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Prepared by
California Immigrant Welfare
Collaborative
and
National Immigration Law Center
Recent news reports
implied that the federal government has a new policy that affects the
newborn U.S. citizen babies of immigrant women who receive Emergency
Medicaid.[1] The articles on Medicaid coverage for these U.S. citizen
infants were confusing and in some cases misleading.
All citizen infants remain eligible for
Medicaid, regardless of the immigration status of their mother. The
question raised is whether some newborns whose mothers are receiving
Medicaid can get coverage automatically, or whether they need to file
their own Medicaid application and proof of citizenship. This issue
brief clarifies the facts concerning coverage of newborns of immigrant
mothers on Medicaid.
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Federal Medicaid law provides that
newborns whose mothers are receiving Medicaid at the time of birth
are automatically eligible for Medicaid and receive immediate and
continuous coverage during their first year of life. Title 42 United
States Code, Section 1396a(e)(4). This law was passed in 1984 with
bipartisan support and remains in effect.
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The only recent change
to federal Medicaid came as part of the Deficit Reduction Act of
2005 (DRA). The DRA did not change immigrants’ eligibility for
Medicaid but required that states must obtain proof of citizenship
from most U.S. citizens who apply for or receive Medicaid. There is
no language in the DRA addressing whether infants born to mothers on
Medicaid can get coverage automatically.
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In July of this year, the federal
government issued interim regulations on the DRA. In the
preamble to these regulations, the administration, through
the Centers for Medicare & Medicaid Services (CMS), stated its
opinion that the U.S. citizen babies of immigrant women with
Emergency Medicaid coverage should not be granted automatic Medicaid
eligibility, but instead must submit an application. As such, CMS
believes that these infants are subject to the citizenship
verification requirements of the DRA and would need to apply for
Medicaid and provide proof of citizenship in order to be covered by
the program.
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Most states apply the longstanding
federal law correctly, by providing automatic or “deemed” Medicaid
eligibility to newborn citizens whose mothers are receiving
Medicaid, regardless of whether the mother is receiving Emergency
Medicaid or full Medicaid coverage.
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However, some states took the
administration’s statements in the preamble to mean that they should
deny automatic eligibility to the U.S. citizen babies of immigrant
women on Emergency Medicaid. Such a practice not only is
inconsistent with longstanding federal law but also has been found
to be unconstitutional. Imposing barriers on access to health
coverage for newborns endangers the health and well being of these
citizen children and increases the risk that simple problems will
become more costly health emergencies.
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Requiring a new Medicaid application
for a newborn based on the mother’s scope of Medicaid coverage
creates an unnecessary barrier to that baby’s ability to receive the
care he or she needs. Application processing delays, the time it
takes to receive a birth certificate, and other factors could
prevent that citizen child from receiving well-baby care and even
more urgent care.
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It is unfortunate that the politics of
immigration are being used to interfere with vital health care
coverage for U.S. citizen newborns. CMS’s preamble language, if
implemented, would threaten the health and safety of vulnerable U.S.
citizen newborns. The preamble’s language was not required by and
has nothing to do with the DRA’s Medicaid citizenship rule. It is a
shameless attack on immigrants’ children that risks individual and
public health.
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