184957 Impact of the New Citizenship Requirements on Receipt of Medicaid in Vulnerable Populations

Tuesday, October 28, 2008: 12:30 PM

Deirdre A. Byrne , The Children's Health Fund, New York, NY
David M. Abramson, PhD MPH , National Center for Disaster Preparedness, Columbia University, New York, NY
Roy Grant, MA , The Children's Health Fund, New York, NY
Arturo Brito, MD , The Children's Health Fund, New York, NY
New citizenship and identification documentation requirements may be a barrier for children and families trying to access Medicaid. The purpose of this study is to describe the impact of federal policy on children's access to Medicaid. The Federal Deficit Reduction Act of 2005 created new enrollment requirements, including providing original citizenship and identification documents. For eligible children in low income families, obtaining original documents may be an economic hardship because of fees, and there may be transportation problems keeping required face-to-face enrollment interviews. We designed a seven question survey to monitor the effects of this policy by interviewing parents of pediatric patients. Items include whether they applied for Medicaid; whether they were denied or granted coverage; whether they were aware of the new policy; and whether the policy discouraged them from applying. The survey was implemented at four mobile medical clinics (in Washington DC, rural WV, Dallas TX and Biloxi MS) during February 2008. These programs serve demographically diverse low income populations, most of whom are Medicaid eligible. Preliminary anecdotal evidence reveals multiple barriers to obtaining Medicaid including potentially punitive policy changes in WV, restrictive enrollment procedures in MS, and an emerging onerous burden caused by the new citizenship documentation requirements. A preliminary review of historical Medicaid data at the implementation time period of the new requirements reveals a dip in enrollment in some states. It is expected that the survey results will elucidate barriers to enrollment and verify that the documentation requirements impede health insurance coverage for eligible children.

Learning Objectives:
Describe problems in their state dealing with Medicaid enrollment. List strategies for improved enrollment procedures. Discuss the affect federal policies have on their patient population.

Keywords: Federal Policy, Insurance-Related Barriers

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: As Director of Policy at the Children's Health Fund, a national non-profit dedicated to providing care to the medically underserved, I identify, analyze and advocate on federal and state policies that may harm vulnerable patient populations. From inception to implementation, I have shaped this research study to better inform federal policy on Medicaid access.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.