This report, prepared by the Center on Budget and Policy Priorities, examines the February, 2006 provision requiring all Medicaid applicants and recipients to provide a birth certificate or passport to become eligible for the program. While the provision was passed as an effort to prevent illegal immigrants from being covered by Medicaid, it is more likely to create unnecessary challenges to a significant number of low-income U.S. citizens.
The federal government's new requirement is this: people claiming to be citizens must provide documentation of citizenship to the Medicaid program. In other words - eligibility has not changed, but there is a new documentation requirement. This is only required of citizens; there is no new Medicaid documentation required from people who are green card holders, or PRUCOL (Permanently Residing Under Color of Law).
You do not need to be a US citizen in order to be allowed to use the Medicaid program. Using Medicaid does not have negative immigration consequences.
Most naturalized US citizens are in a good position to provide this documentation. The documentation is more likely to be a challenge for US-born citizens who don't have their birth certificates. Citizenship documentation is not required for lawful permanent residents or other non-citizens who are eligible for the Medicaid program - the new requirement applies only to citizens.
On August 2, 2007 U.S. Rep. Barbara Lee, from California, introduced a bill to repeal Congress' 1993 statutory exclusion of HIV-positive immigrants and return the authority to determine this policy to the U.S. Secretary of Health and Human Services. The bill would require the HHS Secretary to review the ban on HIV-positive immigrants, allowing for a public comment period before HHS makes its recommendation to Congress on whether to repeal or maintain the ban.
The bills introduction sets out a concise summary of the history of the HIV immigration exclusion, which began as a federal administrative decision and policy and became law in 1993 when President Clintons Secretary of HHS proposed lifting the ban.
The following synopsis is condensed from NY Law School Professor Art Leonards excellent discussion on Leonard Link, http://newyorklawschool.typepad.com/leonardlink/: In Jean-Pierre v. U.S. Attorney General, 2007 WL 2712108 (11th Cir., September 19, 2007), a Haitian man with AIDS who is subject to deportation from the U.S. because of his three drug convictions won a new hearing before the Board of Immigration Appeals, a unanimous panel of the 11th Circuit finding that the Board (and the Immigration Judge) had failed to decide the crucial legal issue of his case. The petitioner is seeking refuge in the U.S. under the Convention Against Torture, under which the U.S. has committed itself to give refuge here to individuals who would more likely than not face torture if deported to their home country. The petitioner entered the U.S. in 1992 on a temporary visa and overstayed. Residing in Florida, he was convicted on drug offenses in 1995, 1997 and 2004. While he was serving time in a Florida jail on this third conviction, the Homeland Security Department began removal proceedings against him. There is no doubt that he is deportable due to his criminal record, so his only hope for refuge in the U.S. is the Convention Against Torture. The petitioner introduced evidence showing that under Haitian policy, he would be immediately sent to prison for an indefinite term and that in light of his medical condition, it was highly likely that he would be subjected to physical torture by prison guards. The basis for this assertion is a somewhat complicated chain of reasoning. The petitioner has AIDS and has already suffered consequences of toxoplasmosis, an opportunistic infection that can cause mental instability if not kept in check. All evidence indicates he would not receive treatment for this in a Haitian prison, and that his resulting abnormalities of behavior would provoke the guards to various depradations that would likely cause his death after intense suffering. The IJ, taking a very literal interpretation of the protections under the CAT, focused on the requirement of proof that "the Haitian government deliberately creates and maintains those conditions as a means of torturing inmates," referring to the substandard conditions generally in Haitian prisons. The IJ accepted the argument that there was no evidence that the Haitian government specifically targets people with AIDS for torture in prison, or that this impoverished country provides substandard housing and healthcare in prisons in order to torture the prisoners. The BIA endorsed this ruling, relying on past 11th Circuit decisions that had denied relief to Haitian petitioners who had argued that sending them back to Haitian prisons would subject them to torture because of the substandard conditions in those prisons. The 11th Circuit panel concluded that the BIA had really missed the point of the case. It wasn't just that there were substandard conditions in the Haitian prisons, but rather that because of the petitioner's particular medical condition, it was highly likely that he would attract the kind of retaliation from the guards for "acting out" that was well-documented to include physical assaults and mistreatment that clearly met the definition of torture -- and, after all, this would be at the hands of the guards, government agents, acting intentionally. The court concluded, however, that the matter would have to be remanded to the BIA for reconsideration rather than being disposed of by the court, since the BIA was entitled to first crack at the legal issues as reframed by the court.
It is not unusual to encounter women battling both HIV disease and breast cancer. But can an undocumented immigrant get prescribed chemotherapy or radiation therapy to treat cancer as an emergency medical service? The NY Department of Health, Office of Health Insurance Programs, issued this directive to local district commissioners, Medicaid directors, and Temporary Assistance directors to clarify that, until told differently, local social services must continue to treat chemotherapy and radiation as emergency medical services payable under Emergency Medicaid, on behalf of immigrants without status (undocumented immigrants).
This report summarizes discussion from two international electronic fora in which advocates, service providers, and HIV-positive women discussed services and policies related to the sexual and reproductive health of HIV-positive women. While the discussions spanned numerous countries and cultures, common threads appeared regardless of the geographical or cultural context. These threads provide lessons for all advocates seeking to promote the well-being of HIV-positive women. Issues such as confidentiality, domestic abuse, and reproductive rights were discussed, with the overarching issue being the high degree of stigma and discrimination experienced by HIV-positive women. Most strikingly, the discussions revealed widespread violations of the human rights of HIV-positive women as a result of the stigma and discrimination that they faced. These violations provided a backdrop to virtually all other topics discussed, creating major obstacles to the attainment of appropriate care and services by HIV-positive women. Another major theme was the lack of the most basic services responsive to the needs of HIV-positive women. Women described significant barriers at the domestic, community, regional and national level in realizing their rights and sexual and reproductive health. Among those mentioned included: inaccessibility of health centers; lack of respect for female patients' rights and judgmental attitudes among health care workers. The report is published by EngenderHealth, Harvard University, International Community of Women Living with HIV/AIDS, Ipas, and the United Nations Population Fund.
The article's abstract explains that "since 1987, the United States has maintained a restrictionist
and discriminatory policy toward foreign nationals
who are HIV positive. This policy can only be waived in
limited circumstances. In most instances, testing positive
for HIV makes it difficult or impossible for a foreign national
to visit or obtain permanent residence in the United
States. This article discusses two unusual cases where,
in direct contrast to general immigration policy, a foreign
national’s HIV-positive status actually helped the individual
to obtain lawful immigration status in the United States.
The first part of this article describes the parameters of
immigration law as it applies to HIV-positive individuals.
The second part focuses on two cases in which two immigration
judges granted legal status to foreign nationals because
of their HIV-positive status. Finally, part three calls
for a change in the law to allow a greater number of foreign
nationals, whose lives would be in jeopardy if they
returned to their home countries, to remain lawfully in the
United States, where they can obtain lifesaving medical
treatment and become productive members of society."
