United States General Accounting Office

GAO Testimony

Before the Subcommittee on Human Resources,

Committee on Ways and Means, House of Representatives

For Release on Delivery

Expected at

10:00 a.m.

Thursday,

May 23, 1996

SUPPLEMENTAL

SECURITY INCOME

Noncitizen Caseload

Continues to Grow

Statement of Jane L. Ross, Director

Income Security Issues

Health, Education, and Human Services Division

G O A

years

1921 - 1996

GAO/T-HEHS-96-149

Supplemental Security Income: Noncitizen

Caseload Continues to Grow

Mr. Chairman and Members of the Subcommittee:

Thank you for inviting me to speak about the rapid growth in the number

of noncitizens receiving Supplemental Security Income (SSI) benefits. As

you are aware, the SSI program provides means-tested income support

payments to eligible aged, blind, or disabled persons. In 1995, over

6.5 million SSI recipients received nearly $25 billion in federal benefits and

over $3 billion in state benefits.

Noncitizens, who include legal immigrants and refugees, accounted for

nearly 25 percent of SSI’s caseload growth from 1986 through 1993. In

December 1995, almost 800,000 noncitizens were receiving SSI benefits,

accounting for about 12 percent of all SSI recipients. In 1995, federal and

state SSI benefits to noncitizens totaled nearly $4 billion.

Today, I would like to focus on three issues: the overall growth in

noncitizen SSI caseloads and some of the reasons for it; aged noncitizen

recipients and how financial support from their families affects their SSI

benefits; and disabled noncitizens and the potential for translator fraud,

and actions the Social Security Administration (SSA) can take to reduce

such fraud. My remarks are based on two reports we issued last year

relating to immigrants and SSI,

1

 and on updated SSA data.

In summary, we found that noncitizens are one of the fastest growing

groups of SSI recipients. They represent nearly 33 percent of aged SSI

recipients and about 6 percent of disabled recipients. While the growth

rate for noncitizen caseloads has slowed somewhat, it is still higher than

that for citizens, and the proportion of noncitizens relative to other SSI

recipients continues to grow. About two-thirds of noncitizen SSI recipients,

roughly 520,000, live in three states—California, New York, and Florida.

On the whole, noncitizens are somewhat more likely to receive SSI than are

citizens, but this may be primarily true for refugees and asylees. Moreover,

the 1980s saw significant growth in immigration. Adult children of aged

immigrants and others who say they are willing to financially support them

sometimes do not. Eventually, some of these aged immigrants receive SSI.

Also, some translators have assisted noncitizens in fraudulently obtaining

SSI disability benefits.

1

Supplemental Security Income: Growth and Changes in Recipient Population Call for Reexamining

Program (GAO/HEHS-95-137, July 7, 1995) and Supplemental Security Income: Disability Program

Vulnerable to Applicant Fraud When Middlemen Are Used (GAO/HEHS-95-116, Aug. 31, 1995).

Page 1 GAO/T-HEHS-96-149
Supplemental Security Income: Noncitizen

Caseload Continues to Grow

Background The Congress established the SSI program in 1972 to replace federal grants

to similar state-administered programs, which varied substantially in

benefit levels and eligibility requirements. The Congress intended SSI as a

supplement to the Social Security Old Age, Survivors, and Disability

Insurance programs for those who had little or no Social Security

coverage.

Federal SSI benefits are funded by general revenues and based on need,

unlike Social Security benefits, which are funded by payroll taxes and, in

effect, are based on the contributions of individuals and their employers.

SSA has overall responsibility for the SSI program.

To be eligible for SSI, individuals must be 65 years old, blind, or disabled.

To be considered disabled, adults must be unable to engage in any

substantial gainful activity because of a physical or mental impairment

expected to result in death or last at least 12 months. Individuals cannot

have income greater than the maximum benefit level, which is about

$5,600 per year in 1996, or own resources worth more than $2,000, subject

to certain exclusions, such as a home. Individuals must also be U.S.

citizens or immigrants lawfully admitted for permanent residence or

noncitizens “permanently residing under color of law” (PRUCOL).2

In 1996, the maximum federal SSI benefit is $470 per month for an

individual and $705 for a couple with both spouses eligible; these benefit

rates are adjusted annually for cost-of-living increases. This monthly

benefit is reduced on the basis of various factors: recipients’ incomes;

living arrangements, such as living with family; and other sources of

support, including Social Security benefits. As a result of these

adjustments, the average monthly federal benefit in 1995 was $334.

In addition to federal SSI benefits, states may provide supplemental

benefits. In December 1995, nearly 40 percent of SSI recipients received an

average of about $105 per month in state supplemental benefits at a total

cost to the states of about $3.2 billion a year.

Most SSI recipients are generally eligible for Medicaid and food stamps,

which can cost the government more than SSI benefits themselves. For

2

PRUCOL is not an immigration status, such as immigrant or refugee. Rather, it is an eligibility status

defined in the enabling legislation for major federal assistance programs, including SSI. PRUCOL is

more frequently a transitional status for noncitizens who are becoming permanent residents than for

those whose deportation has been delayed, though it can be either. Initially, PRUCOL was interpreted

to include primarily refugees and asylees. Court decisions have broadened it to include other

categories of noncitizens. Nearly 75 percent of SSI recipients in the PRUCOL category are refugees or

asylees.

Page 2 GAO/T-HEHS-96-149
Supplemental Security Income: Noncitizen

Caseload Continues to Grow

1994, annual Medicaid benefits averaged about $2,800 for the aged SSI

recipients who received them and about $5,300 for blind and disabled SSI

recipients, excluding long-term care costs. Including long-term care,

Medicaid benefits averaged about $8,300 for the aged and $7,700 for the

disabled. In September 1994, a one-person household eligible for both food

stamps and SSI, with no other income, could receive nearly $1,000 per year

in food stamp benefits, depending on the state.

SSI Provisions for

Noncitizens and Related

Immigration Policy

Immigrants are those with “lawful permanent resident” status. They

include those who came here after obtaining an immigrant visa in their

country of origin. They also include noncitizens already living here who

have changed to this status. Since SSA data do not usually reflect changes

in immigration status, we describe the status SSI recipients had when they

applied for benefits.

In addition to immigrants, noncitizens on SSI include refugees and asylees

as well as undocumented aliens legalized by the Immigration Reform and

Control Act of 1986 (IRCA). Refugees and asylees are noncitizens who are

unable or unwilling to return to their countries of nationality because of

persecution or a well-founded fear of persecution. Refugees apply for their

status from outside the United States, while asylees apply from within.

Both are eligible for permanent resident status after 1 year of continuous

presence in the United States.

Some legal immigrants are admitted to the country under the financial

sponsorship of a U.S. resident. The Immigration and Nationality Act of

1952, as amended, provides for denying permanent resident status to

noncitizens who are likely to become public charges. Noncitizens can

demonstrate they will be self-sufficient in several ways, including having a

financial sponsor. Sponsors sign an affidavit of support assuring the U.S.

government that the immigrant will not become a public charge and in

which they state they are willing and able to provide financial assistance

to the immigrant for 3 years. However, several courts have ruled that these

affidavits of support are not legally binding. Refugees and asylees do not

need to demonstrate they will be self-sufficient to reside in the United

States.

SSI’s “deeming” provisions, which apply only to immigrants with financial

sponsors, attempt to reinforce immigration policy. In determining financial

eligibility and benefit levels, SSA deems a portion of a sponsor’s income

and resources to be available to the immigrant. This provision applies

Page 3 GAO/T-HEHS-96-149
Supplemental Security Income: Noncitizen

Caseload Continues to Grow

regardless of whether a sponsor is actually providing financial support.

This provision currently applies for 5 years from the immigrant’s entry into

the United States.3

On May 2, 1996, the Senate passed an amended version of the Immigration

Control and Financial Responsibility Act of 1996 (H.R. 2202), which the

House of Representatives passed on March 21. The bill is still pending

conference committee action. Both the House and Senate versions of the

bill contain provisions to make the affidavits of support legally

enforceable. They also contain provisions extending the deeming period.

In addition, the bill makes some changes to eligibility requirements for

noncitizens. It also provides that any noncitizen who receives more than

12 months’ worth of federal, state, or local needs-based benefits within 5

years of becoming a lawful permanent resident (with several exceptions)

would be considered deportable as a “public charge.”

Overview of

Noncitizen SSI

Recipients

From 1986 through 1994, the number of aged or disabled noncitizen SSI

recipients grew an average of 15 percent annually. In 1986, noncitizens

constituted about 6 percent of all SSI recipients; by 1994, their proportion

had grown to nearly 12 percent. This year, 800,000 noncitizens will receive

$3.6 billion in federal SSI benefits; SSA projects that nearly 1 million

noncitizens will receive almost $5 billion in the year 2000. From a peak

growth rate of 19 percent in 1991, growth in noncitizen cases has slowed

substantially, with a rate of just 6.4 percent last year. However, this

remains higher than the growth in all SSI cases, which was 3.5 percent last

year. SSA projects that growth rates will remain in this lower range at least

through the year 2000. Figure 1 gives past and projected numbers of

noncitizens on SSI.

3

The Congress temporarily extended SSI’s deeming period from 3 to 5 years from January 1994 through

September 1996. However, in the affidavits of support, sponsors only say they are willing to provide

support for 3 years.

Page 4 GAO/T-HEHS-96-149
Supplemental Security Income: Noncitizen

Caseload Continues to Grow

Figure 1: SSI Noncitizen Caseload Growth

Number of Noncitizen SSI Recipients (in Thousands)

0

200

400

600

800

1000

1986 1988 1990 1992 1994 1996 1998 2000

Calendar Year Actual

Fiscal Year Projection

Source: SSA.

Refugee and asylee cases are growing somewhat faster than immigrant

cases, averaging 18 percent growth annually from 1986 through 1993

compared with 15 percent. Refugees and asylees constitute a larger share

of SSI’s disabled noncitizen population than SSI’s aged population,

23 percent compared with 16 percent.

Factors Contributing to

Caseload Growth

The number of all SSI recipients has grown dramatically since the

mid-1980s, and some of the factors contributing to this growth apply to

noncitizens and citizens alike. Such factors include program outreach,

and, in the case of the disabled, eligibility expansion and limited efforts to

review recipients’ disability status or help them return to work. Still, the

number of noncitizens is growing faster than that of citizens. From 1986

through 1993, the number of all SSI recipients grew at an average annual

rate of 5 percent, compared with the 15 percent rate for noncitizens. In

Page 5 GAO/T-HEHS-96-149
Supplemental Security Income: Noncitizen

Caseload Continues to Grow

particular, growth among those aged 65 or over differs dramatically

between citizens and noncitizens. While the number of aged noncitizens

on SSI has grown dramatically, the number of aged citizens has actually

declined.

Increased immigration has probably contributed to the growth in

noncitizen SSI caseloads. The number of immigrants rose steadily in the

1980s, from about 500,000 per year early in the decade to 1.5 million in

1990, then fell to 900,000 in 1993. Altogether, the number of immigrants

totaled more than 7.3 million in the 1980s. Roughly half of these

immigrants did not need to demonstrate that they would be self-sufficient.

Noncitizens are more likely to receive SSI than citizens: roughly 3 percent

of noncitizens receive SSI compared with 1.8 percent of citizens. One

reason that may partially explain this is that noncitizens typically have

more limited U.S. work histories than life-long residents do and therefore

qualify for smaller Social Security benefits. This, in turn, may make

noncitizens more likely to qualify for SSI.

Still, the likelihood of receiving SSI probably varies for different types of

noncitizens. Refugees and asylees may be more likely than citizens to

receive benefits. They are not subject to sponsorship and deeming

provisions and may qualify for benefits immediately after arriving here.

Immigrants admitted through normal procedures may be no more likely or

even less likely than citizens to be on SSI; data limitations make it difficult

to say.4

About 46 percent of noncitizen recipients applied for SSI within 4 years of

entering the United States. Roughly 5 percent of immigrants receiving SSI

applied within a year of entry compared with 52 percent of the remaining

noncitizens receiving SSI, such as refugees.

Noncitizen Beneficiary

Profile

Fifty-one percent of noncitizens on SSI come from six countries—Mexico,

the former Soviet Union, Cuba, Vietnam, the Philippines, and China.

However, rates of growth vary substantially by country of origin. For

example, among these six countries, annual caseload growth from 1986

4

Data limitations that prevent drawing firmer conclusions include the following: (1) the general

population data we examined estimated the noncitizens’ status on the basis of country of origin rather

than on their actual status and (2) SSI data about noncitizens reflect their status when they applied for

benefits, not when they entered the United States. See Michael Fix and Jeffrey S. Passel, Immigration

and Immigrants: Setting the Record Straight (Washington, D.C.: The Urban Institute, 1994), pp. 19-22,

34, and 63-67.

Page 6 GAO/T-HEHS-96-149
Supplemental Security Income: Noncitizen

Caseload Continues to Grow

through 1993 ranged from an average of 11 percent for Cuba to 33 percent

for the former Soviet Union.

About 20 percent of noncitizens on SSI also qualify for Social Security

benefits, compared with 40 percent of all SSI recipients. When looking at

aged SSI recipients alone, the contrast is even greater. About 22 percent of

aged noncitizens on SSI qualify for Social Security compared with over

60 percent of all aged recipients. Those noncitizens who do qualify for

Social Security tend to get smaller Social Security benefits and larger SSI

benefits compared with other SSI recipients.

About two-thirds of noncitizen SSI recipients live in three

states—California, New York, and Florida. Average annual growth rates

from 1986 through 1993 for the noncitizen caseload varied from 7 percent

in Maine to 27 percent in New Mexico.

Aged Recipients and

Affidavits of Support

Nearly 70 percent of noncitizens on SSI are at least 65 years old. Without

the growth in noncitizen cases, SSI’s aged population would have

decreased 10 percent from 1986 through 1993; instead, it remained

relatively level. The aged noncitizen caseload grew an average of

14 percent annually during this period, increasing from 9 percent of aged

cases to 23 percent. In December 1995, noncitizens were nearly one-third

of aged cases. In 1993, the average federal SSI monthly benefit was $304 for

aged noncitizens compared with $188 for all aged recipients.

Nearly 60 percent of aged noncitizen SSI recipients have been in the

country fewer than 5 years. This raises questions about whether

immigration policies have been effective in ensuring that immigrants will

be self-sufficient. SSI’s deeming provisions apply only to immigrants with

financial sponsors. About 25 percent of immigrants receiving SSI applied

for benefits within a year after the deeming period expired. Furthermore,

even some affluent sponsors refuse to support the immigrants they

sponsor, especially after the affidavits of support expire, but we do not

know how many.

In considering changes to financial sponsorship or SSI deeming policies, it

is worth noting that immigrants may respond by changing their behavior.

For example, restricting benefit eligibility may prompt more immigrants to

become citizens to retain their eligibility. Also, immigrants who lose

eligibility for federal welfare programs may turn to state-funded public

assistance programs, thus shifting costs to the states. For example, the

Page 7 GAO/T-HEHS-96-149
Supplemental Security Income: Noncitizen

Caseload Continues to Grow

Orange County, California, Social Services Agency reported a significant

cost shift to its General Relief program as a result of the extension in the

SSI deeming period from 3 to 5 years.

Disabled Recipients

and Translator Fraud

While disabled recipients constitute a smaller share of noncitizen cases

than aged recipients, their number is growing faster, averaging 19 percent

growth annually from 1986 through 1993. Noncitizens increased from

3 percent of disabled cases to 5.5 percent during this period. Perhaps the

most significant factor contributing to caseload growth for disabled

citizens and noncitizens alike was changes in the criteria for qualifying as

disabled. New and broader standards for mental impairments were

implemented in the late 1980s. Since then, disabled cases with psychiatric

diagnoses have accounted for a large share of the caseload growth. These

changes to the mental impairment standards may have also contributed to

growth in noncitizen caseloads involving mentally disabled adults; the

proportion of cases with a psychiatric diagnosis is similar for both citizens

and noncitizens.

Translator Fraud May Add

to Disabled Noncitizen

Caseload

Translator fraud may contribute to disabled caseload growth and occurs

primarily in noncitizen cases. Some ineligible non-English-speaking

applicants have obtained SSI benefits illegally with the help of translators.

The actual number of people who have done so is unknown. A translator,

also sometimes referred to as a “middleman,” is a person or organization

that provides translation and/or other services for a fee to help individuals

apply for SSI.

For example, a Washington State translator arrested for fraud had helped

at least 240 immigrants obtain $7 million in SSI benefits by coaching them

on which medical symptoms to claim and by providing false information

on their medical conditions and family histories. In California, at least

6,000 potentially fraudulent applications have been identified since July

1992. Of these 6,000 applications, about 30 percent represented SSI claims

that were being paid.5

 Mistakes in accurately determining disability are

costly. Given that the average time on disability is 11 years before

recipients reach age 65, we estimated that a single ineligible SSI recipient

5

About 1,800 of the 6,000 applications represented cases that could have been subject to periodic

reviews of a recipient’s disability status. SSA had completed about 400 of these reviews as of

June 1995.

Page 8 GAO/T-HEHS-96-149
Supplemental Security Income: Noncitizen

Caseload Continues to Grow

can receive a total of about $113,000 from SSI, Medicaid, and the Food

Stamp program.6

A combination of factors has contributed to SSI’s vulnerability to fraud

involving translators. First, SSA’s management practices and shortage of

bilingual staff have allowed applicants to use translators that they select.

For example, applicants have been able to apply for benefits at the field

office of their choice—SSA has not restricted applicants to offices in which

SSA has staff who speak their language. In addition, applicants’ medical

histories often have lacked documentation. And finally, SSA has had limited

monitoring of translators, limited funds for investigations, and a lack of

coordination with state Medicaid agencies.

The Congress, SSA, and several states have begun efforts to prevent or

detect fraudulent SSI claims involving translators. Federal legislation has

made SSI fraud a felony and has given SSA access to information from the

Immigration and Naturalization Service and the Centers for Disease

Control and Prevention. SSA established a task force in April 1993 on

translators that has suggested initiatives such as developing and managing

a translator database. Also as a result of this task force, SSA’s San

Francisco regional office is periodically reviewing the disability status of

possibly fraudulent cases involving translators.

In addition to these efforts, we have recommended that SSA implement a

more comprehensive, programwide strategy for keeping ineligible

applicants from ever being accepted on the SSI rolls.7 SSA could require that

its own bilingual staff or contractors conduct interviews with

non-English-speaking applicants and explore the use of videoconferencing

technology to maximize the use of SSA bilingual staff. SSA should also share

among its field offices information it has already gathered about

translators until its planned database is established. Furthermore, SSA

should institute a mechanism to obtain regular access to investigative

results from states with Medicaid fraud control units to help identify

fraudulent claims associated with illegal translator activity.

Observations Noncitizens are one of the fastest growing groups of SSI recipients; their

number grew an average of 15 percent annually from 1986 through 1993.

6

The actual total amount of $112,805 represents $50,688 from SSI, $55,396 from Medicaid, and $6,721

from food stamps. Some applicants ineligible for SSI could still be eligible for Medicaid, food stamps,

or both.

7

GAO/HEHS-95-116, Aug. 31, 1995.

Page 9 GAO/T-HEHS-96-149
Supplemental Security Income: Noncitizen

Caseload Continues to Grow

To some extent, this parallels the rapid growth in immigration in the 1980s

as well as in SSI caseloads overall. Caseload growth for noncitizens has

slowed substantially to just over 6 percent last year, and SSA projects that

growth rates will remain in this more moderate range. Still, according to

SSA, noncitizen SSI recipients are projected to number nearly 1 million and

receive nearly $5 billion in federal benefit payments in the year 2000

compared with about 800,000 and $3.6 billion this year.

As a percentage of aged SSI recipients, noncitizens increased from

9 percent to nearly 33 percent from 1986 through 1995. Adult children of

some aged immigrants say they are willing to financially support their

relatives but sometimes do not. Eventually, some of these aged immigrants

receive SSI. About 25 percent of immigrants receiving SSI applied for

benefits within a year of the deeming period’s expiration.

Regarding translator fraud, our work suggests that it occurs primarily in

noncitizen cases. Although we do not know how often such fraud occurs,

we believe it can be reduced with a more comprehensive, programwide

strategy for keeping ineligible applicants from ever receiving benefits.

This concludes my testimony. I would be happy to answer any questions.

Contributors For more information on this testimony, please call Jane Ross, Director, at

(202) 512-7215. Other major contributors include Assistant Directors Chris

Crissman and Cindy Fagnoni and Evaluators Ken Stockbridge and Ann

Lee.

(106810) Page 10 GAO/T-HEHS-96-149
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