WASHINGTON, Jan. 5 /US Newswire/ -- A bill nearing final passage in Congress that would cut programs such as Medicaid, student loans, and child support enforcement contains a little- noticed provision that would require all citizens applying for Medicaid to produce a passport or a birth certificate to prove they are US citizens. The new rule also would apply to all citizens currently receiving Medicaid when they seek to renew their Medicaid eligibility, which in most cases must be done every six months. The requirement will take effect July 1 if the House approves the bill, which is scheduled for a vote on the House floor on February 1.
Roughly 49 million low-income Americans, including 12 million African Americans - and 800,000 elderly African Americans -- would be subject to the new requirement between July 2006 and June 2007. Many of these people lack passports and do not have birth certificates in their possession. Medicaid applicants who have neither of these documents could find that their Medicaid coverage is denied or seriously delayed; current Medicaid beneficiaries who have neither of these documents could lose their Medicaid coverage.

Americans are at special risk. Many elderly African Americans have no birth certificate: they were born in a time when racial discrimination in hospital admissions kept their mothers from giving birth at a hospital, so their birth often was not officially registered.

One study estimated that about one in five African Americans born in the 1939-40 period lack a birth certificate.

"This ill-conceived requirement would exacerbate a historical legacy of discrimination and could cause many elderly African Americans to lose access to health care," stated Leighton Ku, a senior fellow at the Center and co-author of the report.

Also at special risk are:
-- people whose personal documents have been destroyed by disasters like Hurricane Katrina (many of whom are African American);

-- people who have a sudden medical emergency but cannot get their documents quickly (some states take a month or longer to provide a duplicate birth certificate when one is requested); and

-- people who are homeless, mentally ill, severely disabled, or in nursing homes.

The new rule provides no exceptions, even for people who are extremely old or have severe impairments, such as Alzheimer's disease.