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Letter to the Honorable Nancy Pelosi 1 (October 2007)

handle is hein.congrec/cbo9291 and id is 1 raw text is: CONGRESSIONAL BUDGT OFFICE Peter R. Orszag, Drect U .S. Congress ashington, DC 20515 October 25, 2007 Honorable Nancy Pelosi Speaker U.S. House of Representatives Washington, DC 20515 Dear Madam Speaker: As you requested, I am providing additional information on CBO's estimate of the budgetary impact of section 211 of H.R. 3963, the Children's Health Insurance Program Reauthorization Act of 2007, as introduced on October 24, 2007. Under current law, individuals who apply for Medicaid and claim to be U.S. citizens are required to provide certain documents (such as a passport or birth certificate, and, in certain circumstances, a driver's license or other documentation that establishes identity) to demonstrate that they are citizens. That provision was enacted in the Deficit Reduction Act of 2005 (DRA, Public Law 109-171), and has been effective since July 1, 2006. (Before the DRA provision took effect, those individuals were permitted to attest to their citizenship, under penalty of perjury.) Section 211 would allow states the option to either use the requirements created in the DRA for citizenship documentation under Medicaid or instead verify an individual's name and Social Security number with the Social Security Administration. Some states have reported a drop in enrollment since implementation of the DRA because some Medicaid applicants have had difficulty satisfying the documentation requirement. Available evidence, based on state reports and other information provided by state officials, suggests that virtually all of those who have been unable to provide the required documentation are U.S. citizens.1 1. See, for example, reports by the General Accountability Office (hittp:/www.,ao.,ov/newitems/d07889.pdf) and the Virginia Health Care Foundation (http://www.vhcf.org/uploads/resource/DRAStudyUnintendedConsequencesFINAL52407.pdf).

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