Agencies unite for the needy
Various groups aim to ensure that a new law will not deprive Medicaid recipients of benefits
Nearly 40 government and community organizations are working together to make sure no Hawaii Medicaid or QUEST recipients lose benefits because of a new federal law.
The law, which went into effect July 1, requires all people who renew or apply for the health insurance programs to show proof of U.S. citizenship and photo identification.
About 204,000 low-income adults and children statewide receive Med-QUEST health insurance.
The state Department of Human Services, which operates the Med-QUEST Division, is urging all recipients to check their mail this month for a letter regarding documents they may need to verify their identity and citizenship.
"If we need documents, the letter will provide details and ask the recipient to call 211 for more information," said state Human Services Director Lillian Koller.
Advocates on the mainland are challenging the federal law, saying millions of low-income citizens could become uninsured.
A class-action lawsuit was filed in U.S. District Court in Chicago against U.S. Health and Human Services Secretary Mike Leavitt, charging that the citizenship-proof requirement puts an undue burden on beneficiaries.
"In Hawaii, we're not letting that happen," said Barbara Luksch, Hawaii Covering Kids project director, who heads a task force organized to help Hawaii's 204,000 low-income Med-QUEST recipients retain their benefits.
Hawaii Covering Kids has worked since 1999 to simplify the eligibility process and enroll children in free health insurance programs.
About half of Hawaii's recipients are children, primarily in low-income families, she said.
States that don't implement the documentation requirement for Medicaid risk losing matching federal funds, Luksch said.
About 8 million people considered the most vulnerable will be exempted from the new requirements, according to 92 pages of interim rules issued Thursday by the Centers for Medicare and Medicaid Services. The public has 30 days to comment before final rules are issued.
Luksch said the task force is meeting this week to discuss the issues and get people to comment on the interim rules.
Those exempted include about 6 million people who qualify for both Medicare and Medicaid, and another 2 million aged and disabled people who get an income supplement, called Supplemental Security Income, that helps them meet basic needs.
But foster kids weren't exempted, Luksch pointed out, and Hawaii has about 2,500. "They may have immediate health care needs and to be eligible for Medicaid, they have to find a birth certificate and photo I.D."
Luksch said the task force began meeting in April to try to find where documents exist and link to data systems "so people don't have to go on scavenger hunts to get hard copies."
The Department of Human Services and the task force have helped Med-QUEST establish data links with the Social Security Administration, state Department of Health Vital Records, the Attorney General's state identification office and other agencies where information may be recorded to prove citizenship.
Recipients also must prove who they are through photo identification, Luksch said. People with state identification or driver's licenses can offer such proof, but children and youth have no photo identification, she said.
Consequently, free document sites were set up where people can take photos in and a third party (doctor, nurse, school, community health center or agency) can confirm that is the person in the photo.
Case workers and social workers also are going to care and nursing homes and taking pictures of recipients that an agency can verify, Luksch said.
The Department of Human Services said Med-QUEST is working with many agencies to contact recipients via health fairs, hospitals, community health centers, doctors' offices, pharmacies and other places.
The department also will initiate a public awareness campaign to reach people through direct mail, news releases, Internet postings and media advertisements.
The U.S. Centers for Medicare & Medicaid Services, Region IX in San Francisco, said there are many ways U.S. citizens can satisfy the citizenship regulations so they don't lose access to Medicaid.
Documentary evidence can include a U.S. passport, certificate of U.S. citizenship, state birth certificate, report of birth abroad of a U.S. citizen or certification of birth aboard, a U.S. citizen I.D. card, an American Indian card issued by the Department of Homeland Security, a final adoption decree, evidence of U.S. civil service employment before June 1976, military service records and a Northern Mariana Identification Card.
Among other documents that could be offered as evidence are life, health or other insurance records showing a U.S. birth place; admission papers from a nursing home, skilled nursing care facility or other institution; and medical cards indicating a U.S. birth.