July 13, 2006
Thursday

WASHINGTON -- When humorist Will Rogers appeared at the passport office as he prepared for a trip to Russia he was told that he couldn't receive one until he produced a birth certificate. Having come into the world before the turn of the last century in what was then Indian Territory, he said he didn't quite understand and was told by the pinch-faced bureaucrat that it was a document proving his birth.

Professing incredulity, the gum chewing, rumpled Oklahoman replied that he had never heard of such a thing. "Why back home," he said, "when folks saw you walking around they just sort of took it for granted that you had been born."

But that isn't enough to gain one much of anything these says, including access to Medicaid, the federal health care program for the indigent. Under a new federal law it is now mandatory that every applicant show proof of citizenship with either a passport or a birth certificate, a requirement that is aimed at denying service to illegal immigrants but, according to its opponents, is inevitably going to do the same thing to thousands of Americans who like Rogers have no record of when or where they were born.

This is a dilemma of large proportions for the states that administer the giant health care program and are so bent under the economic weight of millions of illegal aliens that their other programs are on the verge of bankruptcy. If they don't comply, they will be denied federal funds. Yet the solution truly does seem to have disastrous potential for a large number of poor African Americans, the homeless and the elderly, few of whom have a passport and many who have absolutely no other official document proving when or where they were born. Many were born at home.

In addition, the law is unnecessarily restrictive, allowing for no exceptions even for those who might need immediate care but are unable to provide the required proof because of Alzheimer's disease or other mental infirmities or who are victims of natural disasters. Even those receiving care under other federal programs and who have been cleared at one time or another by Social Security aren't exempt.

There is evidence that this questionable action is another politically motivated over-response to the crushing problem of immigration and how to handle the 12 million or so undocumented immigrants who are straining social and governmental institutions throughout the nation. On the surface at least there seems to be far less a problem in Medicaid than in other programs. Only four states don't require applicants to attest to their citizenship under the penalty of perjury. If there is any doubt, officials can ask for further documentation.

This solution, which is the subject of a number of lawsuits already, also is an expensive one both for those seeking health benefits and those administering them and adds to the giant bureaucracy surrounding both Medicare for the elderly and Medicaid. So what is the answer?

The number of Americans distraught over the immigration problem is so large that it has become politically worthwhile for members of Congress to produce legislation that is aimed at appeasing constituents even if often it is not well thought out. The entire question of how to stop the flow of illegal aliens has been skewed by ideological dogma and politicians on the right and left have used the issue as a whipping boy.

Conservatives want to build a moat along the entire U.S. border with Mexico and would prefer it be filled with surplus Florida alligators. Liberals would make nearly everyone a citizen automatically and allow others to keep coming. There has to be a middle ground and the president has offered one. But it doesn't seem to satisfy the congressional hardliners within his own party. It would give preference to those who have proven they are productive citizens over a period of time, allow for worker permits and provide a variety of other sensible solutions.

Meanwhile, the politicians on either side of the issue probably will continue making small passes at solving the problem without meeting it head on in the interest of responding to what polls show is one of the top concerns of voters. The result is likely to make things worse. This certainly seems the case with the Medicaid requirement. Even those officials who are in charge of assuring that no one is receiving help who shouldn't have condemned the approach.

Will Rogers would be really dismayed.

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