Medicaid's Citizenship Documentation Requirement

Improvements in Medicaid’s Citizenship Documentation Rule

"A key provision of the Children’s Health Insurance Reauthorization Act (CHIPRA) is helping to reduce the detrimental effects of a Medicaid citizenship documentation requirement enacted in 2006 that has caused many eligible citizen children, pregnant women, and parents to lose or be denied health coverage. The CHIPRA provision gives states the option of meeting this requirement by conducting a data match with the Social Security Administration’s database to verify an applicant’s U.S. citizenship. States that have taken up this option, which became available on January 1, report that it eases the paperwork burden on families applying for coverage, simplifies enrollment procedures, and produces significant administrative savings.

"The new health reform law requires states to use this data-matching system to verify citizenship for people who seek coverage in the new health insurance “exchanges” that will be established. The early success of this system suggests that it will work well when individuals apply for subsidies and health coverage through the exchanges. This system also can help states coordinate the eligibility determinations they will conduct for Medicaid, CHIP, and the new health reform subsidies."  Read more


Under a federal requirement that took effect in 2006, most U.S. citizens applying for Medicaid or renewing their coverage must prove their citizenship by submitting a passport or a combination of a birth certificate and an ID.  This new requirement was intended by its sponsors to keep illegal immigrants from fraudulently enrolling in Medicaid.  Yet its main impact is likely to be to impede or delay coverage for significant numbers of eligible U.S. citizens, many of whom lack the required documents.

By the Numbers

Graphic: Percent of U.S.-Born Adults With at Least One Child Who Has No Passport of Birth Certificate Available
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