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Bread For The City Files Lawsuit Against District of Columbia to Protect Medicaid Patients

Washington, D.C. – June 29, 2006: Bread for the City and 11 individual Washington, D.C. residents have filed a lawsuit against the District of Columbia to stop the District’s most vulnerable and in need from losing critical Medicaid benefits, including coverage for medical services and nursing home care. The lawsuit, filed by Crowell & Moring LLP, aims to enjoin the District from applying new requirements prompted by the federal government that could arbitrarily terminate Medicaid benefits for thousands of U.S. citizens in the District who cannot produce specific forms of paperwork to prove their birth in the country.

The new requirements were spurred by the Deficit Reduction Act of 2005 (DRA), which requires the District and states to obtain proof of U.S. citizenship from all new Medicaid applicants and from current beneficiaries in annual reviews. While ostensibly designed to root out cases where immigrants falsely declared U.S. citizenship when applying for Medicaid, the new requirements will create a severe barrier for patients who are not able to produce the limited forms of paperwork that are being permitted to demonstrate citizenship. The requirements will hit most hard those patients who are physically or mentally incapacitated, or homeless, and have outlived or lack close connections with family members.

The effect will be that many of the District’s most vulnerable patients may lose their health care benefits. The requirements will be especially burdensome for many elderly African-Americans born outside of hospitals due to poverty and discrimination for whom birth certificate may never have been issued. The Secretary of the U.S. Department of Health & Human Services is empowered to issue regulations expanding the range of acceptable documentation, but has so far provided guidance that exacerbates the problem.

"The scariest thing about this law is that it takes American-born citizens who have been living and working in the US their whole life and declassifies them as non-citizens just because they can't produce a piece of paper," said George Jones, executive director of Bread for the City, a community health center that serves many low-income Medicaid recipients in the District.

Plaintiffs in the case include a 91 year-old man who is a nursing home patient in the District suffering from a severe a heart condition and other ailments. He was born in his parents' home in Spartanburg, South Carolina, but has been previously told by the Census Bureau that the government office in Spartanburg had been destroyed by fire and all of its records, including any birth certificate that it may have had for him, were lost or destroyed. Other plaintiffs include two ladies over the age of 80 who suffer from dementia and other conditions, are unable to produce the necessary documentation to meet the requirements of the new rules, and risk losing their Medicaid benefits.

The lawsuit specifically calls for an injunction to stop the District from applying the new requirements that will arbitrarily terminate Medicaid benefits. It also calls for the development of a fair process that guards against fraud and abuse but still protects the access of citizens resident in D.C. to Medicaid benefits when they need it by giving them a fair opportunity to prove citizenship without arbitrary limits on the documentation that will be sufficient.

Crowell & Moring partner Clifton S. Elgarten, lead attorney for the case, said, “The rule of law is on our side. The United States Constitution determines that persons born in the United States are American citizens. There is no basis in the Constitution for deeming persons who are, in fact, American citizens to be treated as non-citizens merely because they don't have, or cannot obtain, certain documents."

Community organizations, such as the District Columbia Primary Care Association (DCPCA) and IONA Senior Services have also voiced support for the case.

"Medicaid has been under fire for a while, but this birth certificate requirement would be the most egregious attack on literally tens of millions of Medicaid recipients around the country," said Sharon Baskerville, executive director of DCPCA, which assisted in planning the lawsuit. "The serious legal deficiencies of the new requirements made it obvious we had to challenge it in court."

The Crowell & Moring pro bono legal team that filed the lawsuit includes co-lead counsel Clifton S. Elgarten and Arthur N. Lerner, along with Barry M. Parsons, Michael W. Paddock, Michael J. Goecke, and Portia R. Brown.

Bread for the City is a private, non-profit charitable organization that provides vulnerable residents of Washington, D.C. with comprehensive services, including food, clothing, medical care, legal, and social.

Through the efforts of more than 500 volunteers and the contribution of thousands of community members, the organization provides free services to over 10,000 people each month. Visit Bread for the City online at

Crowell & Moring LLP is a full-service law firm with more than 300 lawyers practicing in litigation, health care, antitrust, government contracts, corporate, intellectual property and more than 40 other practice areas. More than two-thirds of the firm's attorneys regularly litigate disputes on behalf of domestic and international corporations, start-up businesses, and individuals. Crowell & Moring's extensive client work ranges from advising on one of the world's largest telecommunications mergers to representing governments and corporations on international arbitration matters. Based in Washington, D.C., the firm also has offices in Brussels, California and London.

Complaint [PDF]

Plaintiffs' Memorandum [PDF]

Tabs A-O [PDF]

Supplemental Submission [PDF]

Motion for Preliminary Injunction and Expedited Hearing [PDF]

Application for Temporary Restraining Order [PDF]

Plaintiffs' Motion for Expedited Discovery [PDF]


Phill McGowan
Director of PR, Media and Communication
+1 202.508.8835

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