Therefore, if sponsor deeming occurs, benefits are  only granted to sponsored noncitizens when both they and their sponsors  are sufficiently low-income. 1). 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. 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. Staff at all regional offices reported that they continue to  encounter few sponsored noncitizens applying for SSI. For instance, less than 0.4 percent of SSI  recipients were sponsored noncitizens during the years 2004 through 2007,  according to SSA. 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, inaction by CMS has stalled  some states’ implementation of sponsor deeming in Medicaid. 3.) 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 fig. In addition, many reported that additional  federal guidance on areas related to the indigence exception to deeming  would be useful. 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. 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. SSI benefits, which applies nationwide. 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. In these cases, local staff are to  send a request for repayment to the sponsor. 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. 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.
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.