Summer 2000 OCR UPdate - 9
Immigrant Access to Health and Welfare Programs
In our Fall 1999 Newsletter, OCR reported on our activities to address some of the unique challenges confronting immigrant populations. This updates our efforts to eliminate inappropriate inquiries on applica- tion forms that hinder immigrants' access to health and welfare benefits.
Of the nearly 5 million children eligible for but not enrolled in Medicaid, nearly one-third live in immigrant families. One potential explanation may be inappropriate questions on public benefit application forms. Immigrant families may be deterred from applying for benefits when applicants and non-applicant household members are asked to provide Social Security Numbers (SSNs) and disclose information about their immigration status (when the information is not legally required).
For example, in Georgia, the state's joint application form for cash, food stamps and medical assistance asked applicants to provide SSNs for the applicant and each member of the applicant's household, regardless of whether the household member was seeking benefits. In addition, the person completing the application form had to certify, "under penalty of perjury that each person in the applicant's household is a U. S. citizen or an alien in lawful immigration status." The application form also stated, "INS [the Immigration and Naturalization Service] may be contacted in regard to your immigration status."
After receiving complaints about Georgia's joint benefits application form, OCR Atlanta Regional Office staff initiated an investigation. In addition to establishing that Georgia's application form solicited information not required by federal law, OCR concluded that the form contained inquiries that might discourage eligible individuals from applying for Medicaid or TANF (Temporary Assistance for Needy Families) benefits. OCR also became concerned that Georgia may be denying Medicaid and TANF benefits to eligible applicants because they failed to provide information that was not required by law—e.g., requiring Medicaid applicants to provide SSNs for all non-applicant household members.
Once alerted to these concerns, Georgia promptly agreed to work with OCR to resolve the problems. Georgia has agreed to revise its joint application form to eliminate irrelevant inquiries that may deter applicants (who live in immigrant families) from applying for and receiving benefits. We are confident that Georgia will soon have in place an application form that will serve as a model for other states.
The problems identified with Georgia's application form are not unique to Georgia. Our informal review of combined Medicaid, Food Stamp and TANF benefit application forms from other states revealed similar concerns in many states. To address these concerns, OCR Headquarters is working with the U. S. Department of Agriculture's Food and Nutrition Service, and this Department's Health Care Financing Administration and Administration for Children and Families, to draft guidance to state agency directors. The guidance will spell out when states may require disclosure of immigration status and SSNs of applicants and non-applicant household members in the Medicaid, SCHIP (State Children's Health Insurance Program), Food Stamp and TANF programs. OCR expects the guidance to be ready this summer.
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