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entitled 'Sponsored Noncitizens and Public Benefits: More Clarity in 
Federal Guidance and Better Access to Federal Information Could Improve 
Implementation of Income Eligibility Rules' which was released on May 29, 
2009. 

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Report to the Ranking Member, Subcommittee on Income Security and 
Family Support, Committee on Ways and Means, House of Representatives: 

United States Government Accountability Office: 
GAO: 

May 2009: 

Sponsored Noncitizens and Public Benefits: 

More Clarity in Federal Guidance and Better Access to Federal 
Information Could Improve Implementation of Income Eligibility Rules: 

GAO-09-375: 

GAO Highlights: 

Highlights of GAO-09-375, a report to the Ranking Member, Subcommittee 
on Income Security and Family Support, Committee on Ways and Means, 
House of Representatives. 

Why GAO Did This Study: 

Federal law restricts noncitizens’ access to public benefits, including 
Temporary Assistance for Needy Families (TANF), Medicaid, the 
Supplemental Nutrition Assistance Program (SNAP), and Supplemental 
Security Income (SSI). Further, when noncitizens who legally reside in 
this country through sponsorship of a family member apply for these 
benefits, they are subject to sponsor deeming, which requires benefit 
agencies to combine noncitizens’ incomes with those of their sponsors 
to determine eligibility. Sponsors are also financially liable for 
benefits paid to the noncitizen, and benefit agencies must seek 
repayment for these costs. GAO was asked to analyze (1) what is known 
about the size of the noncitizen population potentially affected by the 
sponsor deeming requirements for TANF, Medicaid, SNAP, and SSI; (2) to 
what extent have agencies implemented sponsor deeming; (3) to what 
extent have agencies implemented sponsor repayment. To address these, 
GAO analyzed federal data, surveyed states, and interviewed federal, 
state, and local officials. 

What GAO Found: 

The number of sponsored noncitizens potentially affected by sponsor 
deeming is unknown; however, federal restrictions on their eligibility 
for TANF, Medicaid, SNAP, and SSI, as well as other factors, likely 
limit the number affected. The most recent data available suggest that 
11 percent (473,000) of sponsored noncitizens applied for TANF, 
Medicaid, or SNAP during the course of 2007, and less than 1 percent 
(29,000) applied for SSI. In addition to federal restrictions, benefit 
agency officials reported that applicants’ reluctance or inability to 
obtain sponsor income information further reduces instances of deeming. 

Nationwide, most benefit administering agencies have established 
sponsor deeming policies for TANF, SNAP, and SSI. However, agencies in 
20 states have not done so for Medicaid, due in part to the lack of 
federal guidance for Medicaid on this requirement. Yet, even among 
administering agencies that have established policies, many expressed 
the desire for more federal guidance on various aspects of deeming. For 
example, over 60 percent of state officials reported that additional 
clarification on applying an exception to deeming when noncitizen 
applicants are indigent would be useful. Local officials also reported 
difficulties accessing information from the Department of Homeland 
Security needed to determine whether an applicant is sponsored—an 
essential part of the deeming process. 

Few agencies have taken steps to implement sponsor repayment of TANF, 
Medicaid, SNAP, and SSI, due in part to inconsistent federal guidance. 
While law requires that agencies administratively pursue repayment, 
federal regulations and guidance suggest it is optional. In total, only 
two states have pursued sponsor repayment. Benefit agency officials 
reported that several factors discourage pursuit of repayment. 
Specifically, they reported that the process involves high relative 
costs since noncitizens who receive benefits after deeming only qualify 
because both they and their sponsors have very low incomes. Officials 
also reported that local staff who pursue repayment for these benefits 
sometimes have competing priorities. 

Figure: Sponsor Deeming and Repayment Processes: 

[Refer to PDF for image: illustration] 

Deeming: 

Applicant: Contacts local benefit administering agency; 

Local benefit administering agency: adds applicant and sponsor's income 
together; 

Applicant is eligible if under income threshold; 

Repayment: 

Eligible applicant receives benefit from Local benefit administering 
agency; 

Local benefit administering agency: bills sponsor for benefit costs. 

Source: GAO. 

[End of figure] 

What GAO Recommends: 

GAO recommends that the Secretary of Health and Human Services (HHS) 
provide additional guidance on sponsor deeming and the Secretary of 
Homeland Security improve access to information on who is sponsored. 
Both agencies generally agreed with the recommendations, although HHS 
disagreed that additional guidance specifically for TANF was needed. 

To view the full product, including the scope and methodology, click on 
[hyperlink, http://www.gao.gov/products/GAO-09-375]. For more 
information, contact Kay Brown at (202) 512-7215 or brownke@gao.gov. 

[End of section] 

Contents: 

Letter: 

Background: 

Restrictions on Sponsored Noncitizens' Eligibility for Benefits, and 
Other Factors, Limit the Number Potentially Affected by Sponsor 
Deeming: 

Most Agencies Have Taken Steps to Implement Sponsor Deeming, but Gaps 
in Federal Guidance and Noncitizen Information Hinder Full 
Implementation: 

Agencies Generally Have Not Implemented Sponsor Repayment, Due in Part 
to Unclear Federal Guidance and Other Factors: 

Conclusions: 

Recommendations for Executive Action: 

Agency Comments and Our Evaluation: 

Appendix I: Objectives, Scope, and Methodology: 

Appendix II: Comments from the Department of Health and Human Services: 

Appendix III: Comments from the Department of Homeland Security: 

Appendix IV: GAO Contact and Staff Acknowledgments: 

Table: 

Table 1: Federal and State Responsibilities for Key Program Functions 
Vary: 

Figures: 

Figure 1: Steps Generally Involved in Processing a Sponsored 
Noncitizen's Benefit Application: 

Figure 2: Federal Eligibility Restrictions and Other Factors Likely 
Limit the Number of Sponsored Noncitizens Affected by Deeming and 
Receiving Benefits: 

Figure 3: Number of States in Which There Is a Sponsor Deeming Policy, 
by Benefit: 

Figure 4: State Administering Agencies' Views on Areas for Which 
Additional Federal Assistance Would Be Useful: 

Figure 5: Example of Variation Regarding When an Indigence Exception Is 
Determined in the Application Process: 

Figure 6: Number of States in Which There Is a Sponsor Repayment 
Policy, by Benefit: 

Abbreviations: 

ACF: Administration for Children and Families: 

CMS: Centers for Medicare and Medicaid Services: 

DHS: Department of Homeland Security: 

HHS: Health and Human Services: 

IIRIRA: Illegal Immigration Reform and Immigrant Responsibility Act: 

LPR: legal permanent resident: 

OIS: Office of Immigration Statistics: 

PRWORA: Personal Responsibility and Work Opportunity Reconciliation 
Act: 

SAVE: Systematic Alien Verification for Entitlements: 

SCHIP: State Children's Health Insurance Program: 

SNAP: Supplemental Nutrition Assistance Program: 

SSI: Supplemental Security Income: 

TANF: Temporary Assistance for Needy Families: 

USCIS: U.S. Citizenship and Immigration Services: 

USDA: U.S. Department of Agriculture: 

[End of section] 

United States Government Accountability Office: 
Washington, DC 20548: 

May 19, 2009: 

The Honorable John Linder: 
Ranking Member: 
Subcommittee on Income Security and Family Support: 
Committee on Ways and Means: 
House of Representatives: 

Dear Mr. Linder: 

To ensure that the availability of public benefits does not provide an 
incentive for immigration and that noncitizens residing in this country 
are self-reliant, Congress significantly limited noncitizens' access to 
public benefits through the Personal Responsibility and Work 
Opportunity Reconciliation Act of 1996 (PRWORA) and the Illegal 
Immigration Reform and Immigrant Responsibility Act of 1996 (IIRIRA). 
Key federal means-tested public benefits involved are: Temporary 
Assistance for Needy Families (TANF), Medicaid, the Supplemental 
Nutrition Assistance Program (SNAP),[Footnote 1] and Supplemental 
Security Income (SSI). In many cases, the 1996 legislation restricted 
entire categories of legal noncitizens, such as those who have resided 
in the United States fewer than 5 years, from receiving these benefits. 
For those legal noncitizens who obtained their status through the 
financial sponsorship of a family member, there is an additional 
restriction. Sponsored noncitizens[Footnote 2] generally cannot qualify 
for benefits unless their incomes, combined with that of their 
sponsors, are low enough to meet program eligibility thresholds--a 
process known as "sponsor deeming." Sponsors must sign affidavits of 
support, when these noncitizens immigrate, which verify that the 
sponsors' incomes are at least 125 percent of the federal poverty 
guidelines and pledge financial support for the noncitizens. Under the 
1996 laws, this pledge of support was made legally binding and 
enforceable, in part through the "sponsor repayment" provision, which 
requires benefit granting agencies to seek repayment of the cost of 
benefits provided to a sponsored noncitizen from the sponsor. Sponsor 
repayment, in this context, is not related to error or fraud and must 
be pursued after benefits are granted solely on the basis that the 
sponsor agreed to be financially responsible for the noncitizen when he 
or she immigrated. 

Since these laws were passed and made effective, very little research 
has examined how many people have been affected by the sponsor deeming 
and repayment policies or how these policies have been implemented by 
government agencies at the federal, regional, state, and local levels. 
In light of the current economic downturn, this information may be of 
growing importance, as increased numbers of sponsored noncitizens and 
others may seek assistance from these benefits. Based on your request, 
this report provides information on the following questions: (1) What 
is known about the size of the noncitizen population potentially 
affected by the sponsor deeming requirements for TANF, Medicaid, SNAP, 
and SSI? (2) To what extent are agencies implementing sponsor deeming, 
and what factors may hinder them? (3) To what extent are agencies 
implementing sponsor repayment, and what factors may hinder them? 

To answer these questions, we collected and analyzed information 
through several methods. To gather relevant federal-level information, 
we interviewed officials from: 

* the Department of Health and Human Service's (HHS) Administration for 
Children and Families (ACF) and Centers for Medicare and Medicaid 
Services (CMS), which, respectively, oversee TANF and Medicaid; 

* the Department of Agriculture's (USDA) Food and Nutrition Service, 
which oversees SNAP; 

* the Social Security Administration (SSA), which oversees SSI; and: 

* the Department of Homeland Security (DHS), which oversees immigration 
and provides noncitizen information to benefit administering agencies 
through its Systematic Alien Verification for Entitlements (SAVE) 
system. 

As criteria for policy implementation, we reviewed relevant federal 
laws, regulations, and agency guidance. We also reviewed available 
federal data on noncitizens, as well as benefit applicants and 
recipients and, when appropriate, used these to produce estimates 
related to sponsored noncitizens. Through interviews with agency 
officials, as well as our own analyses, we determined that these data 
were sufficiently reliable for the purposes of this report. 

To gather regional, state, and local information on sponsor deeming and 
repayment implementation, we used several methods. First, to collect 
information on TANF, Medicaid, and SNAP, which are administered by 
states, we conducted a Web-based survey of state administrators of each 
of these benefits in all 50 states and the District of Columbia between 
August and October 2008.[Footnote 3] All administrators responded to 
our survey. While we did not validate specific information that 
administrators reported through our survey, we reviewed their 
responses, and we conducted follow-up as necessary to determine that 
their responses were complete, reasonable, and sufficiently reliable 
for the purposes of this report. Second, we conducted site visits in 
five states selected because they had significant populations of legal 
permanent residents and low-income, foreign born residents, as both of 
these populations include sponsored noncitizens and are captured in 
federal data. The selected states - California, Connecticut, Florida, 
Georgia, and Minnesota - also provided geographic variation. In each 
state, we interviewed state-level benefit administrators, as well as 
officials from two to five local offices within a selected region that 
had experienced significant growth in its legal permanent resident 
population in recent years. Through both the survey and site visits, we 
collected data on sponsored noncitizen applicants and recipients from 
the limited number of states and localities that could provide such 
information, and we determined that these data were sufficiently 
reliable to include in this report. Third, to collect information on 
sponsor deeming and repayment in SSI, which is federally administered 
by SSA, we interviewed officials from all 10 SSA regional offices. We 
also interviewed researchers knowledgeable about immigrant and public 
benefit issues. 

We conducted this performance audit from March 2008 to May 2009, in 
accordance with generally accepted government auditing standards. Those 
standards require that we plan and perform the audit to obtain 
sufficient, appropriate evidence to provide a reasonable basis for our 
findings and conclusions based on our audit objectives. We believe that 
the evidence obtained provides a reasonable basis for our findings and 
conclusions based on our audit objectives. See appendix I for 
additional information on our methodology. 

Background: 

The passage of PRWORA significantly limited the conditions under which 
legal permanent residents (LPR) are eligible for federal means-tested 
public benefits. LPRs are noncitizens who are legally permitted to live 
permanently in the United States and include those who obtain this 
status through the sponsorship of a family member, an employer-based 
preference, or are granted asylum or refugee status.[Footnote 4] 
Benefits affected by the law include TANF,[Footnote 5] which provides 
time-limited cash assistance and other support services; Medicaid, 
which provides health care assistance; SNAP, which provides food 
assistance; and SSI, which provides cash assistance to the aged, blind, 
and disabled. 

One particular subgroup of LPRs affected by the PRWORA changes to 
eligibility requirements for TANF, Medicaid, SNAP, and SSI includes 
those who obtained their LPR status through sponsorship by a relative 
who is also a LPR or U.S. citizen. Specifically, sponsored noncitizens 
who entered the United States on or after the passage of PRWORA on 
August 22, 1996, are generally only eligible for TANF, Medicaid, and 
SNAP after they have been in the United States for 5 years and eligible 
for SSI after they have been credited with 40 quarters of work. Certain 
veterans, active duty military, and their spouses and children, are 
exempted from these time-and work-related criteria, as are children 
under the age of 18 who apply for SNAP benefits. As with all benefit 
applicants, after sponsored noncitizens are determined to be qualified 
for benefits based on their noncitizen status, their eligibility is 
assessed on other criteria. For example, because these benefits are 
means-tested, applicants' income and asset information is reviewed to 
determine whether they fall below the established financial eligibility 
threshold for each benefit.[Footnote 6] 

At the same time that it limited the conditions under which sponsored 
noncitizens are eligible for benefits, PRWORA, along with IIRIRA, 
strengthened the requirement that sponsors demonstrate their ability to 
provide financial support, if needed, to immigrating noncitizens. 
Consequently, since December 19, 1997, a sponsor must sign a legally 
binding affidavit of support as part of each sponsored noncitizen's 
immigration application, which proves that the sponsor's income is at 
least 125 percent of the federal poverty guidelines.[Footnote 7] The 
affidavit, as a formal contract between the sponsor and the noncitizen, 
also specifies that the sponsor will provide necessary support to 
maintain the noncitizen at an annual income of no less than 125 percent 
of the federal poverty guidelines while the affidavit is enforceable. 
[Footnote 8] The goal of the strengthened affidavit, as stated in 
PRWORA, is to ensure that sponsored noncitizens do not become public 
charges. 

Sponsor Deeming and Repayment in Federal Law: 

Sponsor deeming is the attribution of the income and resources of the 
noncitizen's sponsor (and that of the sponsor's spouse, if any) as the 
applicant's own income when determining benefit eligibility and benefit 
amounts. Specifically, when the sponsor's income is deemed, it is added 
to that of the applicant, and that sum is compared with the benefit's 
financial eligibility threshold.[Footnote 9] Therefore, if sponsor 
deeming occurs, benefits are only granted to sponsored noncitizens when 
both they and their sponsors are sufficiently low-income.[Footnote 10] 
Policies requiring sponsor deeming for noncitizen benefit applicants 
existed prior to 1996. However, PRWORA strengthened these deeming 
policies by generally extending the deeming period from 3 years to when 
the noncitizen naturalizes or has been credited with 40 quarters of 
work in the United States, or when the sponsor dies. Medicaid was also 
later added as a benefit subject to sponsor deeming, in addition to 
TANF, SSI, and SNAP.[Footnote 11] 

IIRIRA, which was passed shortly after PRWORA, specified two exceptions 
to sponsor deeming for battery and indigence. A battery exception to 
sponsor deeming can be made by a benefit agency if a sponsored 
noncitizen benefit applicant is a battered spouse, child, or parent or 
child of a battered person.[Footnote 12] An indigence exception to 
sponsor deeming can be made by a benefit agency if a sponsored 
noncitizen benefit applicant is unable to obtain food and shelter 
despite any assistance provided by the sponsor or others. These cases 
may include instances in which the sponsor has abandoned the noncitizen 
or is otherwise unable to provide the noncitizen with sufficient 
financial support. For any case in which the indigence exception is 
applied, the administering agency processing the application must send 
details related to the case, including the name of the sponsored 
noncitizen and the sponsor, to DHS. Both exceptions may be granted for 
1 year, and agencies may extend the exceptions in certain circumstances 
after reassessing the case at that time. 

Sponsor repayment is the collection of benefit costs paid to a 
sponsored noncitizen by a benefit administering agency from that 
person's sponsor. This provision, which originated with PRWORA, is 
designed to legally enforce the affidavit of support, which pledges a 
sponsor's continuous financial support of the noncitizen. Accordingly, 
under the law, whenever a sponsored noncitizen receives federal means- 
tested public benefits, the administering agency that provided the 
benefit must request repayment of the benefit costs from the sponsor. 
If sponsors do not repay benefits after the agency's request, the 
agency may also pursue repayment from the sponsor through court action, 
if it so chooses. These sponsor repayment provisions are separate from 
the traditional benefit recovery provisions used in cases of benefit 
fraud or payment error. 

Agency Roles in Implementing the Deeming and Repayment Policies: 

Federal and state agencies have different roles in overseeing and 
administering the four federal means-tested public benefits. SSI is 
overseen and administered by federal SSA staff across the country. In 
contrast, TANF, Medicaid, and SNAP are generally overseen by the 
relevant federal agencies and administered by states, although specific 
roles vary by program (see table 1). For all four benefits, 
administering agencies are responsible for deeming sponsor income 
during the application process and pursuing sponsor repayment of 
benefits received by sponsored noncitizens. In the case of SSI, these 
administering agencies are SSA regional and field offices. For TANF, 
Medicaid, and SNAP, the administering agencies are state and local 
benefit offices. 

Table 1: Federal and State Responsibilities for Key Program Functions 
Vary: 

Key functions: Funding benefits; 
Program: TANF: federal and state shared responsibility; 
Program: Medicaid: federal and state shared responsibility; 
Program: SNAP: federal responsibility; 
Program: SSI: federal responsibility. 

Key functions: Funding administrative costs; 
Program: TANF: federal and state shared responsibility; 
Program: Medicaid: federal and state shared responsibility; 
Program: SNAP: federal and state shared responsibility; 
Program: SSI: federal responsibility. 

Key functions: Establishing eligibility rules; 
Program: TANF: federal and state shared responsibility; 
Program: Medicaid: federal and state shared responsibility; 
Program: SNAP: federal and state shared responsibility[A]; 
Program: SSI: federal responsibility. 

Source: GAO. 

[A] SNAP eligibility rules are established by the federal agency, but 
states may chose certain state options for eligibility. 

[End of table] 

Sponsor deeming is implemented by staff at the administering agency as 
part of the benefit application process. While agencies vary to some 
degree in the methods used to process applications, the method used for 
noncitizen applicants for whom deeming applies generally involves 
several steps (see figure 1). First, eligibility workers processing 
these cases typically review an applicant's documents, such as an LPR 
or green card, to determine noncitizen status and verify the 
information they contain using DHS's U.S. Citizenship and Immigration 
Services (USCIS) automated SAVE system.[Footnote 13] Workers may then 
determine whether an applicant has a sponsor by obtaining verification 
from USCIS or by obtaining proof from the noncitizen. Once workers 
determine that the noncitizen applicant is sponsored, they assess the 
applicant's benefit eligibility based on the benefit-specific criteria. 
To assess income eligibility, the worker requests proof of the 
applicant's income and asset information, as well as that of the 
sponsor, such as tax forms or other financial documents. Upon receipt 
of that documentation, the worker performs the deeming step to 
determine whether the applicant's income, when coupled with the 
sponsor's, is below the benefit-specific financial eligibility 
thresholds. 

Figure 1: Steps Generally Involved in Processing a Sponsored 
Noncitizen's Benefit Application: 

[Refer to PDF for image: illustration] 

Noncitizen applies for benefits: 
TANF; Medicaid; SNAP; SSI; 

Review applicant documents: 
Eligibility worker requests and reviews applicant’s noncitizen 
documents (e.g., green card). 

Verify citizenship status: 
Worker seeks to verify noncitizenship status as LPR who is potentially 
eligible for benefits through USCIS. 

Check sponsor information: 
Worker asks applicant if she/he is sponsored and seeks to confirm 
answer through USCIS or other means. 

Request and review sponsor’s income information: 
Worker obtains information on the sponsor’s current income through the 
applicant, sponsor, or other means. 

Deeming sponsor income: 
Worker ‘deems’ or counts the sponsor’s income when determining 
eligibility. 

Ineligible if income is over threshold; or; 
Eligible if income is under threshold. 

Source: GAO. 

[End of figure] 

Sponsor repayment is also implemented by staff at the administering 
agency, though after benefits are received by the sponsored noncitizen. 
Federal law and DHS regulations on affidavits of support define several 
steps that agencies must follow when pursuing sponsor repayment. 
Specifically, once benefits have been received by a sponsored 
noncitizen, the administering agency must contact the sponsor in 
writing and request repayment of the costs associated with those 
benefits. The written request must include several elements, such as 
the name and address of the noncitizen, dates benefits were provided, 
and amount of the benefits. If the sponsor has not responded to the 
written request by either repaying the benefit costs or indicating a 
willingness to pay after 45 days, the agency may initiate litigation to 
recover benefit costs from the sponsor. 

Restrictions on Sponsored Noncitizens' Eligibility for Benefits, and 
Other Factors, Limit the Number Potentially Affected by Sponsor 
Deeming: 

The number of sponsored noncitizens potentially affected by sponsor 
deeming is unknown; however, factors such as the restrictions on their 
eligibility for TANF, Medicaid, SNAP, and SSI, as well as the deeming 
process itself, likely limit the number affected. Overall, 
approximately 12.8 million legal noncitizens, including sponsored and 
nonsponsored, were permanently residing in the United States as of 
January 1, 2007, according to the most recent DHS estimates 
available.[Footnote 14] We estimate that around 4.2 million of those 
individuals obtained their legal noncitizen status via an executed 
affidavit of support, whereby the sponsor assumed financial 
responsibility for the noncitizen.[Footnote 15] Because demographic 
data for this population, such as income and length of U.S. residency, 
are unavailable,[Footnote 16] it is unknown how many of these 
individuals are eligible for TANF, Medicaid, SNAP, or SSI. 

The total number of sponsored noncitizens that apply for these benefits 
is also unknown, in part because most federal benefit agencies do not 
collect this data. However, during 2007, TANF, Medicaid, and SNAP 
administering agency staff used DHS's SAVE system to verify the 
noncitizen status of approximately 473,000 applicants who were 
sponsored--a step typically taken when noncitizens apply for benefits. 
[Footnote 17] This is approximately 11 percent of the estimated 
sponsored noncitizen population in the United States as of January 1, 
2007,[Footnote 18] and it is the best proxy available for the number of 
sponsored noncitizen applicants for these three programs. In addition, 
approximately 29,000 (0.7 percent) sponsored noncitizens applied for 
SSI benefits in that year, according to SSA data.[Footnote 19] 

Local benefit agency staff we spoke with during our five site visits 
reported that sponsored noncitizens currently constitute a small 
proportion of the people they encounter applying for benefits. For 
example, staff in many of the local offices we visited said that they 
encounter only a few sponsored noncitizen applicants each month, though 
staff in other offices said they saw these applicants more frequently. 
Some staff noted that the number of sponsored noncitizens seeking TANF, 
Medicaid, or SNAP benefits noticeably dropped, and has remained low, 
since PRWORA became effective. Specifically, staff cited the PRWORA 
requirement that sponsored noncitizens live in the United States for 5 
years before they become eligible for those benefits as a significant 
contributor to this change. 

Likewise, SSA officials we spoke to reported that eligibility 
restrictions imposed by PRWORA caused a similar drop in the number of 
sponsored noncitizens pursuing SSI benefits. The requirement that most 
sponsored noncitizens obtain credit for at least 40 quarters of work to 
be eligible for SSI benefits was frequently cited by staff at regional 
SSA offices as causing this decrease.[Footnote 20] Staff at all 
regional offices reported that they continue to encounter few sponsored 
noncitizens applying for SSI. 

When sponsored noncitizens do apply for benefits, staff at most of the 
local offices we visited during our site visits told us that very few 
of these applications for TANF, Medicaid, and SNAP progress to the 
point where local staff deem sponsor income.[Footnote 21] The perceived 
low incidence of deeming was also supported by state administering 
agency officials through our survey, as 69 percent indicated that cases 
involving sponsor deeming had seldom or never occurred in their states 
during the past 2 years.[Footnote 22] Local officials in several 
offices indicated that applicants often withdraw their applications 
after they are made aware of the sponsor deeming rules. State and local 
staff also cited the reluctance or inability of the sponsored 
noncitizen applicant to obtain sponsor income information as a reason 
that the application process frequently ends before deeming occurs. 
Staff reported the following examples of situations: 

* some applicants withdraw their applications because they do not wish 
to bother their sponsor with a request for income documentation; 

* some withdraw because they are concerned about how their pursuit of 
benefits will impact their sponsors' ability to remain in the United 
States or naturalize, if their sponsors are legal noncitizens 
themselves; 

* some withdraw after being told their sponsor may be asked to repay 
the benefits in the future, as specified by federal law; 

* some applicants' sponsors cannot be located, resulting in denial of 
the application due to lack of sponsor income information; and, 

* some applicants' sponsors refuse to provide income information, also 
resulting in denial of the application. 

Officials from SSA also reported a low incidence of sponsor deeming 
during the processing of SSI benefits. For example, officials from all 
10 SSA regional offices reported that deeming has occurred either 
rarely or never since PRWORA became effective. Specifically, because 
the sponsor deeming policy does not apply to sponsored noncitizens 
credited with 40 quarters of work, and most sponsored noncitizens are 
only eligible for SSI if they have satisfied the 40-quarter work 
eligibility requirement, deeming is inevitably rare. As a result, only 
sponsored noncitizens who apply for SSI and are exempted from the 40- 
quarter work eligibility criteria, such as those with military 
connections, are subject to sponsor deeming. 

While local staff from our five site visit states reported that sponsor 
deeming has been applied in a limited number of cases at their offices, 
the extent to which deeming has affected whether sponsored noncitizens 
receive benefits or the amount of benefits they receive is unknown. 
However, selected federal and state data that we were able to obtain 
provide some insight into the proportion of benefit recipients that are 
sponsored noncitizens.[Footnote 23] For instance, less than 0.4 percent 
of SSI recipients were sponsored noncitizens during the years 2004 
through 2007, according to SSA.[Footnote 24] Similarly, Florida, which 
has a relatively large noncitizen population, reported that, in 
December 2008, less than 0.05 percent of TANF, Medicaid, or SNAP 
recipients were sponsored noncitizens. Utah and Minnesota also have few 
sponsored noncitizens receiving TANF and SNAP, with their proportions 
ranging from zero to 0.9 percent of each benefit's total recipients. 
[Footnote 25] Figure 2 shows the progression of sponsored noncitizens 
through the benefit application and sponsor deeming processes to become 
recipients. 

Figure 2: Federal Eligibility Restrictions and Other Factors Likely 
Limit the Number of Sponsored Noncitizens Affected by Deeming and 
Receiving Benefits: 

[Refer to PDF for image: illustration] 

Legal permanent residents: about 12.8 million. 

Sponsored noncitizens: about 4.2 million. 

Local benefit administering agency: about 473,000 noncitizens applied 
for TANF, Medicaid, and SNAP; about 29,000 applied for SSI. 

Applicant eligible? ineligible (narrows the number of sponsored 
noncitizens): Applicants don’t meet PRWORA eligibility requirements 
(e.g., 5-year residency) and denied benefits. 

Sponsor’s income? ineligible (narrows the number of sponsored 
noncitizens): Sponsor’s income information not provided; applicant 
withdraws, or is denied benefits. 

Deeming: Add sponsor and applicant’s income together: ineligible 
(narrows the number of sponsored noncitizens): Applicant is ineligible 
if over income threshold and denied benefits. 

Remaining eligible applicants receive benefits. 

Sources: GAO; estimates from DHS and SSA 2007 data. 

Note: Conceptual depiction; figure not drawn to scale. 

[End of figure] 

Most Agencies Have Taken Steps to Implement Sponsor Deeming, but Gaps 
in Federal Guidance and Noncitizen Information Hinder Full 
Implementation: 

Most Administering Agencies Have Established Sponsor Deeming Policies 
but Report Needing Additional Federal Guidance: 

Although benefit administering agencies have generally established 
sponsor deeming policies for TANF, Medicaid, SNAP, and SSI, based on 
federal regulations and federal guidance,[Footnote 26] inaction by CMS 
has stalled some states' implementation of sponsor deeming in Medicaid. 
SSA disseminated SSI guidance to staff nationwide in 2000 addressing 
the sponsor deeming provisions under the 1996 legislation. As a result, 
field office staff nationwide have implemented sponsor deeming in SSI 
by following procedures and using automated systems established by SSA 
headquarters. Similarly, USDA and HHS issued guidance to state benefit 
administering agencies in 2003 on sponsor deeming for SNAP and TANF, 
respectively. Accordingly, all state agencies administering SNAP 
reported in our survey that they have established sponsor deeming 
policies, and administering agencies in all but five states reported 
having established sponsor deeming policies for TANF. In contrast, CMS 
has not issued formal guidance regarding sponsor deeming for Medicaid, 
[Footnote 27] and CMS officials stated that the agency does not 
currently have plans to do so. Thus, fewer administering agencies (31) 
have established policies for Medicaid, and officials from a few states 
cited the lack of guidance from CMS as a reason for their unwillingness 
to establish sponsor deeming policies in their Medicaid programs. 
Officials in one state referred to the issue's political sensitivity 
and the high cost of reworking automated eligibility systems to include 
sponsor deeming as reasons they would not act without clear federal 
guidance. (See figure 3.) 

Figure 3: Number of States in Which There Is a Sponsor Deeming Policy, 
by Benefit: 

[Refer to PDF for image: four pie-charts] 

Number of States in Which There Is a Sponsor Deeming Policy, by 
Benefit: 

TANF: 
Have a policy: 46 states; 
Do not have a policy: 5 states. 

Medicaid: 
Have a policy: 31 states; 
Do not have a policy: 20 states. 

SNAP: 
Have a policy: 51 states; 
Do not have a policy: 0 states. 

SSI: 
Have a policy: 51 states; 
Do not have a policy: 0 states. 

Sources: GAO survey of state administrators of TANF, Medicaid, and SNAP 
(from left to right, first three pie charts); SSA Program Operations 
Manual System (see SSI pie chart far right). 

Note: For SSI, SSA eligibility staff follow uniform federal-level 
policies that cover all states and the District of Columbia. 

[End of figure] 

Although most administering agencies have established sponsor deeming 
policies, agency officials reported that additional guidance in certain 
areas would be helpful. Specifically, between 60 and 70 percent of 
state administering agencies with sponsor deeming policies for TANF, 
Medicaid, or SNAP expressed some desire for more guidance on various 
aspects of deeming (see figure 4). For example, about 70 percent 
reported that clarification on how to handle cases where information on 
the sponsor's income is determined to be unobtainable would be 
moderately, extremely, or very useful. In addition, many reported that 
additional federal guidance on areas related to the indigence exception 
to deeming would be useful.[Footnote 28] Guidance in these areas is 
particularly important because how administering agencies handle 
applicants who are unable to obtain sponsor income information can have 
implications for how agencies apply the indigence exception, as well as 
whether these applicants are determined to be eligible for benefits. 
SSI guidance, as well as recently issued SNAP guidance, indicate that 
when sponsor income information is unobtainable an indigence exception 
is to be considered; however, federal TANF guidance does not clearly 
address this issue. 

Figure 4: State Administering Agencies' Views on Areas for Which 
Additional Federal Assistance Would Be Useful: 

[Refer to PDF for image: stacked horizontal bar graph: Percentages of 
administering agencies with sponsor deeming policies] 

Type of assistance: Clarification on how to handle cases in which 
information on the sponsor’ income is determined to be unobtainable; 
Extremely or very useful: 56%; 
Moderately useful: 14%; 
Slightly or not at all useful: 25%; 
Don't know: 5%. 

Type of assistance: Clarification on who to send indigence exception 
reports to at the federal level; 
Extremely or very useful: 49%; 
Moderately useful: 19%; 
Slightly or not at all useful: 23%; 
Don't know: 9%. 

Type of assistance: Clarification on how to define indigence and who 
qualifies for the indigence exception; 
Extremely or very useful: 41%; 
Moderately useful: 21%; 
Slightly or not at all useful: 33%; 
Don't know: 5%. 

Type of assistance: Clarification on who qualifies for the battery or 
extreme cruelty exception; 
Extremely or very useful: 41%; 
Moderately useful: 24%; 
Slightly or not at all useful: 30%; 
Don't know: 5%. 

Type of assistance: Additional assistance on how to calculate the 
amount of sponsor's income to deem; 
Extremely or very useful: 38%; 
Moderately useful: 23%; 
Slightly or not at all useful: 33%; 
Don't know: 5%. 

Source: GAO survey of state administrators of TANF, Medicaid, and SNAP. 

Note: Percentages are calculated based on the number of state 
administrators who reported that their agencies had established a 
sponsor deeming policy and responded to this question. For all five 
types of assistance, 25 out of 153 administrators skipped this question 
because they did not have a sponsor deeming policy. For the first and 
third types of assistance (reading from top to bottom), two additional 
administrators did not respond to this question. Percentages may not 
add up to 100 due to rounding. 

[End of figure] 

Similarly, about 62 percent of state administering agencies reported 
that clarification on how to define indigence and who qualifies for the 
indigence exception would be moderately, very, or extremely useful. 
Although SSI guidance and recently issued SNAP guidance indicate at 
what point in the eligibility screening process indigence should be 
considered, and whether those who qualify for indigence must provide 
full sponsor income and asset information, federal guidance for TANF 
again does not clearly address this issue. During our site visits to 
five states, we found that states and localities sometimes proceed 
differently, which can directly affect who is determined eligible for 
benefits. In some cases, local staff are directed to consider whether 
an applicant qualifies for an indigence exception before deeming 
occurs. Accordingly, if the agency's indigence criteria are met, the 
applicant can qualify for benefits regardless of the applicant's 
ability or willingness to provide full sponsor income information and 
without deeming the sponsor's income. In these cases, the eligibility 
worker counts only the actual amount of income or assistance the 
applicant receives from the sponsor, rather than deeming all or most of 
the sponsor's income and assets. One local official stated that 
eligibility staff in his locality assess an applicant's eligibility for 
the indigence exception before deeming and, though staff do not serve 
many sponsored noncitizens, those that do apply typically qualify for 
benefits this way.[Footnote 29] In contrast, the policy in some other 
localities is to require applicants to provide sponsor income 
information before considering an exception. For these agencies, 
applicants who are unable or unwilling to provide sponsor income 
information are not considered for an indigence exception. One local 
official expressed concern that this requirement results in applicants, 
whose sponsors have essentially abandoned them, being denied benefits. 
(See fig. 5 for one example of how this process could vary.) 

Figure 5: Example of Variation Regarding When an Indigence Exception Is 
Determined in the Application Process: 

[Refer to PDF for image: illustration] 

Sponsored applicant: 

1) Indigence exception: 
Yes (applicant meets indigence criteria): proceed to #9. 
No: proceed to #2. 

2) Sponsor's income is checked; 

3) No sponsor’s income information provided: applicant withdraws, 
sponsor cannot be located, or sponsor refuses to provide information; 

4) ineligible. 

5) Sponsor's income is checked; Sponsor’s current information provided; 

6) Indigence exception? 
If yes, proceed to #9; 
If no, proceed to #7. 

7) Deeming: Add sponsor and applicant’s income together; 

8) Over income threshold: ineligible; 

9) Under income threshold: eligible. 

Source: GAO. 
 
[End of figure] 

Administering agencies also reported that additional federal guidance 
on other areas related to the indigence and battery exceptions would be 
helpful. For example, administering agencies are required to report 
indigence exception cases to DHS,[Footnote 30] but neither DHS 
regulations nor federal benefit agency guidance provides the correct 
address for them to do so. As a result, state officials in four of the 
five states we visited did not have the correct address to send 
indigence reports, and some told us that they have not reported these 
cases to DHS. DHS officials also told us that they may not be receiving 
reports of every indigence exception case. Consequently, DHS has 
incomplete information on which sponsors are failing to financially 
support the noncitizens for which they signed affidavits of support. 
[Footnote 31] In addition, about two-thirds of state administering 
agencies reported in our survey that further clarification on who 
qualifies for the battery exception would be useful.[Footnote 32] 
However, among local officials we spoke with, some stated they have 
never made a battery exception. 

Administering Agencies Also Reported Needing Assistance Accessing 
Federal Information Needed to Determine Who Is Sponsored: 

Administering agency officials reported that additional federal 
assistance on accessing DHS information needed to determine who is 
sponsored would also help them implement sponsor deeming policies. 
Specifically, state or local officials in each of the five states we 
visited reported difficulties accessing DHS information needed to 
determine whether a noncitizen applicant has a sponsor, and 65 percent 
of agencies administering these benefits nationwide reported that more 
specific policies on using SAVE in determining sponsorship would be 
useful. Agencies' difficulties in using SAVE could leave them 
vulnerable to fraud or improper payments because SAVE is a key 
mechanism for verifying eligibility and sponsorship status.[Footnote 
33] DHS officials stated that the agency provided SAVE users with 
technical assistance focused on using the automated system to obtain 
sponsorship information when this feature became available in 2005, and 
it continues to offer SAVE technical assistance through user-directed 
online tools and instructor-led seminars or webinars upon request. 
[Footnote 34] However, 30 to 40 percent of administering agencies for 
TANF, Medicaid, and SNAP reported that they had not received any 
technical assistance or communication from DHS on determining if a 
noncitizen applicant has a sponsor. 

As a result, benefit agencies report that staff commonly use SAVE to 
verify noncitizen information, but not all staff are aware of how to 
use SAVE to obtain sponsorship information. As an initial step, staff 
in all local offices we visited use DHS's automated SAVE system to 
verify the applicant's basic noncitizen information, such as name and 
admission code.[Footnote 35] Some local officials said SAVE provides 
this information quickly and easily. However, not all local offices we 
visited were aware that, by taking an additional step, the automated 
SAVE system can provide information on whether that person is 
sponsored. Specifically, the system can provide the sponsor's name and 
address to administering agencies, usually within a few days. Instead, 
staff in some local offices used methods to verify sponsorship that 
either took longer or were less reliable, sometimes because they were 
unaware of the option to use SAVE. For example, some local officials 
said eligibility staff manually submit paper request forms to DHS, 
which usually results in a response within a few weeks but may take 
several months. In other local offices, staff use the noncitizen's 
admission code provided by SAVE to determine whether the applicant has 
a sponsor. However, many different codes indicate that a noncitizen is 
sponsored, and DHS has not provided administering agencies with an 
official list specifying which group of codes indicate sponsorship. 
Thus, eligibility staff sometimes rely on lists of codes developed in 
their own offices, which may not be fully accurate.[Footnote 36] Some 
state and local officials said that maintaining such lists is 
challenging because admission codes are numerous and can change. 

Agencies Generally Have Not Implemented Sponsor Repayment, Due in Part 
to Unclear Federal Guidance and Other Factors: 

Federal Regulations and Guidance Suggest Pursuit of Sponsor Repayment 
Is Optional, and Very Few Administering Agencies Pursue Repayment: 

Although federal law states that benefit granting agencies must 
administratively pursue sponsor repayment, DHS regulations on 
affidavits of support, as well as some federal benefit agency guidance, 
suggest that administrative pursuit of sponsor repayment is optional. 
Specifically, the law states that benefit administering agencies that 
have granted a means-tested public benefit to a sponsored noncitizen 
"shall request reimbursement by the sponsor." The law also states that 
if the sponsor does not respond to this request within 45 days, "an 
action may be brought against the sponsor" in court to enforce the 
affidavit of support. The DHS regulations on affidavits of support, 
however, simply describe the process a benefit agency must go through 
if the agency "wants to seek reimbursement" from a sponsor. In 
addition, the Federal Register notice accompanying the issuance of the 
DHS regulations, states that "the agency may seek reimbursement" if a 
sponsored noncitizen receives a means-tested benefit. 

When asked about this apparent discrepancy between the language in the 
statute and that in the regulations and Federal Register notice, a 
USCIS Associate Counsel explained that the regulations are intended to 
describe the process agencies must use when they pursue sponsor 
repayment rather than address whether they are required to do so. As 
stated in the Federal Register notice, "the request for reimbursement 
[is] a prerequisite to suit," but the act "does not require the agency 
to sue." Accordingly, DHS concluded that a request for reimbursement 
does not have to be made if the agency has no intention to sue. 
Agencies generally have enforcement discretion in carrying out laws, 
and the USCIS Associate Counsel noted that the decision of whether to 
pursue sponsor repayment involves an exercise of the federal benefit 
agencies' discretion. He added that federal benefit agencies may 
require their benefit administering agencies to pursue sponsor 
repayment by issuing their own pertinent regulations. While the federal 
benefit agencies have not issued related regulations, some have issued 
federal guidance that also suggests pursuit of sponsor repayment is 
optional. 

The importance of this issue was noted by state administering agency 
officials. Specifically, over two-thirds of the TANF, Medicaid, and 
SNAP state agency officials responding to our survey reported that 
clarification on whether it is mandatory or optional for agencies to 
administratively pursue sponsor repayment would be moderately, very, or 
extremely useful.[Footnote 37] A few benefit administering agency 
officials we spoke with noted that their state policies indicate locals 
"may" pursue sponsor repayment and, in those states, local staff are 
not pursuing repayment. 

Nationwide, most state benefit administering agencies reported that 
they have not established policies on sponsor repayment for TANF, 
Medicaid, or SNAP. In contrast, SSA has established a sponsor repayment 
policy for SSI benefits, which applies nationwide. (See figure 6.) 

Figure 6: Number of States in Which There Is a Sponsor Repayment 
Policy, by Benefit: 

[Refer to PDF for image: four pie-charts] 

Number of States in Which There Is a Sponsor Repayment Policy, by 
Benefit: 

TANF: 
Have a policy: 16; 
Don't have a policy: 28; 
Don't know: 2. 

Medicaid: 
Have a policy: 7; 
Don't have a policy: 20; 
Don't know: 4. 

SNAP: 
Have a policy: 21; 
Don't have a policy: 27; 
Don't know: 3. 

SSI: 
Have a policy: 51; 
Don't have a policy: 0; 
Don't know: 0. 

Sources: GAO survey of state administrators of TANF, Medicaid, and SNAP 
(from left to right, first three pie charts); SSA Program Operations 
Manual System (see SSI pie chart far right). 

Notes: In our survey, we assumed that state benefit administering 
agencies without a sponsor deeming policy in place would similarly not 
have a sponsor repayment policy. Therefore, state agencies without a 
sponsor deeming policy were not asked about sponsor repayment in our 
survey--5 for TANF, and 20 for Medicaid. For SSI, SSA eligibility staff 
follow uniform federal-level policies that cover all states and the 
District of Columbia. 

[End of figure] 

However, even in states with sponsor repayment policies formally in 
place, state and local staff do not always understand the unique 
characteristics of the sponsor repayment provisions. For example, a few 
staff we spoke to during one of our site visits thought that the 1996 
sponsor repayment provisions apply only when sponsored noncitizens 
receive benefits erroneously or in greater amounts than they are 
eligible for, as is the case with traditional benefit recovery 
provisions.[Footnote 38] A few others believed that the provisions 
require the federal government, rather than state or local 
administering agencies, to pursue sponsor repayment of benefits. In 
addition, some of the state and local officials we interviewed in one 
state were unaware of the sponsor repayment provisions and surprised to 
see that they were included in their state's policy manuals. 

Officials from only two states reported in our survey that they have 
pursued sponsor repayment of TANF, Medicaid, or SNAP benefits. 
Similarly, SSA officials told us that neither its regional nor field 
offices have pursued sponsor repayment of SSI benefits.[Footnote 39] 
With the exception of SSA, federal benefit agency officials we 
interviewed did not know if their administering agencies had pursued 
sponsor repayment, as neither federal law nor regulations require that 
these efforts be monitored. In addition, neither federal law nor 
federal regulations impose penalties on administering agencies that do 
not pursue sponsor repayment. 

Of the two states that reported pursuing sponsor repayment, neither was 
doing so for all cases. Specifically, Connecticut and New York state 
officials reported that some of their local offices have pursued 
sponsor repayment of TANF, Medicaid, or SNAP benefits received by 
sponsored noncitizens. In addition, these states have pursued repayment 
in different ways, and the full extent of their implementation is 
unknown. 

* Connecticut's sponsor repayment policy requires that after local 
staff grant a sponsored noncitizen TANF, Medicaid, or SNAP benefits, 
they refer the case to local resource recovery staff. According to 
officials, the resource recovery staff are expected to initiate an 
investigation, which involves obtaining a copy of the affidavit of 
support and assessing the amount of benefits paid to the noncitizen, 
and then send a letter to the sponsor requesting repayment. If the 
sponsor does not respond to this request, local staff are to submit the 
case to the Connecticut Attorney General. However, while Connecticut 
officials consider this to be the state's sponsor repayment policy, it 
is still in draft, and they report that not all offices have pursued 
repayment. In addition, sponsor repayment in Connecticut has been on 
hold statewide since March 2007, when several legal services 
organizations questioned the legality of this policy in a complaint 
letter.[Footnote 40] Connecticut state officials did not know how many 
cases were pursued prior to that time or how many benefits were repaid 
by sponsors. 

* In New York, a state official reported that sponsor repayment is to 
be pursued when noncitizens receive TANF or SNAP benefits after 
qualifying for the indigence exception to deeming.[Footnote 41] In 
these cases, local staff are to send a request for repayment to the 
sponsor. The official noted that New York's policies for TANF and SNAP 
indicate that counties should pursue sponsor repayment of benefits paid 
to sponsored noncitizens; however, individual counties have some 
discretion in determining whether to pursue sponsor repayment in each 
specific case. He indicated that repayment has been pursued 
administratively by several counties, but he did not know for how many 
cases. 

Administering Agencies Reported That High Relative Costs, Competing 
Priorities, and Limited Federal Guidance Hinder Their Pursuit of 
Sponsor Repayment: 

During our site visits, some state and local TANF, Medicaid, and SNAP 
officials suggested that pursuing sponsor repayment has clear costs and 
unclear financial benefits. Specifically, if a sponsored noncitizen 
qualifies to receive benefits after sponsor deeming occurs, it is 
because both the noncitizen and the sponsor are low-income. Agencies 
that pursue repayment of benefits from those sponsors may, therefore, 
expend more in administrative and potential court costs than they are 
able to recover from the sponsors. Because of these high relative 
costs, several officials we spoke to indicated that sponsor repayment, 
as it is currently defined in federal law, does not make sense for 
administering agencies to pursue. 

Some state and local TANF, Medicaid, and SNAP officials told us that 
the staff who pursue sponsor repayment sometimes have competing 
priorities that also discourage the pursuit of sponsors for repayment. 
Local recovery staff we spoke to in one state noted that their office 
is significantly understaffed for the investigations it is required to 
perform for cases of benefit fraud and overpayment. While benefit 
agencies have access to DHS information on sponsors, including their 
names and addresses,[Footnote 42] the local recovery staff we spoke to 
said that pursuing sponsor repayment is particularly labor intensive 
because there is no national-or state-established infrastructure to 
efficiently and effectively track down and bill sponsors for repayment. 
Other state officials we spoke to reported that administering agencies 
would like to pursue sponsor repayment through the courts, but the 
state or county attorneys who need to litigate these cases have other 
higher priority cases to pursue. 

Benefit administering agencies also reported that additional federal 
guidance on sponsor repayment is needed to assist implementation. For 
example, approximately two-thirds of the TANF, Medicaid, and SNAP state 
benefit administering agency officials responding to our survey 
reported that specific federal guidance on how to pursue sponsor 
repayment administratively, and when to pursue sponsor repayment 
administratively or in the courts, would be moderately, very, or 
extremely useful.[Footnote 43] While HHS guidance for TANF 
administering agencies notes that states may want to consider the 
sponsor's particular circumstances, such as financial status, and other 
feasibility factors in determining whether to pursue sponsor repayment 
of TANF benefits, other federal benefit agencies' guidance does not 
address this issue. In addition, during one of our site visits, state 
administering agency officials indicated that they would benefit from 
additional federal guidance on pursuing sponsor repayment for cases 
involving a battery exception to deeming. In these cases, the batterer 
may be the sponsor. However, DHS regulations require that agencies 
pursuing sponsor repayment send a letter to the sponsor containing 
several elements, including the noncitizen benefit recipient's address. 

Conclusions: 

The PRWORA and IIRIRA changes to sponsor deeming and repayment in TANF, 
Medicaid, SNAP, and SSI, coupled with simultaneous changes to 
noncitizen eligibility for these benefits, were intended in part to 
"assure that aliens be self-reliant in accordance with national 
immigration policy." While the laws' restrictions on noncitizen benefit 
eligibility directly work toward this goal, sponsor deeming and 
repayment efforts have not been as effective, in part because benefit 
administering agencies do not have the information and guidance they 
need to implement these provisions as intended. 

Specifically, agencies lack clear federal guidance on implementing 
deeming in Medicaid and also struggle to obtain federal information on 
a noncitizen's sponsorship status from DHS. As a consequence, certain 
sponsored noncitizens may receive means-tested public benefits based on 
their income and assets alone, even though they have sponsors who 
signed legally enforceable affidavits agreeing to support them when 
they became permanent residents in this country. In addition, agencies 
that are unaware of the most efficient and reliable method of accessing 
a noncitizen's sponsorship status from DHS are vulnerable to benefit 
fraud and improper payments. Medicaid and TANF agencies' efforts to 
implement sponsor deeming have also been affected by a lack of clear 
federal guidance on applying the indigence exception to deeming. 
Because some low-income sponsored noncitizens have sponsors who choose 
not to provide them financial assistance, or are unable to, 
inconsistencies in implementation of the law's indigence exception to 
sponsor deeming may cause these noncitizens unintended harm if they are 
prevented from obtaining benefits. 

In addition, while very few administering agencies currently are 
pursuing sponsor repayment, agencies seem to be considering reasonable 
factors when deciding whether to pursue repayment. Specifically, 
because the sponsored noncitizens who receive means-tested benefits 
after deeming occurs are those that have low-income sponsors, full 
implementation of repayment may yield less than would be expended to 
achieve this outcome. While the costs of pursuing repayment may be a 
significant deterrent to agencies in most cases, there may be some 
cases in which the monetary benefits of pursuing repayment are 
substantial enough to outweigh the costs. For example, when sponsored 
noncitizens receive benefits after qualifying for the indigence 
exception to sponsor deeming because their sponsors have sufficient 
financial means but choose not to support them, agencies may be able to 
recover the costs of benefits from these sponsors. Under the current 
law, federal regulations, and federal guidance, though there appears to 
be inconsistency in whether pursuit of sponsor repayment is a 
requirement, this does not in any way bar an administering agency from 
pursuing sponsor repayment. 

Because of the potentially high relative costs associated with pursuing 
sponsor repayment, efforts to improve benefit administering agencies' 
implementation of sponsor deeming may yield greater results. While the 
limited available data suggest that sponsor deeming currently affects 
relatively few people, ensuring that agencies have the federal guidance 
needed to administer these provisions is of increasing importance in 
the current economic environment. Specifically, it is possible that the 
number of sponsored noncitizens, like citizens, applying for and 
receiving these benefits will increase in the near term. If such an 
increase occurs at the same time that federal and state budgets are 
stretched, it will be even more important for the government to ensure 
that the sponsor deeming provisions, in particular, are being 
implemented in the way they were intended. If administering agencies 
are better able to determine which benefit applicants are sponsored and 
appropriately deem their sponsors' income, or grant related exceptions, 
agencies will be less likely to either issue improper payments or 
unintentionally harm noncitizens who have been abandoned by their 
sponsors. 

Recommendations for Executive Action: 

To help ensure sponsor deeming is implemented for Medicaid, we 
recommend that the Administrator of CMS issue guidance to help 
administering agencies implement the law in this area. 

To improve consistency of benefit administering agencies' application 
of the indigence exception to sponsor deeming, we recommend that the 
Secretary of Health and Human Services clarify in the guidance for TANF 
a suggested process for determining an applicant's eligibility for that 
exception. 

To help benefit administering agencies access information on sponsored 
noncitizens, we recommend that the Secretary of Homeland Security take 
the following two actions: 

* Improve information on sponsorship status of noncitizens provided 
through the automated SAVE system. For example, a class of admission 
code list that indicates sponsored noncitizens could be added to the 
SAVE technical assistance tools or effectively distributed to SAVE 
users. 

* Provide guidance to SAVE users that improves their understanding of 
how to request sponsor information through the automated SAVE system 
rather than through manual submission of paper request forms. 

Agency Comments and Our Evaluation: 

We provided a draft of this report to HHS, USDA, SSA, and DHS for 
review and comment. HHS and DHS provided written comments, which appear 
in appendix II and III, respectively, of the report. SSA provided no 
comments. 

In oral comments, HHS concurred with our recommendation that the 
Administrator of CMS issue guidance on sponsor deeming for Medicaid. 
However, in its written comments, HHS disagreed with our recommendation 
that the Secretary of HHS clarify in the TANF guidance the process for 
determining indigence exceptions to sponsor deeming. HHS stated that, 
unless there is an express law to the contrary, states have flexibility 
in determining TANF eligibility procedures and also asserted that it 
already addresses this issue in its guidance. We agree with HHS's 
comments, in part, and revised the recommendation to add the word 
"suggested" before "process" to clarify that states have flexibility in 
establishing their own TANF processes for determining eligibility for 
the indigence exception. However, we continue to believe that 
additional federal guidance is needed, as over 60 percent of state 
administering agencies reported through our survey that federal 
clarification on who qualifies for the indigence exception would be 
useful. In addition, procedures for determining indigence exceptions 
varied in the states we visited, including whether states require 
applicants to provide full sponsor income and asset information before 
assessing their eligibility for this exception. While a federal HHS 
official previously stated that the law suggests full sponsor income 
and asset information does not need to be provided to determine an 
applicant's eligibility for the indigence exception, the TANF guidance 
does not clearly state this. We believe adding this clarification to 
the TANF guidance would help address the inconsistencies among states 
and prevent unintended harm to noncitizens who lack the support of 
their sponsors. 

DHS concurred with both our recommendations to help benefit 
administering agencies access information on sponsored noncitizens and 
indicated that it plans to take actions to address these in the coming 
months. HHS, USDA, and DHS also provided technical comments, which we 
incorporated into the report as appropriate. 

As agreed with your office, unless you publicly announce the contents 
of this report earlier, we plan no further distribution until 30 days 
from the report date. At that time, we will send copies to relevant 
congressional committees; the Secretaries of Agriculture, Health and 
Human Services, and Homeland Security; the Administrator of the Centers 
for Medicare and Medicaid Services; the Commissioner of SSA; and other 
interested parties. The report also will be available at no charge on 
the GAO Web site at [hyperlink, http://www.gao.gov]. 

If you or your staff have any questions about this report, please 
contact me at (202) 512-7215 or brownke@gao.gov. Contact points for our 
Offices of Congressional Relations and Public Affairs may be found on 
the last page of this report. Key contributors to this report are 
listed in appendix IV. 

Sincerely yours, 

Signed by: 

Kay Brown: 
Director, Education, Workforce, and Income Security Issues: 

[End of section] 

Appendix I: Objectives, Scope, and Methodology: 

To obtain information on agency implementation of sponsor deeming and 
repayment, as well as the population affected, we: 

* reviewed available federal data on noncitizens, as well as available 
federal and state data on benefit applicants and recipients, to develop 
estimates of the sponsored noncitizen population and noncitizen 
applicants and recipients; 

* conducted a nationwide survey of states regarding Temporary 
Assistance for Needy Families (TANF), Medicaid, and the Supplemental 
Nutritional Assistance Program (SNAP); 

* visited five states and selected localities within each state and 
interviewed officials administering TANF, Medicaid, and SNAP; 

* interviewed officials from all 10 regional offices of the Social 
Security Administration (SSA) regarding relevant Supplemental Security 
Income (SSI) policies, implementation processes and challenges, and the 
frequency that officials had encountered related cases; 

* interviewed officials from relevant federal agencies and reviewed 
pertinent federal laws, regulations, and agency guidance; and: 

* interviewed researchers knowledgeable in immigrant and public benefit 
issues.[Footnote 44] 

We conducted this performance audit from March 2008 to May 2009, in 
accordance with generally accepted government auditing standards. Those 
standards require that we plan and perform the audit to obtain 
sufficient, appropriate evidence to provide a reasonable basis for our 
findings and conclusions based on our audit objectives. We believe that 
the evidence obtained provides a reasonable basis for our findings and 
conclusions based on our audit objectives. 

Sponsored Noncitizen Population Estimate: 

In determining the size of the sponsored noncitizen population, we 
reviewed potential data sources from Department of Homeland Security 
(DHS) and the U.S. Census Bureau. We concluded that no single federal 
data source contained the relevant information necessary to generate a 
precise measure of this population. However, by combining data from 
several DHS sources we were able to produce an estimate of the number 
of sponsored noncitizens in the United States as of January 1, 2007. 

Beginning with the overall noncitizen population, the DHS Office of 
Immigration Statistics (OIS) reports annually on the estimated number 
of legal permanent residents (LPR) residing in the United States. 
Recently, OIS reported that approximately 12.8 million LPRs were 
residing in the United States as of January 1, 2007.[Footnote 45] Upon 
our request, OIS officials calculated that approximately 6.7 million of 
those LPRs entered the United States after the legally enforceable 
sponsor affidavit of support became effective in December 1997. 

In order to estimate how many of the 6.7 million LPRs were sponsored by 
a family member, we used two additional sources of DHS data. First, 
from DHS, we requested a list of all admission codes denoting 
sponsorship.[Footnote 46] While DHS does not have a list of all 
admission codes ever issued for this group, we worked with subject 
matter experts in DHS to compile a list of the codes that applied to 
noncitizens sponsored by a family member during 2006 and 2007. We 
determined that the codes from these 2 years would be sufficient for 
our analysis, as the DHS experts attested that the resulting list would 
include most of the codes applied to the sponsored noncitizens relevant 
to our analysis.[Footnote 47] OIS then matched this list of codes with 
their records of noncitizens who obtained LPR status in 2006 and 2007 
to estimate the percentage that were sponsored. OIS estimated that 62.5 
percent of LPRs obtaining this status in 2006 and 2007 were sponsored. 

By applying OIS's sponsored LPR percentage of 62.5 percent to their 
estimate of 6.7 million potentially sponsored LPRs, we estimate that 
4.2 million sponsored noncitizens were residing in the United States as 
of January 1, 2007. The data used in this estimate are limited by 
assumptions made about emigration, mortality, and naturalization, which 
are discussed in OIS's report, "Estimates of the Legal Permanent 
Resident Population in 2007." The estimate is also limited by our 
assumption that the LPR percentage for new noncitizens in 2006 and 2007 
reasonably reflects that of past years. Despite these limitations, we 
determined, in collaboration with an OIS official knowledgeable of the 
data, that our methodology and the data used are sufficiently reliable 
for establishing a rough estimate of the size of the sponsored 
noncitizen population. 

Noncitizen Applicant and Recipient Estimates: 

In determining the number of sponsored noncitizens applying for TANF, 
Medicaid, and SNAP benefits during 2007, we reviewed federal data from 
the U.S. Department of Health and Human Services (HHS) and the U.S. 
Department of Agriculture (USDA) and found no source that contained 
information specific to sponsored noncitizen applicants. We instead 
determined, and United States Citizenship and Immigration Services 
(USCIS) officials confirmed, that DHS's Systematic Alien Verification 
for Entitlements (SAVE) system database is the best available proxy for 
noncitizen applicants. Benefit administering agency staff from all 
states typically access SAVE to obtain and verify citizenship status 
for noncitizen TANF, Medicaid, and SNAP applicants.[Footnote 48] Each 
time that a benefit agency staff member accesses SAVE to obtain 
noncitizen information, the system captures several pieces of data, 
including the date of the query and the admission code of the 
applicant. 

Therefore, to estimate the number of sponsored noncitizen applicants, 
USCIS examined data on SAVE usage by benefit agency staff in 2007. 
Specifically, USCIS matched the SAVE database with the list of 
admission codes applied to noncitizens sponsored by a family member 
during 2006 and 2007. Through this analysis, USCIS estimated that 
benefit agency staff obtained information from SAVE on approximately 
473,000 sponsored noncitizens in 2007. As noted previously, because 
SAVE is typically accessed by benefit agency staff when they are 
assessing noncitizen applicants, 473,000 is our proxy for sponsored 
noncitizen TANF, Medicaid, and SNAP applicants. Limitations on this 
estimate include the possibility that SAVE is not used by benefit 
agency staff 100 percent of the time, which would result in this being 
an underestimation. Conversely, benefit agency staff may access SAVE 
multiple times for the same applicant, which would result in this being 
an overestimation. While we are not able to estimate how often either 
of these situations occurs, we determined that the SAVE data are 
sufficiently reliable to use as a proxy for sponsored noncitizen 
applicants of TANF, Medicaid, and SNAP nationwide.[Footnote 49] 

To provide estimates on the number of noncitizens, both sponsored and 
nonsponsored, receiving TANF, Medicaid, and SNAP benefits, we relied on 
data we were able to obtain from the limited number of states that 
maintain relevant recipient information for those benefits. Florida 
officials, after analyzing state benefit data for December 2008, 
reported that approximately 5.20, 8.12, and 9.50 percent of TANF, 
Medicaid, and SNAP benefit recipients, respectively, were noncitizens 
in that month. Further, they reported the corresponding percentages for 
sponsored noncitizens were approximately 0.01, 0.04, and 0.03. Utah and 
Minnesota officials were also able to provide us with information on 
TANF and SNAP recipients in their states, based on analysis of state 
benefit data for fiscal year 2008. Utah officials reported that 
approximately 0.33 percent and 0.87 percent, respectively, of TANF and 
SNAP recipients were sponsored noncitizens. Minnesota reported that no 
sponsored noncitizen received TANF or SNAP benefits in that state 
during fiscal year 2008. Based on our conversations with officials in 
each state that provided the data, we determined that the data are 
sufficiently reliable for the purposes of this report.[Footnote 50] 

SSA is the only federal benefit agency to collect and maintain 
applicant and recipient data on sponsored noncitizens. To estimate the 
number of sponsored noncitizen SSI applicants and recipients during 
2007, SSA officials analyzed agency data on SSI applicants for that 
year. Specifically, officials analyzed citizenship and sponsorship 
codes for each SSI applicant in order to identify noncitizen 
applicants. Based on this analysis, SSA officials reported that 
approximately 5.5 percent of SSI applicants were noncitizens in 2007, 
and approximately 1.1 percent were sponsored noncitizens.[Footnote 51] 
Similar analysis on recipient data found that approximately 9 percent 
of SSI recipients were noncitizens in that year, and approximately 0.3 
percent were sponsored noncitizens. However, these are overestimates of 
our target group of sponsored noncitizens because they include all 
sponsored noncitizens, both those who entered the United States before 
the legally enforceable affidavit of support was required and those who 
entered after. Because SSA does not maintain data on each noncitizen 
applicant's or recipient's date of entry into the United States, we 
were unable to isolate our target group of sponsored noncitizens. 
Despite this limitation, and based on our conversations with the SSA 
official who provided the data, we determined that the data are 
sufficiently reliable for the purposes of this report. 

Survey: 

To better understand state implementation of sponsor deeming and 
repayment for TANF, Medicaid, and SNAP, we conducted a Web-based survey 
of state administrators of each of these benefits in all 50 states and 
the District of Columbia. The survey was conducted between August and 
October 2008 with 100 percent of state administrators responding (a 
total of 153). The survey included questions about the extent that 
states have encountered benefit cases involving sponsor deeming, state 
policies on sponsor deeming and repayment, state efforts to pursue 
repayment administratively and through the courts, the availability of 
relevant data on sponsored noncitizen applicants and recipients, 
implementation challenges, and areas of assistance from federal 
agencies that have been or may be useful. 

Because this was not a sample survey, there are no sampling errors. 
However, the practical difficulties of conducting any survey may 
introduce nonsampling errors, such as variations in how respondents 
interpret questions and their willingness to offer accurate responses. 
We took steps to minimize nonsampling errors, including pretesting 
draft instruments and using a Web-based administration system. 
Specifically, during survey development, we pretested draft instruments 
with TANF, Medicaid, and SNAP administrators from six states (Arizona, 
Connecticut, Florida, Mississippi, South Dakota, and Texas) between 
June and July 2008. We selected the pretest states to provide variation 
in the proportion of state residents that are LPRs, as well as 
geographic location. In the pretests, we were generally interested in 
the clarity, precision, and objectivity of the questions, as well as 
the flow and layout of the survey. For example, we wanted to ensure 
definitions used in the surveys were clear and known to the 
respondents, categories provided in closed-ended questions were 
complete and exclusive, and the ordering of survey sections and the 
questions within each section was appropriate. We revised the final 
survey based on pretest results. Another step we took to minimize 
nonsampling errors was using a Web-based survey. By allowing 
respondents to enter their responses directly into an electronic 
instrument, this method automatically created a record for each 
respondent in a data file and eliminated the need for and the errors 
associated with a manual data entry process. To further minimize 
errors, programs used to analyze the survey data and make estimations 
were independently verified to ensure the accuracy of this work. 

While we did not fully validate specific information that states 
reported through our survey, we took several steps to ensure that the 
information was sufficiently reliable for the purposes of this report. 
For example, we reviewed the responses and identified those that 
required further clarification and, subsequently, conducted follow-up 
interviews with those respondents to ensure the information they 
provided was reasonable and reliable. In our review of the data, we 
also identified and logically fixed skip pattern errors - questions 
that respondents should have skipped but did not. On the basis of these 
checks, we believe our survey data are sufficiently reliable for the 
purposes of our work. 

Site Visits: 

To better understand administering agency implementation of sponsor 
deeming and repayment in TANF, Medicaid, and SNAP, we conducted site 
visits to five states, and selected localities in those states, between 
May and September 2008. The states and localities visited included 
California--Los Angeles and Orange Counties; Connecticut--Cities of 
Bridgeport and Stamford; Florida--Broward and Miami-Dade Counties; 
Georgia--DeKalb, Fulton, and Gwinnett Counties; and Minnesota-- 
Hennepin and Ramsey Counties. The five states were selected primarily 
because they had significant populations of LPRs and low-income foreign-
born residents, and they provided geographic variation. In addition, 
the states selected varied in the proportion of their cash assistance 
recipients that were noncitizens and in their provision of state-funded 
assistance programs for noncitizens. The localities were selected 
because they were within a region of the relevant state that had 
experienced significant growth in its LPR population in recent years or 
had a historically large base LPR population in the state. We visited 
two to five local benefit agency offices in each state. We cannot 
generalize our findings beyond the states and localities we visited. 

During the site visits, we interviewed state and local administering 
agency officials. Through interviews with state officials, we collected 
information on states' sponsor deeming and repayment policies, possible 
variation in local office implementation, challenges to implementation, 
and areas in which officials thought federal assistance has been or 
would be useful. Through interviews with local officials, we gathered 
information on the processes staff use to determine eligibility for 
noncitizens, the frequency that they have encountered cases involving 
sponsored noncitizens and sponsor deeming, implementation of sponsor 
repayment policies, implementation challenges, and areas that staff 
indicated they would like additional assistance. During some site 
visits, we observed the systems and tools eligibility staff use to 
process an application. During our interviews with both state and local 
officials, we also inquired about the availability of data on sponsored 
noncitizen benefit applicants and recipients. 

[End of section] 

Appendix II: Comments from the Department of Health and Human Services: 

Department Of Health & Human Services: 
Office Of The Secretary: 
Assistant Secretary for Legislation: 
Washington, DC 20201: 

April 9, 2009: 

Kay Brown, Director: 
Education, Workforce, and Income Security Issues: 
U.S. Government Accountability Office: 
441 G Street N.W.
Washington, DC 20548: 

Dear Ms. Brown: 

Enclosed are comments on the U.S. Government Accountability Office's 
(GAO) report entitled: "Non-Citizens And Public Benefits: More Clarity 
in Federal Guidance and Better Access to Federal Information Could 
Improve Sponsor Deeming Implementation" (GAO-09-375). 

The Department appreciates the opportunity to review this report before 
its publication. 

Sincerely, 

Signed by: 

Barbara Pisaro Clark: 
Acting Assistant Secretary for Legislation: 

Attachment: 

[End of letter] 

Comments Of The Department Of Health And Human Services (HHS) On The 
Government Accountability Office's (GAO) Draft Report Entitled: "Non-
Citizens And Public Benefits: More Clarity In Federal Guidance And 
Better Access To Federal Information Could Improve Sponsor Deeming 
Implementation" (GAO-09-375): 

GAO Recommendation: 

To improve consistency of benefit administering agencies' application 
of the indigence exception to sponsor deeming, we recommend that the 
Secretary of Health and Human Services clarify in the guidance for TANF 
the process for determining an applicant's eligibility for that 
exception. 

HHS Comment: 

ACF respectfully disagrees with this recommendation. ACF addressed the 
process for determining eligibility for this exception in TANF-ACF-PI-
2003-03, Response 5, cited below in pertinent part: 

In determining whether the sponsored LPR is indigent, States would use 
their own standards and methods for deciding whether the sponsored 
alien "would, in the absence of the assistance provided by the agency, 
be unable to obtain food and shelter, taking into account the alien's 
own income plus any cash, food, housing, or other-assistance provided 
by other individuals, including the sponsor." For example, Food Stamp 
program regulations at 7 C.F.R. 273.4(c)(3)(iv) define the phrase "is 
unable to obtain food and shelter" to mean that the immigrant's own 
family income, plus any cash or in-kind assistance actually provided by 
the sponsor and others, does not exceed 130 percent of the Federal 
poverty level for the size of the immigrant's household. Subsection 
(iv) also states that "each indigence determination is renewable for 
additional 12-month periods." The TANF agency may elect to adopt part 
or all of the policy used by the Food Stamp program or establish its 
own policy for determining whether the sponsored alien would, in the 
absence of the assistance provided by the agency be "unable to obtain 
food and shelter." 

The TANF block grant program gives States the authority and flexibility 
to design and operate their own programs. Unless there is an express 
law to the contrary, States may establish their own methods and 
procedures for determining eligibility and payment, and States may 
establish their own methods and procedures for verifying eligibility 
and payment criteria. The statute on sponsor deeming at 8 U.S.C. 
1631(e) provides no such process for determining an applicant's 
eligibility for the indigence exemption. Therefore, it is left to the 
State (as expressly stated in the law) to make the determination. 
Nevertheless, the last sentence of Response 5 offers States an example 
of a way to determine whether indigence exception would apply: 

The TANF agency may elect to adopt part or all of the policy used by 
the Food Stamp program or establish its own policy for determining 
whether the sponsored alien would, in the absence of the assistance 
provided by the agency be "unable to obtain food and shelter." 

[End of section] 

Appendix III: Comments from the Department of Homeland Security: 

U.S. Department of Homeland Security: 
Washington, DC 20525: 

April 8, 2009: 

Kay Brown: 
Director: 
Education, Workforce, and Income Security Issues: 
U.S. Government Accountability Office: 
441 G Street, NW: 
Washington, DC 20548: 

Dear Ms. Brown: 

We appreciate the opportunity to review Draft Report GAO-09-375 titled, 
"Non-Citizens And Public Benefits: More Clarity in Federal Guidance and 
Better Access to Federal Information Could Improve Sponsor Deeming 
Implementation." USCIS concurs with the recommendations made in your 
Draft Report and is submitting their formal responses for your 
consideration in the Final Report. 

To help benefit administering agencies access information on sponsored 
non-citizens, we recommend that the Secretary of Homeland Security: 

Recommendation 1: Improve information on sponsorship status of non-
citizens provided through the automated SAVE system. For example, a 
class of admission code list that indicates sponsored non-citizens 
could be added to the SAVE technical assistance tools or effectively 
distributed to SAVE users. 

USCIS Response: Concur. USCIS will prepare an updated list of class of 
admission codes to indicate whether non-citizens are sponsored. USCIS 
will post that list to its Online Resources so that it is accessible by 
all user agencies, and will provide notice to all user agencies when 
the list is posted. This action should be completed in April 2009. 

Recommendation 2: Provide guidance to SAVE users that improves their 
understanding of how to request sponsorship information through the 
automated SAVE system rather than through manual submission of paper 
request forms. 

USCIS Response: Concur. Currently, user agencies can only access 
sponsorship information online through the automated system if they are 
using the Web-1 method to access the SAVE Program. SAVE is currently 
undergoing system upgrades intended to increase the overall 
verification efficiency of the Program and reduce the number of manual 
verification requests. As part of this effort, SAVE has been upgrading 
its Web-3 access method which currently has connection to more 
databases and features not found on other access methods. 

As indicated in the report, the SAVE Program is adding the sponsorship 
feature to the Web-3 access method as part of its improvements. This 
upgrade is scheduled for June 2009, at which time SAVE will move all of 
its current Web-1 user agencies onto Web-3. These agencies will receive 
the added benefits of the Web-3 method while retaining the ability to 
receive sponsorship information. 

The changeover to Web-3 includes an outreach program to educate user 
agencies on the system capabilities, as well as in-system notices in 
the time leading up to the change. With this outreach effort, SAVE will 
advise the affected agencies that sponsorship information is available 
through the online system in lieu of the manual Form G-845 process. 
SAVE will continue to offer customized training to these user agencies 

We ask that you consider and reflect this response in the final GAO 
report on this subject. If you have any questions regarding USCIS's 
comments, you may contact Jane Chung at 202-272-9627. 

Sincerely, 

Signed by: 

Jerald E. Levine: 
Director: 
Departmental GAO/OIG Liaison Office: 

[End of section] 

Appendix IV: GAO Contact and Staff Acknowledgments: 

GAO Contact: 

Kay Brown, (202) 512-7215, or brownke@gao.gov: 

Staff Acknowledgments: 

Heather McCallum Hahn, Assistant Director; Rachel Frisk, Analyst-in- 
Charge; Theresa Lo; David Perkins; Heather Whitehead; Jean McSween; 
Cathy Hurley; Kirsten Lauber; Doreen Feldman; Alexander Galuten; Susan 
Bernstein; and Mimi Nguyen also made significant contributions to this 
report. 

[End of section] 

Footnotes: 

[1] SNAP was formerly known as the Food Stamp Program. 

[2] Throughout this report, "sponsored noncitizen" is used to denote a 
legal permanent resident who obtained this status through sponsorship 
by a family member, and whose sponsor signed a legally enforceable 
affidavit of support. Noncitizens who enter the country through the 
"sponsorship" of an organization, as well as those who do not have a 
sponsor, such as refugees and asylees, are not subject to sponsor 
deeming. 

[3] In reporting survey results, we consider the District of Columbia 
as a state. 

[4] LPRs differ from other legal noncitizens who are admitted to the 
country for a specific purpose and temporary period of time, such as 
students. In addition, asylees and refugees become LPRs after they 
enter the country and apply to have their status adjusted, according to 
DHS officials. 

[5] Through PRWORA, TANF replaced the Aid to Families with Dependent 
Children program. 

[6] While TANF, Medicaid, SNAP, and SSI all serve low-income people, 
the financial eligibility thresholds, or income limits, for these 
benefits differ. Specifically, TANF's income limit varies by state. 
Medicaid income limits can also vary by state, as well as type of 
recipient. For example, the Medicaid income limits for children 
generally range from 100 to 185 percent of the federal poverty 
guidelines. The SNAP income limit is generally set at 130 percent of 
the federal poverty guidelines. In contrast, SSI's income limit is set 
at a fixed dollar amount. 

[7] Sponsors who are on active duty in the U.S. military must 
demonstrate they have an income of at least 100 percent of the federal 
poverty guidelines if they are sponsoring their spouse or child. 

[8] Affidavits of support generally remain enforceable until the 
noncitizen naturalizes or has been credited with 40 quarters of work in 
the United States, or when the sponsor dies. 

[9] The exact amount of the sponsor's income and assets to deem can 
vary by benefit and, for TANF and Medicaid, can vary by state. 

[10] For example, to be eligible for SNAP benefits after deeming has 
occurred, the total combined income of the applicant and sponsor must 
be less than the SNAP income limit of 130 percent of the federal 
poverty guidelines. 

[11] Medicaid was added as a federal means-tested public benefit 
subject to deeming through a 1997 Federal Register notice. In addition, 
the State Children's Health Insurance Program (SCHIP), created through 
the Balanced Budget Act of 1997, was added as a benefit subject to 
deeming. However, the recently enacted Children's Health Insurance 
Program Reauthorization Act of 2009 allows states to waive certain 
federal rules related to some sponsored noncitizens for both SCHIP and 
Medicaid. Specifically, states can now opt to provide Medicaid and 
SCHIP benefits to certain sponsored noncitizen children or pregnant 
women within their first 5 years of U.S. residency. In such cases, the 
sponsor's income is neither deemed to determine the applicant's income 
eligibility nor is the sponsor held liable for reimbursement costs. 

[12] The noncitizen might be battered by the sponsor, but that 
relationship is not required to grant the exception. 

[13] While eligibility workers review noncitizen documents, they may 
not be able to detect fraudulent documents, even through the use of 
SAVE. For more information on identity fraud related to noncitizens see 
GAO, Employment Verification: Challenges Exist in Implementing a 
Mandatory Electronic Employment Verification System, [hyperlink, 
http://www.gao.gov/products/GAO-08-895T] (Washington, D.C.: June 10, 
2008). 

[14] While DHS's USCIS tracks the total number of people obtaining LPR 
status in the United States each year, it does not maintain data on how 
many of those individuals emigrate, naturalize, or die. As a result, 
DHS Office of Immigration Statistics (OIS) publishes an annual 
estimation of the number of LPRs in the United States rather than the 
actual total. 

[15] While this estimate is limited by several assumptions in our 
methodology, we determined that both the methodology and data are 
sufficiently reliable for establishing a rough estimate of the size of 
the sponsored noncitizen population. For more information on this 
estimate, see appendix I. 

[16] DHS does not update demographic information, such as income, hours 
worked, or length of residency, for noncitizens after they enter the 
United States. Also, while the U.S. Census Bureau maintains some data 
on the U.S. foreign born population, it does not delineate the data by 
noncitizen status, such as those who are sponsored by a family member. 

[17] Benefit administering agencies in 48 states, and the District of 
Columbia, have signed memorandums of understanding allowing them to 
request information from the SAVE system for the purposes of verifying 
the noncitizenship status of applicants and recipients of these 
benefits. However, we don't know the extent to which local benefit 
staff nationwide use SAVE for this purpose. We also do not know the 
frequency with which staff who do use SAVE for this purpose enter a 
noncitizen applicant's information into SAVE more than once. While 
these are both limitations of the SAVE data, we determined that they 
are sufficiently reliable for establishing a proxy measure of the 
sponsored noncitizen applicants for TANF, Medicaid, and SNAP 
nationwide. Our assessment of the SAVE data's reliability are limited 
to use of the data for this purpose. 

[18] National data on the percentage of sponsored noncitizens with 
incomes below the federal poverty level is unavailable. However, 
approximately 21 percent of the foreign-born, noncitizen population, 
including both sponsored and nonsponsored, had incomes below the 
federal poverty level in 2007, according to the U.S. Census Bureau. 

[19] We also obtained SAVE and SSA data for 2006, which were consistent 
with 2007, as they showed that approximately 11 percent and 0.7 percent 
of the sponsored noncitizen population had applied for these benefits 
in that year. However, we did not obtain SAVE and SSA data for earlier 
years and, therefore, we do not know if these proportions changed over 
time. Further, the SSA data includes both sponsored noncitizens who 
entered the United States before the legally enforceable affidavit of 
support was required and those who entered after. Because SSA does not 
maintain data on each noncitizen applicant's date of entry into the 
United States, we were unable to further isolate the sponsored 
noncitizens with a legally enforceable affidavit. For more information 
on the SAVE and SSA estimates, see appendix I. 

[20] Generally, sponsored noncitizens who are veterans or active duty 
military, including their spouses and children, are exempt from the 40- 
quarter work eligibility requirement. In addition, noncitizens who 
entered the country before PRWORA was enacted and changed their 
noncitizen status to sponsored after PRWORA are exempt from the 40- 
quarter work eligibility requirement, according to SSA officials. 

[21] In addition, if the sponsor of the noncitizen applicant is part of 
the same family or household, the sponsor's income is often counted as 
part of the applicant's income under general eligibility rules that 
apply to both citizens and noncitizens. For example, if a noncitizen 
applies for SNAP benefits and lives with his or her sponsor, the 
sponsor's income is counted as part of the applicant's household income 
under general SNAP eligibility rules. The noncitizen sponsor deeming 
provisions do not affect the applicant's eligibility in such cases-- 
which are very common, according to USDA officials. 

[22] Of the remaining 31 percent, 14 percent reported that deeming has 
sometimes occurred, 3 percent reported that it has occurred frequently 
or very frequently, and another 13 percent did not know the frequency. 
The additional 1 percent constitutes rounding error. Percentages are 
based on those who responded and, of the 153 state benefit agency 
administrators for TANF, Medicaid, and SNAP that we surveyed, one 
administrator did not respond to this question. 

[23] We did not attempt to estimate benefit amounts that have been paid 
to sponsored noncitizens, largely because of the lack of data on this 
recipient group. In addition, this type of analysis is complicated by 
the fact that one benefit is often provided for all members of a 
household or family, though they may have different citizenship 
statuses. 

[24] SSA is the only federal benefit agency that maintains recipient 
data for sponsored noncitizens. According to SSI data as of December 
2004, 27,300 of 7.0 million total recipients - citizen and noncitizen - 
were sponsored noncitizens. The corresponding data for December 2005, 
2006, and 2007 were 24,200 of 7.1 million, 21,500 of 7.2 million, and 
19,200 of 7.4 million, respectively. (All figures are approximate.) 
However, this data includes both sponsored noncitizens who entered the 
United States before the legally enforceable affidavit of support was 
required and those who entered after. Because SSA does not maintain 
data on each noncitizen recipient's date of entry into the United 
States, we were unable to further isolate the sponsored noncitizens 
with a legally enforceable affidavit. For more information about the 
SSI estimate, see appendix I. 

[25] Florida benefit data as of December 2008 show that 12 of 95,000 
total TANF recipients - citizen and noncitizen - were sponsored 
noncitizens. Corresponding Florida data for Medicaid and SNAP were 950 
of 2.1 million, and 500 of 1.8 million, respectively. Utah fiscal year 
2008 benefit data showed 93 of 28,300 total TANF recipients were 
sponsored noncitizens as were 2,100 of 246,000 SNAP recipients. 
Minnesota reported that in fiscal year 2008 none of the 42,000 and 
209,000 recipients of TANF and SNAP, respectively, were sponsored 
noncitizens. (All figures are approximate, except for those less than 
100.) For more information about the state estimates, see appendix I. 

[26] USDA and SSA issued federal regulations as well as guidance to 
address the PRWORA sponsor deeming provisions for SNAP and SSI, 
respectively. HHS issued only guidance to address the PRWORA sponsor 
deeming provisions for TANF. 

[27] CMS issued a letter to state Medicaid Directors in 1998 indicating 
that guidance on sponsor deeming would be forthcoming; however, no such 
guidance was ever issued. 

[28] In addition, 32 TANF, Medicaid, or SNAP administering agencies (in 
21 states) that have sponsor deeming policies reported that they did 
not have a policy on the indigence exception. 

[29] This official and other local officials we interviewed, however, 
said that some sponsored noncitizens who may qualify for benefits 
through the indigence exception ultimately withdraw their application 
when they are told that their names and those of their sponsors must be 
reported to the federal government, as required by law. 

[30] The 1996 legislation required benefit administering agencies to 
report any indigence exception cases to the U.S. Attorney General. 
However, due to the reorganization of immigration services into DHS, 
since 2003, such cases should be reported to USCIS Office of Policy and 
Strategy, according to agency officials. 

[31] When we informed DHS of the situation, officials agreed to provide 
the correct address to the relevant federal benefit agencies. 

[32] In addition, 17 TANF, Medicaid, or SNAP administering agencies (in 
14 states) that have sponsor deeming policies reported that they did 
not have a policy on this exception. 

[33] One local benefit official reported that she believes some 
sponsored noncitizen applicants intentionally withhold information 
about their sponsorship status in order to avoid sponsor deeming. We do 
not know the extent to which this occurs, though other local staff we 
spoke to on our site visits did not mention this issue. 

[34] In addition, DHS officials stated that the agency plans to offer 
enhanced Web access to SAVE beginning in 2009 that will, in part, 
assist benefit agencies with fraud detection. Training on the enhanced 
access will be offered to benefit agency users, and officials also 
indicated that they plan to convene a SAVE user conference in 2010 to 
provide additional assistance and training. 

[35] Noncitizens receive an admission code from DHS upon entry and, if 
they change their status, which classifies the individual by noncitizen 
status, such as refugee, asylee, or family-sponsored. 

[36] We obtained a few lists developed by state, local, and SSI 
agencies enumerating codes for sponsored noncitizens. We compared these 
with a similar list provided by DHS for our analysis and noted some 
discrepancies. For example, in some cases, the lists developed by 
administering agencies were missing codes that DHS uses to classify 
sponsored noncitizens, while in other cases, they included codes that 
DHS indicated are not used for sponsored noncitizens. 

[37] This percentage was calculated based on the number of state 
benefit agency administrators who responded to this question (128). In 
our survey, we assumed that state agencies without a sponsor deeming 
policy in place would similarly not have a sponsor repayment policy. 
Therefore, state agencies without a sponsor deeming policy were not 
asked about sponsor repayment in our survey--5 for TANF, and 20 for 
Medicaid. 

[38] We use "traditional benefit recovery provisions" in this report to 
refer to benefit administering agencies' routine efforts to recover 
improperly issued benefits in cases of benefit fraud or payment error. 

[39] SSA policy requires its regional and field offices to report cases 
of SSI sponsor repayment to SSA headquarters. SSA headquarters 
officials reported that they have not received any reports of sponsor 
repayment. 

[40] Connecticut officials thought they were following federal law when 
they initiated sponsor repayment for TANF, Medicaid, and SNAP, but the 
complaint letter they received that led to the suspension of their 
efforts in this area cites the DHS regulations as support that 
repayment is optional. 

[41] The state official we spoke to indicated that repayment is pursued 
when a sponsored noncitizen qualifies for the indigence exception to 
deeming because he or she is not receiving sufficient financial support 
from the sponsor. However, if the sponsored noncitizen qualified for 
the indigence exception because he or she was abandoned by the sponsor, 
and the sponsor's whereabouts were unknown, the official said that 
repayment would not be pursued because the state would likely not be 
able to locate the sponsor. 

[42] DHS data on sponsors' names and addresses, if complete and easily 
accessible, could assist state and local officials pursuing sponsor 
repayment. However, while federal regulations require sponsors to 
submit address changes to DHS, the extent to which this is done is 
unknown, according to DHS officials. 

[43] This percentage was calculated based on the number of state 
benefit administering agencies who responded to each of these 
questions. In our survey, we assumed that state agencies without a 
sponsor deeming policy in place would similarly not have a sponsor 
repayment policy. Therefore, state agencies without a sponsor deeming 
policy were not asked about sponsor repayment in our survey--5 for 
TANF, and 20 for Medicaid. One additional agency chose not to respond 
to the question related to the usefulness of clarification on when to 
pursue sponsor repayment administratively. 

[44] We interviewed researchers from the Catholic Legal Immigration 
Network, the Center for Immigration Studies, the Migration Policy 
Institute, the National Conference of State Legislatures, the National 
Immigration Law Center, and the Urban Institute, among others. 

[45] This is a point-in-time estimate. 

[46] DHS applies an admission code to each noncitizen upon their entry 
to the United States, classifying the entrant by noncitizen status, 
such as refugee, asylee, or family-sponsored. 

[47] This list included codes only for those noncitizens required to 
have an enforceable affidavit of support, the I-864, completed by a 
family member for entry into the United States. 

[48] Benefit administering agencies in 48 states, and the District of 
Columbia, have signed memorandums of understanding allowing them to 
request information from the SAVE system for the purposes of verifying 
the noncitizen status of benefit applicants and recipients. 

[49] We did not assess the reliability of SAVE data for other purposes. 

[50] However, the quality of this data is dependent on the ability of 
benefit agency staff to correctly identify the recipient as a sponsored 
noncitizen. State or local officials we spoke with in each of the five 
states we visited reported that they have difficulty determining who is 
sponsored. 

[51] This 1.1 percent is equal to approximately 29,000 SSI applicants, 
which corresponds to 0.7 percent of the estimated sponsored noncitizen 
population. 

[End of section] 

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