Up to 320,000 clinic patients nationally may be losing Medicaid coverage they are entitled to because of federal rules designed to keep illegal immigrants from getting benefits, a study has found.
George Washington University researchers surveyed 300 Medicaid clinics around the country to assess the effect of the 2005 law requiring applicants to prove citizenship before receiving benefits.
In Colorado, 15 nonprofit groups operate 115 clinic sites that serve Medicaid and uninsured patients.
The Colorado clinics saw a total of 392,000 patients in 2004, the last year for which figures are available. The George Washington study does not estimate the number of those Colorado patients who might lose their Medicaid coverage as a result of the law.
Medicaid is a state-federal partnership to provide health care to the very poor, disabled and elderly.
While the law may have impacts for nursing homes, public hospitals and other institutions that treat Medicaid recipients, the researchers focused on the nationwide network of clinics treating the uninsured and poor.
The researchers estimate that 2 percent to 7 percent of clinic patients on Medicaid will lose coverage at least temporarily.
About 4.8 million Medicaid patients and 9 million poor and uninsured people relied on federally qualified health centers for care in 2005.
Those clinics will “absolutely” continue to care for those patients, even without Medicaid reimbursements, said David Adamson, director of the Western Slope’s Mountain Family Health Centers.
It will cost the health centers between $28 million and $85 million to continue to treat people without Medicaid reimbursements, the study estimates.
The majority of people losing coverage are not illegal residents, but those without birth certificates or documents the law requires, such as the elderly and those born in rural areas, said Dan Hawkins, vice president of the National Association of Community Health Centers, in Washington, D.C.
That seems to be true at Mountain Family’s clinics. “There never have been hordes of immigrants applying for Medicaid,” Adamson said. “They are not stupid; they know they don’t qualify.”
About 43 percent of the nation’s 952 federally qualified health centers were operating at a deficit before the law was enacted in 2005, Hawkins said.
“This just serves to make an already bad situation much worse,” he said.
Health centers told researchers they may have to cut staff because of the cash shortfalls.
Illegal residents were never eligible for Medicaid coverage, except in case of emergency. That has not changed.
Congress, in the Deficit Reduction Act of 2005, changed the requirements for proving citizenship before receiving Medicaid and other benefits.
Colorado last year enacted its own set of rules on which documents could be used to prove residency. State lawmakers last month passed a bill that would expand that list of documents. The legislation is awaiting Gov. Bill Ritter’s signature.
Staff Karen Augé can be reached at 303-954-1733 or kauge@denverpost.com.
