New state rules are requiring all Medicaid recipients – including newborns and nursing home residents – to show photo identification to get health care.
The federally mandated rule could create barriers to health care for children, the elderly and disabled, advocates for the groups say.
The requirements, adopted May 12, require anyone applying for Medicaid to provide either a passport or a birth certificate and driver’s license or state-issued photo identification card.
“We’re going to see a big problem in Colorado” as people go without medication and those who care for the indigent go without payment, said Deb DeBoutez of the Colorado Coalition for the Homeless.
Denver Health estimates the rules will create a $12 million loss in Medicaid reimbursements, said Dr. Patricia Gabow, the hospital’s chief executive.
Even state officials who wrote the rules see problems.
“The idea of a newborn baby having a photo ID, it just kind of boggles the mind,” said Barbara Prehmus, director of the state’s Medicaid program.
Medicaid, the state and federal health-care program for poor children, the elderly and the disabled, covers an estimated 400,000 people, Prehmus said.
About 60 percent of the recipients are children.
“What everybody is frankly hoping for is that there will be federal guidance that interprets these things maybe not as strictly,” Prehmus said. “In the meantime, we have to comply with federal law.”
Medicaid also pays for about six of every 10 nursing home patients, according to the Colorado Health Institute.
It is unlikely nursing home patients with dementia or advanced Alzheimer’s have driver’s licenses, said Linda M. Mitchell, head of the Alzheimer’s Association of Colorado. “Hopefully they haven’t been driving for some time.
“And they’re not in any condition to be taken down to the motor vehicle department to get a state ID,” she said. “For a confused elderly person to be put through that, that’s just wrong.”
Many elderly people born in rural areas may never have been issued birth certificates, Mitchell said.
The rules apply to people applying for Medicaid for the first time and to those who are already enrolled but have to re-apply annually.
The requirements are part of federal Deficit Reduction Act, which slashed $39 billion over five years from programs including Medicaid, Medicare and student loans.
Citizenship or legal residency has always been required to receive Medicaid. The act merely changes the requirements for proving legal status.
“It’s U.S. citizens who are going to have difficulty complying with this,” said Elisabeth Arenales of the Colorado Center on Law and Policy.
The rules will take effect July 1. State officials, Prehmus said, will be meeting with advocates for Medicaid recipients to look for “some nuance or some wiggle room” in the rules.
Staff writer Karen Augé can be reached at 303-820-1733 or kauge@denverpost.com.
