Wisconsin Shows How States Can Mitigate the Downside of New Puerto Rico Law – Say Ahhh! A Children’s Health Policy Blog

By Jon Peacock, Wisconsin Council on Children and Families

It isn’t often that state policymakers have to make
program changes and policy choices because of a law passed in another state or
territory of the U.S.  Thus, it
came as a big surprise to learn that a law enacted in Puerto Rico forces states
to make a choice about how they administer public benefit programs, including
Medicaid and CHIP.    

The Puerto Rico law invalidates all
certified copies of birth certificates issued by the Puerto Rico Health
Department before July 1, 2010. The law was adopted by the commonwealth last year after it was informed that stolen birth certificates were being used fraudulently. Beginning on October 1, 2010, states may no longer use those birth
certificates to document citizenship to identity those eligible for public benefit
programs.  The new law was
initially scheduled to take effect on July 1, but states and program applicants
have been given three additional months to prepare for the change.

The older certified copies will not be valid for new
applications starting October 1, but states have the option of not requiring
Puerto Ricans who are already enrolled to obtain a new birth certificate when
they come up for their annual review of eligibility.  Additional information on the new law, as well as
application forms for new copies of birth certificates, can be found here

Wisconsin recently became one of the first states to
tackle this issue:  the state
decided not to make current program participants obtain new copies of their
birth certificates. (See Operations Memos # 10-39.) The WI
Department of Health Services (DHS) decided that requiring all enrolled Puerto
Ricans to obtain new birth certificates would be a burden for those individuals
and wouldn’t be a cost-effective use of time for caseworkers.  

Wisconsin’s BadgerCare Plus program has been extremely effective in giving nearly all
Wisconsin children access to quality affordable health insurance, and in making
enrollment and renewals easier for eligible families.  However, Wisconsin still has room for improvement in
streamlining renewals, and DHS is working toward that goal.  The department’s choice not to require
new birth certificates for already-enrolled Puerto Ricans prevents what could
have been a setback to Wisconsin’s efforts to reduce churning among program

For new Puerto Rican applicants, states can mitigate the
potential burden of the law by taking advantage of the CHIPRA option to use
Social Security numbers for automated verification of citizenship and
identity.  Although Wisconsin does
not currently employ that option, DHS is preparing to put it in place this
fall–and many states are already up and running with it.    

There is no avoiding the fact that the Puerto Rico law
will affect Medicaid and CHIP programs across the U.S and is likely to delay
some applications.  However, the
choices made in Wisconsin illustrate that states can minimize the additional
burdens for program applicants, participants and caseworkers.  Especially when budgets are tight,
smart decisions that avoid additional red tape can pay off for both state
budgets and uninsured kids.

The views expressed by Guest Bloggers do not necessarily reflect the views of the Center for Children and Families.

Scroll to Top