after helping care for a family member who experienced a debilitating event.  Mr. Paranal is excited to join an established law firm and hopes to educate his Filipino community about the tremendous benefits of proper estate planning.

For more information, please visit elderlawcalifornia.com or call 1-800-411-0546

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