State of Wisconsin Department of Health Services

Release 24-02 August 22, 2024

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7.1 US Citizens and Nationals

7.1.1 U.S. Citizens and Nationals Introduction

To qualify for Medicaid, persons who are otherwise eligible and declare that they are U.S. citizens or nationals must provide documentation of their citizenship, unless they are exempt or their citizenship is verified by the Social Security Administration through a data exchange.

A U.S. citizen is anyone who:

• Was born in the United States, the Commonwealth of Northern Mariana Islands, Puerto Rico, Guam or the U.S. Virgin Islands.
• Was born to a U.S. citizen who was living abroad.
• Is a naturalized U.S. citizen.

A U.S. national is anyone who was born in American Samoa (including Swain's Island). The Independent State of Samoa (also known as Western Samoa) is not part of American Samoa; therefore, individuals from this country are not U.S. nationals.

7.1.2 Child Citizenship Act of 2000

The Child Citizenship Act of 2000 amended the Immigration and Naturalization Act (INA) to provide derivative citizenship to certain foreign-born children of U.S. citizens. This applies to individuals who were under 18 years old on February 27, 2001 and anyone born since that date. The children included in the act are:

• Adopted children meeting the two year custody requirement ,
• Orphans with a full and final adoption abroad or adoption finalized in the U.S,
• Biological or legitimated children, or
• Certain children born out of wedlock to a mother who naturalizes

The CCA provides that foreign-born children who meet the conditions below automatically acquire U.S. citizenship on the date the conditions are met. They are not required to apply for a certificate of naturalization or citizenship to prove U.S. citizenship. These conditions are that the child:

• Has at least one parent who is a U.S. citizen (whether by birth or naturalization),
• Is under 18 years of age,
• Has entered the U.S. as a legal immigrant,  
• If adopted, has completed a full and final adoption; and,
• Lives in the legal and physical custody of the U.S. citizen parent in the U.S.

Adopted children automatically become U.S. citizens if they meet all the above conditions and were:

1. Adopted under the age of 16, and have been in the legal custody of and have resided with the adopting parent or parents for at least two years,
2. Adopted while under the age of 18, and have been in the legal custody of and have resided with the adopting parent or parents for at least two years and are a sibling of another adopted child who is under 16,
3. Orphans adopted while under the age of 16, who have had their adoption and immigration status approved by the USCISU.S. Citizenship and Immigration Services. The federal agency responsible for immigration and citizenship. This agency was formerly known as Immigration and Naturalization Service (INS). (Form I-171, “Notice of Approval of Relative Immigrant Visa Petition”). These children need not have lived with the adoptive parents for two years, or
4. Orphans adopted under the age of 18, who have had their adoption and immigration status approved by the USCIS, and are siblings of another adopted child who is under the age of 16. These children need not have lived with the adoptive parents for two years.

7.1.3 Compacts of Free Association

Citizens of the Compacts of Free Association are not considered U.S. citizens or nationals. The Compacts of Free Association include the Republic of the Marshall Islands, the Federated States of Micronesia and the Republic of Palau. Citizens of the Compacts of Free Association (COFA) have a special status with the US that allows them to enter the country, work here, and acquire an SSN without obtaining an immigration status.

As of December 27, 2020, COFA citizens may be eligible for health care if they meet all other eligibility requirements. In addition, COFA citizens are not subject to the 5-year waiting period. However, COFA citizens who adjust their status and become Lawful Permanent Residents are subject to the 5-year waiting period.

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The information concerning the Medicaid program provided in this handbook release is published in accordance with: Titles XI and XIX of the Social Security Act; Parts 430 through 481 of Title 42 of the Code of Federal Regulations; Chapters 46 and 49 of the Wisconsin Statutes; and Chapters HA 3, DHS 2, 10 and 101 through 109 of the Wisconsin Administrative Code.

Notice: The content within this manual is the sole responsibility of the State of Wisconsin's Department of Health Services (DHS). This site will link to sites outside of DHS where appropriate. DHS is in no way responsible for the content of sites outside of DHS.

Publication Number: P-10030