Human Services News

Center on Budget and Policy Priorities:

Now, without any change in the law, the Centers for Medicare and Medicaid Services (CMS) of the U.S. Department of Health and Human Services has instructed states that they may no longer provide automatic coverage to some babies, even though these babies have been born in the United States and are U.S. citizens and Medicaid has covered the cost of their birth.

In its July 12, 2006 interim final regulations, CMS restricted the type of records that can be used to document citizenship for babies whose births are paid for by Medicaid.

As a result, CMS unnecessarily has subjected these children to the risk of losing their Medicaid coverage when their eligibility is redetermined at age 1.

While Congress did not exempt babies who receive automatic coverage from the citizenship documentation requirements once these children reach age 1, Congress did give CMS discretion to determine the types of records that are considered a reliable means of documenting citizenship and personal identity.

States must continue to provide Medicaid coverage to such babies as long as they continue to live with their birth mother and the mother either remains eligible for Medicaid or would remain eligible if she were still pregnant.

Undocumented immigrants and most legal immigrants who have been in the United States for less than five years are not eligible for the full scope of benefits covered under a state's Medicaid program.

See, e.g., Helen Pelletier and Melinda Abrams, "ABCD: Lessons from a Four-State Consortium," Commonwealth Fund and National Association of State Health Policy (December 2003) (available at http://www.nashp.org/Files/CW9_ABCD_Lessons_Learned.pdf) and "Children's Health---Why Health Insurance Matters," Kaiser Commission on Medicaid and the Uninsured (May 2002) (available at http://www.kff.org/uninsured/4055-index.cfm).