Challenge to Citizenship Rule Dropped

Residents' Coverage No Longer in Jeopardy, Attorneys Say

A federal lawsuit against the city's implementation of a new Medicaid rule ended yesterday afternoon after lawyers for vulnerable District residents concluded that their health and nursing home coverage no longer was at risk.

The rule, which took effect July 1, requires more than 50 million poor Americans on Medicaid to establish their citizenship when re-enrolling or applying for benefits. With critics warning that many people would be unable to supply the documentation, federal officials moved to exempt about 8 million elderly and disabled recipients who they decided had provided adequate proof of citizenship through other programs.

That change was enough to protect all but one of the plaintiffs named in the District litigation, attorneys said. That man, they said, is not in immediate jeopardy because of the city's more generous interpretation of the regulation.

Specifically, individuals who can show they are making a "good-faith effort" to produce passports, birth certificates or other paperwork will continue to have Medicaid coverage. Their effort will not face a deadline, "which is how it should be," attorney Clifton S. Elgarten of Crowell & Moring LLP said yesterday.

District officials are acting "in as humane a way as they could," Elgarten said several hours before his firm voluntarily dismissed the suit. It brought the case pro bono on behalf of several D.C. residents and Bread for the City, a nonprofit social services organization.

Traci Hughes, a spokeswoman for D.C. Attorney General Robert J. Spagnoletti, said the District agreed with the outcome. "It was the city's concern all along that the District residents who benefit from those services continue to be served," she said.

More than 142,800 people in the District are on Medicaid, and the recent federal exemptions immediately affected about 34,000 of them.

The documentation provision became law this year as part of the Deficit Reduction Act. Though supporters in Congress pushed the measure as a way to ensure that illegal immigrants were not getting Medicaid, opponents feared that it could harm many elderly, mentally ill, mentally retarded and homeless Americans.

A federal inspector general's report concluded there was little fraud in the program by noncitizens.

A second, national lawsuit, also seeking to block the regulation, is pending in U.S. District Court in Chicago.