Medicaid: States Reported That Citizenship Documentation Requirement Resulted in Enrollment Declines for Eligible Citizens and Posed Administrative Burdens Page: 3 of 43
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Contents
Letter 1
Results in Brief 4
Background 6
Many States Reported That the Requirement Resulted in Delayed
or Lost Medicaid Coverage for Some Individuals Who Appeared
to Be Eligible 13
States Reported Investing Resources to Implement Requirement,
with Fiscal Benefits Uncertain 19
Agency Comments and Our Evaluation 26
Appendix I List of Acceptable Documents for Proving
Citizenship and Identity, as Defined under Federal
Regulations 31
Appendix II Comments from the Centers for Medicare &
Medicaid Services 34
Appendix III GAO Contact and Staff Acknowledgments 38
TablesTable 1: Examples from the List of Acceptable Documents for
Proving Citizenship Defined under Federal Regulations, by
Level of Reliability
Table 2: Administrative Measures Frequently Taken by States to
Implement the Requirement and Assist Individuals with
Compliance
Table 3: Challenges Posed by Certain Aspects of the Requirement,
as Reported by States
Table 4: List of Acceptable Documents for Proving Citizenship, as
Defined under Federal Regulations
Table 5: Acceptable Documents for Proving Identity, as Defined
under Federal RegulationsGAO-07-889 Medicaid Citizenship Documentation Requirement
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United States. Government Accountability Office. Medicaid: States Reported That Citizenship Documentation Requirement Resulted in Enrollment Declines for Eligible Citizens and Posed Administrative Burdens, report, June 28, 2007; Washington D.C.. (https://digital.library.unt.edu/ark:/67531/metadc300413/m1/3/: accessed April 19, 2024), University of North Texas Libraries, UNT Digital Library, https://digital.library.unt.edu; crediting UNT Libraries Government Documents Department.