Deficit Reduction Act Citizenship Requirements Through the Eyes of Covering Kids Families Grantees

The Deficit Reduction Act of 2005 attempted to reduce the federal budget deficit by implementing changes in a wide range of federal programs, including Medicaid. Among the changes, the act requires that all Medicaid recipients and future applicants prove their citizenship and identity. This brief presents the results of a survey of Covering Kids & Families grantees in 31 states within the first month that citizenship requirements were in effect. Grantees reported initial confusion among state officials and advocates about what the law required, causing delayed implementation in some states. Grantees also described potentially serious consequences, including lower Medicaid and SCHIP enrollment, more people without insurance, increased churning, and higher costs.