Deficit Reduction Act 2005 - Citizenship Requirements

On February 8, 2005, President Bush signed into law the DRA which made certain changes to Medicaid (Medi-Cal in California) law. One of those changes was the requirement for individuals declaring to be U.S. citizens or U.S. nationals to show documentary evidence of this fact as well as proof of identity. This website contains information on both the state and federal law regarding this requirement and the implementation of this requirement in California.

This site will be updated periodically, if you have questions on the information presented on this site, you may direct them to the following email inbox: dracitiz@dhcs.ca.gov .

All County Welfare Directors Letter

• The purpose of this All County Welfare Director's Letter (ACWDL 07-12) (PDF) is to provide counties with instructions for implementing the new requirements of the federal Deficit Reduction Act of 2005 (DRA) for documentation of United States (U.S.) citizenship or U.S. national status and identity as a condition of Medi-Cal eligibility for applicants and beneficiaries who declare that they are U.S. citizens or nationals.
• The purpose of this All County Welfare Directors Letter (ACWDL 08-29) (PDF) is to provide counties with updated information and instructions for implementing the Medi-Cal citizenship and identity requirements under the Federal Deficit Reduction Act of 2005 (DRA).

Medi-Cal Eligibility Information Letter

• The purpose of this Medi-Cal Eligibility Division Information Letter (MEDIL I08-02) (PDF) is to inform the counties that the Deficit Reduction Act (DRA) poster and fliers are available for use.

DRA Questions and Answers

• In an effort to address questions received on the evidence of citizenship and identity requirements included in All County Welfare Director's Letter (ACWDL) 07-12, the Department is posting QUESTIONS AND ANSWERS to the DHCS website. (Updated October 8, 2008)

DRA Outreach Materials

• Poster
• Fliers

Final DRA Forms available:

• DHCS 0001 (1/08)  U.S. Citizens and Nationals Applying for Medi-Cal Must Show Proof of Citizenship and Identity - (Enclosure 1A) (PDF)
• DHCS 0002 (1/08)  Proof of Citizenship and Identity -- New Requirements for Medi-Cal Beneficiaries who are U.S. Citizens or Nationals - (Enclosure 1B)(PDF)
• DHCS 0003 (6/07)  Affidavit of Reasonable Effort to Get Proof of Citizenship - (Enclosure 3) (PDF)
• DHCS 0004 (6/07)  Request for California Birth Record - (Enclosure 4) (PDF)
• DHCS 0005 (2/08) Receipt of Citizenship or Identity Documents (Enclosure 5) (PDF)
• DHCS 0006 (8/07) Proof of Citizenship and Identity Needed -- For Medical Applicants and Beneficiaries Who Are U.S. Citizens or Nationals - (Enclosure 6) (PDF)
• DHCS 0007 (12/07)  Acceptable Citizenship and Identity Documents - (Enclosure 8) (PDF)
• DHCS 0008 (1/08)  Proof of Citizenship and Identity Requirements -- For Children Who Are U.S. Citizens or Nationals Filling Out The Healthy Families/Medi-Cal Joint Application - (Enclosure 10 (PDF)
• DHCS 0009 (9/07)  Affidavit of Identity for U.S. Citizenship or National Children Under 18 - (Enclosure 11) (PDF)
• DHCS 0010 (1/08) Affidavit of Identity for U.S. Citizen or National For Disabled Individuals Living in Institutional Care Facility (Enclosure 14) (PDF)
• DHCS 0011 (6/08) Proof of Acceptable Citizenship and Identity Documents (Enclosure 15) (PDF)

DRA forms available in translated languages:  Arabic, Armenian, Chinese, Farsi, Hmong, Khmer, Lao, Russian, Spanish, Tagalog and Vietnamese.  To view or download, go to http://www.dhcs.ca.gov/formsandpubs/forms/Pages/MCEBTranslatedForms.aspx

 Additional Information

• Note to DRA Stakeholders for review of final ACWDL (PDF) CA Codes (WIC 14011 2);
  http://www.leginfo.ca.gov/cgi-bin/waisgate?WAISdocID=76279525143+0+0+0&WAISaction=retrieve 
• Evidence of Citizenship ACWDL-- DRAFT Version for review 7 11 06 (2) (PDF)
• Process for stakeholders to comment on the DRAFT Evidence of Citizenship ACWDL (PDF)
• Public Law 109-171 DRA Section 6036 (PDF)
• CMS Fact Sheet (PDF)
• CMS SMD Letter (PDF)
• CMS Interim - Final Regs (PDF) 
• High Level Issues Presented at August 18, 2006 Stakeholder Meeting (PDF)

(Coming Soon)

• Department Comments on the Interim Final Federal Regulations for Evidence of Citizenship and Identity
• Stakeholder Comments on the Draft All County Welfare Directors Letter