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Some Americans are getting a break from a new law requiring proof of citizenship to qualify for the taxpayer-funded Medicaid program.

The U.S. Department of Health and Human Services has issued a policy modification to exempt aged or disabled people with Supplemental Security Income, SSI, from having to prove they are U.S. citizens in order to receive or continue receiving Medicaid coverage. Also newly exempt are seniors who have Medicare as their primary insurance who meet other requirements for Medicaid as a secondary source of insurance.

The federal agency said the reason for exempting these groups is because they already have met certain documentation requirements. A third policy change will allow states to document citizenship by identity matches through state databases.

The changes to the law, which took effect July 1, do not mean an end to a lawsuit filed by the Sargent Shriver National Center on Poverty Law against the federal government. The Chicago-based organization, which fights poverty, says the new law is unconstitutional and will harm 40 million poor and vulnerable Americans. The citizenship requirement is intended to stop illegal immigrants from receiving Medicaid benefits.

The poverty center says the government’s rule changes last week will mean 8 million Americans are spared from having to prove their citizenship for Medicaid but that’s not enough.

“While the plaintiffs are thrilled that new regulations protect some of the most vulnerable Americans, we are not out of the woods yet,” John Bouman, an attorney with the poverty center, said in a written statement. “There are still 40 million Americans who must comply with this law or face loss of coverage. This includes disaster victims, the homeless, the mentally disabled and foster children.”

Southwest Florida hospital officials say the exemptions for seniors and people with disabilities will be of some help, yet they still fear low-income people will lose their Medicaid and that means loss of Medicaid reimbursement at a time when hospital operating expenses continue to rise.

The Lee Memorial Health System has a large Medicare population but few also receive Medicaid as secondary coverage, and so the policy change won’t have a tremendous impact, said Billie Jo DeBolt, system director for business services at the Lee County hospital system.

“It’s not a huge volume,” she said. “It is the straight Medicaid population who will take the hit.”

Sandra Wood, business office director for the NCH Healthcare System in Collier County, likewise said the rule change could provide some relief.

“We do support the modifications if it will expedite the process of assisting potential Medicaid beneficiaries to receive benefits to which they are deemed eligible,” Wood said.

The lawsuit was filed in federal district court in Chicago on June 28 on behalf of nine individuals who would not be able to prove they are citizens and face losing their Medicaid coverage. For instance, one plaintiff was born in Arkansas in 1911 but the county where she was born only has birth certificates going back to 1914; another plaintiff was born in a farmhouse in Mississippi and was sent to foster homes and likewise has no birth certificate. Other plaintiffs were put up for adoption and don’t have birth certificates or reside in nursing homes and don’t have the documents.

Following a court hearing last week, the federal judge in the case expedited the discovery process and scheduled a status hearing for July 28, according to the poverty center.

The American Hospital Association and other health-care entities with large volumes of Medicaid patients say the citizenship-proof law would cut eligible people off from the program. Hospital officials say there has not been a problem with illegal immigrants trying to acquire Medicaid. Before the new law, eligible Medicaid recipients attested to their citizenship on applications but did not have to present documentation.

Proving citizenship by presenting a U.S. passport, birth certificate or other documents for Medicaid has no bearing on anyone, regardless of ability to pay or their citizenship status, from receiving medical care in a hospital emergency room. The new law likewise does not have an impact on emergency Medicaid coverage that is available to illegal immigrants in emergencies.