Medicaid Wait Rising for Va. Children, Study Says

Nearly six in 10 eligible children whose parents applied for Medicaid in Virginia went without health care for weeks or months because of a new federal rule intended to prevent undocumented immigrants from receiving coverage, according to a state survey of 800 low-income families.

The report is thought to be the first in the country that interviewed applicants to assess the effects of the rule changes. It also found that while waiting for Medicaid, nearly half of the children younger than 2 years old who needed immunizations were unable to get them and one-fourth did not obtain medical care for an illness.

The reduced care is a consequence of the Deficit Reduction Act, a 2006 law that requires people who say they are citizens to provide proof such as a passport or the combination of a birth certificate and driver's license.

The federal law requires that the applications be processed within 45 days. But according to the survey, which was conducted by the Virginia Health Care Foundation and the Virginia Department of Medical Assistance Services, hundreds of children born in the United States waited weeks or months longer, primarily because their parents had trouble providing identity documents. Parents are required to provide documents, such as passports, which most don't have for their children.

During that extra time, 90 percent of the applicants surveyed said they had no other access to treatment beyond Medicaid, the national health-care program for the poor. Of those, 65 percent needed care for their children, and many took them to hospital emergency rooms.

Lawmakers have also said the law has been unduly onerous because it requires people to submit, in person, original documents or copies certified by state and local agencies. That has prevented many states from registering people for Medicaid over the phone or the Internet.

Several national experts who have looked into the issue said Virginia's study provides further evidence of problems with the new rule that many states have reported for at least six months. In Maryland, officials said they have seen a drop of 7,600 Medicaid enrollees from last year, which they attribute largely to the rule change. Officials in Florida, Kansas, Wisconsin and Ohio have also reported problems with enrollment since July, national experts said.

"We don't know what's happening in every state, but we do know that many states have reported specific problems and have been very vocal about them," said Donna Cohen Ross, director of outreach for the Center on Budget and Policy Priorities, a liberal think tank in Washington.

Deborah Whittington, who participated in the survey, said the new rules affected her children. Last fall, she abruptly moved from suburban Dallas to Newport News, Va., to help care for her ailing mother. After a few trying months, new jobs, new schools and other matters were essentially falling into place.

Everything, that is, except securing Medicaid for her two sons and daughter. The three are U.S. citizens, born and raised in Virginia and Texas, but the documents identifying her children as citizens were misplaced in the shuffle of the last-minute move.

It took until January, after more than two months of waiting, for Whittington, 44, to line up health care for her children. "It was a nightmare," she said. Because she could not afford a doctor while she waited for Medicaid -- juggling rent and other necessities -- the hearing problem of her youngest son, David, 6, probably worsened, she said.

"You feel like you can't do every thing for your child . . . everything that you're supposed to do as a parent," Whittington said.