Community Health Center Snapshots Profile Impact of Medicaid Documentation Requirement:  MARIPOSA COMMUNITY HEALTH CENTER, NOGALES, ARIZONA

The Mariposa Community Health Center, which is located in Nogales, Arizona, serves 21,305 patients, providing approximately 100,000 visits each year, 90 percent of whom are Hispanic/Latino, and most of whom are women and children.  Six thousand patients are Medicaid enrollees, 8,300 are Medicaid users, and 6,500 are uninsured. Jim Welden, executive director of the center, notes that in Arizona, the requirements have not changed substantially because the state’s web-based enrollment system has always mandated citizenship verification and documented proof of eligibility for coverage.  However, concern about the new federal law and about how information may be used is keeping people away.  “We have parents who are illegal and children who are legal, and the parents don’t want to apply for SCHIP for their children, for example.  They’re afraid it will compromise their own status,” notes Welden.  “Without coverage, the economic barrier to care persists.”  The requirements have increased the health center’s administrative obligations, though they’ve been able to absorb the additional burden, for now.  Additionally, the center staff has observed a drop in women coming in earlier for prenatal care. Says Welden, “We’ve been able to absorb the increased demand… but we are spending a lot of time reassuring people.  We’re really worried about the people who are not coming in.”