Forty-nine House Democrats recently said that the Centers for Medicare & Medicaid Services’ new proof of citizenship requirements to qualify for Medicaid will have a “devastating impact” on the “health coverage of millions of Medicaid beneficiaries and applicants.” In an effort led by Rep. Hilda Solis, D-CA, the letter urges Administrator Mark McClellan to permit states to begin providing coverage to eligible citizens based on their sworn declaration of citizenship and to permit them a “reasonable opportunity” to provide the necessary documentation and to exempt foster children from the regulations. In addition, the letter requests that CMS allow states to accept a record of Medicaid payment for the birth of a child born in the United States as proof of citizenship and a medical record of birth in a U.S. hospital or other setting as secondary evidence of citizenship for children under age six. The Democrats also recommend that CMS give states flexibility to use alternative methods to prove citizenship, especially for victims of natural disasters, homeless individuals, naturalized citizens who have lost their certificate of naturalization and Native Americans. Earlier this month, the AHA sent a letter to CMS urging the agency to expand the list of vulnerable populations exempted from Medicaid’s new citizenship documentation requirement.