To be proven right about a predicted wrong elicits no pleasure. “I told you so” affords cold comfort when others are suffering. Last year, the Center on Budget and Policy Priorities issued a warning on a Congressionally-mandated change in Medicaid regulations:

Under a new federal requirement that took effect July 1, most U.S. citizens applying for Medicaid or renewing their coverage must prove their citizenship by submitting a passport or a combination of a birth certificate and an ID. This new requirement, part of budget legislation enacted in February [of 2006], was intended by its sponsors to keep illegal immigrants from fraudulently enrolling in Medicaid….Yet the requirement’s main impact is likely to be to impede or delay coverage for significant numbers of eligible U.S. citizens….

Many low-income people do not have birth certificates in their possession and do not have passports. Some may have had a birth certificate in their possession at one time, but after moving various times over the course of their lives, they are no longer able to locate it. This could be a particular problem for uninsured U.S. citizens who are eligible for Medicaid but are not enrolled and who need immediate medical care. Hospitals, physicians, and pharmacies may not be willing to treat these individuals until they have a source of payment, but they cannot qualify for Medicaid until they produce a birth certificate and ID. [full text]

Now comes the following report by Robert Pear in today’s New York Times that demonstrates the unfortunate prescience of the Center on Budget and Policy Priorities (and other advocates for low-income Americans):

Citizens Who Lack Papers Lose Medicaid

A new federal rule intended to keep illegal immigrants from receiving Medicaid has instead shut out tens of thousands of United States citizens who have had difficulty complying with requirements to show birth certificates and other documents proving their citizenship, state officials say.

Florida, Iowa, Kansas, Louisiana, New Mexico, Ohio and Virginia have all reported declines in enrollment and traced them to the new federal requirement, which comes just as state officials around the country are striving to expand coverage through Medicaid and other means….

Medicaid officials across the country report that some pregnant women are going without prenatal care and some parents are postponing checkups for their children while they hunt down birth certificates and other documents.

Rhiannon M. Noth, 28, of Cincinnati applied for Medicaid in early December. When her 3-year-old son, Landen, had heart surgery on Feb. 22, she said, “he did not have any insurance� because she had been unable to obtain the necessary documents. For the same reason, she said, she paid out of pocket for his medications, and eye surgery was delayed for her 2-year-old daughter, Adrianna.

The children eventually got Medicaid, but the process took 78 days, rather than the 30 specified in Ohio Medicaid rules.

Dr. Martin C. Michaels, a pediatrician in Dalton, Ga., who has been monitoring effects of the federal rule, said: “Georgia now has 100,000 newly uninsured U.S. citizen children of low-income families. Many of these children have missed immunizations and preventive health visits. And they have been admitted to hospitals and intensive care units for conditions that normally would have been treated in a doctor’s office.�

Dr. Michaels, who is president of the Georgia chapter of the American Academy of Pediatrics, said that some children with asthma had lost their Medicaid coverage and could not afford the medications they had been taking daily to prevent wheezing. “Some of these children had asthma attacks and had to be admitted to hospitals,� he said.

In Kansas, R. Andrew Allison, the state Medicaid director, said: “The federal requirement has had a tremendous impact. Many kids have lost coverage or have not been able to obtain coverage.� Since the new rule took effect in July, enrollment in Kansas has declined by 20,000 people, to 245,000, and three-fourths of the people dropped from the rolls were children.

Megan J. Ingmire, a spokeswoman for the Kansas Health Policy Authority, which runs the state Medicaid program, said the waiting time for applicants had increased because of a “huge backlog� of applications. “Applicants need more time to collect the necessary documents, and it takes us longer to review the applications,� Ms. Ingmire said. [full text]