Medicaid recipients must start proving citizenship.

Byline: David Steves The Register-Guard

SALEM - Oregonians will need to prove their citizenship or legal U.S. residency starting today when they apply for new or continued Medicaid benefits.

The state set the deadline for carrying out the federal proof-of-citizenship mandate earlier this month. Initially it had planned to come into compliance with the requirement starting July 1.

But because of a delay in issuing federal rules governing how the law would work, states were allowed to phase in their implementation.

The Oregon Department of Human Services decided on the Sept. 1 starting date to allow enough time to publicize the changes and train staff, said Ann Snyder, a spokeswoman for the agency.

About 450,000 Medicaid recipients in Oregon must show proof of citizenship when they enroll or re-enroll in Medicaid-funded programs, such as the Oregon Health Plan, county-provided family planning services and long-term care.

The requirement won't hit everyone at once but will kick in as new applicants show up and as current enrollees seek to renew their benefits, a process that is required every six months.

Oregon Department of Human Services officials estimate as many as 70,000 Oregonians may be unable to immediately and readily provide proof of citizenship.

Acceptable proof includes a U.S. passport or a U.S. birth certificate if an additional document proving identity is submitted, such as a current state driver's license or state-issued identification bearing the applicant's picture.

For a child younger than school age, a birth certificate must be accompanied by an affidavit signed by a parent, vouching for the identity of the child.

Oregon Department of Human Services Director Bruce Goldberg estimated that as many as 3,000 people may need assistance in obtaining their documents as a result of mental illness, homelessness, poverty, illiteracy or other factors.

Clinics, nursing homes and other health-care providers initially expressed concerns that the new rules could cause problems for people who are citizens but are unable to produce documents proving it.

But in the two months since the original starting date for the proof-of-citizenship requirements, leaders from those same groups now say state and federal rule-makers appear to have made big efforts to accommodate their concerns.

Ellen Pinney, executive director of the Oregon Health Action Campaign, said Oregon administrators worked with Medicaid recipient advocates in several important ways. As an example, she said, the state decided to allow Medicaid recipients to provide proof of citizenship at their local clinics, rather than require them to travel to Department of Human Services offices.

"According to everything we're hearing from national groups that are monitoring this around the country, Oregon is way ahead of the curveball in terms of how they are responding to potential client need," she said.

Margaret Murphy Carley - an official with the state's nursing home group, the Oregon Health Care Association - said the revised federal rules were written to exempt the majority of Medicaid clients in nursing homes - those who are eligible for both Medicaid and Medicare, since the latter government health care program, which covers seniors, already requires citizenship proof.

"I think the facilities feel relatively comfortable, given that a significant portion of the population will not be required to be checked," said Carley, who is the association's deputy director and general counsel.

MORE INFORMATION Online: www.oregon.gov/DHS/citizen -medicaid.shtml By telephone: [phone]