Senate Democrats

Setting the Record Straight: The Real Effect of Citizenship Documentation Requirements in the CHIP Reauthorization Act of 2009

This week, the Senate is expected to consider the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIP Reauthorization Act of 2009) (S.275), which will renew and expand the Children’s Health Insurance Program (CHIP) to cover nearly 11 million kids. CHIP provides health insurance coverage to children in low-income families who do not qualify for Medicaid and would otherwise be uninsured. The program was created 12 years ago and by every measure is a cost effective and successful way to meet the basic health care needs of our nation’s children.

Unfortunately, early indicators suggest that instead of focusing on the purpose of the CHIP Reauthorization Act of 2009: to provide better health care coverage for our nation’s children in need, some Senate Republicans are planning to engage in the politics of fear and division by suggesting erroneously that the legislation makes it easier for undocumented immigrants to obtain public health care coverage and attempting to burden the bill with anti-immigrant amendments. To those who would stand in the way of providing quality health care for America’s children: Senate Democrats, like-minded Senate Republicans, and the American people say, "enough."

Last November, Americans voted for change, a change from the partisan politics of the past to the common purpose of the future. At a time when our nation’s families are being stretched thin by fewer resources and greater costs, ensuring that kids still have adequate access to quality health care is a goal that all Senators, on both sides of the aisle, should be working towards achieving.

Dispelling Key Myths about the CHIP Reauthorization Act of 2009 and Citizenship Documentation

The continued success of the Children’s Health Insurance Program (CHIP) is too important to the health our nation’s children to let stand myths and half-truths about who will be covered. Senate Democrats are committed to setting the record straight.

Myth:Citizenship documentation requirements, like presenting valid, government-issued photo identification, make it more difficult for undocumented immigrants to take advantage of health care programs, such as CHIP and Medicaid.

Fact:In reality, citizen documentation requirements only make it more difficult for U.S. citizens to participate in CHIP and Medicaid. Reports by GAO, the Congressional Research Service, the Kaiser Family Foundation, the Commonwealth Fund, and numerous states have shown that tens of thousands of eligible U.S. citizen children have been denied coverage over the last several years as a result of the citizenship documentation requirement. A study by the Brennan Center for Justice, revealed that as many as seven percent of U.S. citizens did not have ready access to government-issued photo identification or U.S. Passports, naturalization papers or birth certificates. This number almost doubles for citizens who are considered lower-income.

At the same time, states implementing the citizenship documentation requirement have discovered that very few undocumented immigrants actually try to receive benefits.

Myth:The new citizenship documentation requirements contained in the CHIP Reauthorization Act of 2009 will make it easier for undocumented immigrants to obtain benefits.

Fact:The new citizenship documentation requirements contained in S.275 do not entitle undocumented immigrants health care benefits. Undocumented immigrants have never been eligible for CHIP or Medicaid coverage. The CHIP Reauthorization Act of 2009 maintains and restates this prohibition. Furthermore, it extends the citizenship documentation requirements to CHIP for the first time.

S.275 simply gives states a new option, via the Social Security Administration, to meet citizenship requirements. The legislation reforms the ineffective and burdensome citizenship documentation requirement that has prevented thousands of U.S citizen children from getting health care coverage.

Myth:Including the Social Security Administration (SSA) provision weakens thecitizenship documentation requirements.

Fact:Actually, the SSA provision gives states an extra tool for verifying eligibility for CHIP.States that select the new option will submit the names and Social Security numbers of all applicants for Medicaid and CHIP who declare they are U.S. citizens to the Social Security Administration (SSA).  SSA will check the information received from the states against the SSA database and determine whether the name and Social Security number match and whether the SSA database confirms citizenship. If SSA cannot confirm the applicant’s name, number and citizenship, the individual will have to provide the state with original documents, such as a birth certificate or passport, to prove his or her citizenship.

Myth:There are hundreds of undocumented immigrants currently enrolled in Medicaid and CHIP programs.

Fact:In reality, abuse of healthcare benefits by undocumented immigrants is neither systemic nor widespread. A GAO study found that six states implementing the citizenship verification requirement spent $8.3 million to find only eight ineligible immigrants in a caseload of 3.65 million, yielding a "savings" of $11,048. Meanwhile, in the process, tens of thousands of eligible U.S. citizens, primarily children, were denied access to health coverage because of this burdensome new requirement.

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