HCFA Confirms Only Applicants for Medicaid Need Provide an SSN or Disclose Immigration Status

IMMIGRANTS & PUBLIC BENEFITS

Health Care

HCFA CONFIRMS ONLY APPLICANTS FOR MEDICAID NEED PROVIDE AN SSN OR DISCLOSE IMMIGRATION STATUS
Immigrants' Rights Update, Vol. 12, No. 7, October 26, 1998

The Health Care Financing Administration (HCFA) recently issued a letter to state health officials addressing two eligibility-related issues in the Medicaid program: (1) who is required to provide a Social Security number (SSN) when an application is made; and (2) how (and whether) non–U.S. citizens are to provide evidence verifying their immigration status. The letter clarifies that only applicants can be required to provide an SSN and verify their immigration status. Nonapplicant family members cannot be required to do so.

With regard to Social Security numbers, the letter states that only applicants for and recipients of Medicaid benefits must supply an SSN. In all other cases, including nonapplicant parents of children applying for Medicaid and children applying for a separate (non-Medicaid) state Child Health Insurance Program (CHIP), states are prohibited from making the provision of an SSN by another family member a condition of the child’s eligibility. This also applies to other members of the household whose income might be used in making the eligibility determination concerning the child. The letter clarifies that states have no legal basis for denying an application based upon a failure to supply the SSN for verification purposes.

With regard to the verification of immigration status, the letter states that children who are U.S. citizens and who are applying for either Medicaid or a separate state CHIP program may establish their citizenship by declaring that they are U.S. citizens. However, states are permitted to require further verification as a condition of eligibility. Children applying for either program who are qualified aliens must present documentation of their immigration status, which states must verify using systems established for that purpose. The citizenship or immigration status of nonapplicant parents (or other household members), however, is irrelevant to their children’s eligibility. States may not require that parents disclose this information.

The letter notes that from a programmatic point of view, asking nonapplicants for their SSNs or evidence of immigration status may discourage immigrant parents (who may not wish to disclose information about themselves) from applying for benefits on behalf of their children who are U.S. citizens. When this occurs, the children are denied access to medical care they both need and are eligible to receive under the law.

[Letter from HCFA Director Sally K. Richardson to State Health Officials (Sept. 10, 1998).]