Impact of Medicaid Documentation Requirements

The federal Medicaid policy documentation reforms enacted in July 2006, which require Medicaid applicants to provide evidence of citizenship or legal U.S. residence and personal identity have had an enormous impact on community health centers and their patients. To better understand the scope of the impact, the RCHN Community Health Foundation supported a study on the effects of the reforms conducted by The George Washington University (GWU) School of Public Health and Health Services. The preliminary findings, released in May 2007, revealed the requirements are disrupting coverage for hundreds of thousands of health center patients, while delaying enrollment in Medicaid for potentially hundreds of thousands more.

GWU is now in the process of repeating the survey in order to provide updated results in fall, 2007, when House and Senate Conferees are expected to consider legislation that could ease the requirements.

The case studies collected as part of the preliminary survey show that the rules are adversely affecting patient care at health centers for insured and uninsured patients, citizens and non-citizens. Patients are facing barriers to continued access, and centers are experiencing the financial fallout.