State law could be keeping citizens from getting benefits
East Valley Tribune
Sept. 21, 2007


Mary K. Reinhart

Tucson, Arizona | Published:

More than 3,000 Arizonans lost public health insurance in the past year because they couldn't prove U.S. citizenship, though it's unknown how many, if any, were in this country illegally.

Now advocates worry that eligible families will be denied food stamps and cash assistance under a state law that takes effect today and applies the same requirement to those benefits.

Already, Arizona taxpayers have spent more in administrative costs than they've saved in reduced Medicaid expenses since the federal law was implemented in June 2006.

A recent federal audit showed most states are in the same boat, and nearly half report enrollment declines caused by denying coverage to eligible citizens.

The Arizona Health Care Cost Containment System, the state's Medicaid program, continues to grow, but there are concerns that the documentation requirements are preventing eligible people, including U.S.-born children of foreign-born parents, from getting health-care coverage. The new state law will have the same result when it comes to food stamps and cash benefits to families with children.

"We think there are a lot of people who may not even be applying because they don't think they can get the papers together," said Kim Van Pelt, health policy director for the Children's Action Alliance.

The state law, passed in the final hours of the legislative session, gives applicants 30 days to provide proof of citizenship, such as a birth certificate or passport, to qualify for food stamps or Temporary Aid to Needy Families.

Like the federal Medicaid requirement, it's intended to ensure that illegal immigrants don't receive benefits. But state and federal officials acknowledged last year that the Medicaid rule would likely snag others who could not produce the required documents.

In Arizona, 3,188 people insured under AHCCCS have so far been denied coverage because they lacked the necessary documents.

Another 623 new applicants have been turned down for the same reason.

"In terms of who they are, we don't have information on that," said Tom Betlach, deputy director for AHCCCS. "In most cases, it's as if, at some point in time, they gave up. They didn't come back to the office."

The numbers are small in relation to the AHCCCS population, and compared to many other states, who report tens of thousands of people have lost coverage. Advocates generally praise AHCCCS for its efforts to keep people insured.

"The problem isn't our state. It's the law itself," Van Pelt said. "It's addressing a problem that didn't exist in a heavy-handed way." Taxpayers spent $10.4 million in state and federal funds to hire eligibility workers to help prove citizenship for the 1 million Arizonans on AHCCCS. Given the average cost of $260 per AHCCCS member per month, the saving under the federal requirements amounts to just under $10 million.

In the past, applicants for public benefits in Arizona and most other states were required to sign an affidavit swearing they were U.S. citizens. State workers routinely checked Social Security numbers against a national database and required additional documentation only in special circumstances.

The state law, part of an 11th-hour compromise between the Republican-controlled Legislature and Gov. Janet Napolitano, a Democrat, came with no money.

"It was explained to us as part of the budget deal and Proposition 300 cleanup language," said Sen. Debbie McCune-Davis, D-Phoenix. "So none of those things set off alarm bells."

Proposition 300, passed by voters in November, blocked illegal immigrants from child care, state-funded programs and in-state tuition at community colleges and public universities.

About 85 state employees were hired last year to help people find the necessary paperwork, scouring medical records and databases.