The DRA also included new rules on citizenship verification. Prior to the DRA, all but four states allowed beneficiaries to self-attest to their citizenship status. Under the DRA, Medicaid and CHIP applicants now have to prove their citizenship status by providing original or certified copies of citizenship documents, such as a U.S. passport, state-issued driver’s license, or birth certificate.

The exact requirements depend on what type of document is submitted. Subsequent laws eased this burden by giving states the option to conduct a data match with the Social Security Administration’s database to verify citizenship. Under the ACA, the matching system must be used to verify citizenship for individuals purchasing insurance in an exchange. These rules were intended to ensure that only eligible beneficiaries received Medicaid benefits. Many individuals have had difficulty obtaining access to these documents and as a result were dropped from the program despite being eligible.

Do you think these rules are a good idea? Do you think this requirement is a reasonable burden? Does it matter that evidence was not available to support the claim that noncitizens or ineligible immigrants were accessing Medicaid benefits? Or, is the possibility that ineligible immigrants might enroll in Medicaid concerning enough to warrant the new documentation requirements?