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CMS Issues Guidance on Enforcement of Immigrant Benefit Rules

The Centers for Medicare & Medicaid Services (CMS) released guidance on Medicaid and Children’s Health Insurance Program (CHIP) eligibility determinations for certain sponsored immigrants.

The guidance follows a May 23 presidential memorandum that called for increased enforcement of existing laws related to individuals sponsoring applicants for immigration status.

Under current law, most individuals applying to enter the country on a visa or applying for a green card must submit an affidavit of support from a sponsor residing in the United States. The affidavit of support is required to demonstrate that the applicant is not likely to become a public charge.

CMS considers the sponsor’s financial resources when determining an immigrant’s eligibility for means-tested public benefits, including Medicaid and CHIP. Sponsors also must reimburse the government for the cost of any benefits the sponsored individual receives during a period of ineligibility.

The CMS guidance reminds states of their obligation to comply with the sponsor requirements and provides additional information about operational considerations, including:

  • applying sponsor requirements;
  • methodologies for deeming a sponsor’s income and resources;
  • reimbursement obligations and recovery of costs for sponsors; and
  • data collection and reporting on sponsor recovery.

CMS will issue additional guidance for states on how to document their sponsor policies and procedures.

Contact Senior Director of Policy Erin O’Malley at or 202.585.0127 with questions.


About the Author

Rachel Schwartz is a former policy associate at America's Essential Hospitals.

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