oversight

Welfare Reform: Public Assistance Benefits Provided to Recently Naturalized Citizens

Published by the Government Accountability Office on 1999-06-23.

Below is a raw (and likely hideous) rendition of the original report. (PDF)

                  United States General Accounting Office

GAO               Report of
                  House  to Representatives
                            the Honorable Elton Gallegly,




June 1999         WELFARE REFORM
                  Public Assistance
                  Benefits Provided to
                  Recently Naturalized
                  Citizens




                                GA 0
                            Accountability * Integrity* Reliability

GAO/HEHS-99-102
         United States
         General Accounting Office
'G             AO
              ~~~~~~Washington,
                     D.C. 20548

         Health, Education, and
         Human Services Division

         B-280390

         June 23, 1999

         The Honorable Elton Gallegly
         House of Representatives

         Dear Mr. Gallegly:

      Between World War II and the mid-1990s, the annual number of
     immigrants who became naturalized U.S. citizens never exceeded 400,000.
      Since then, however, the number of naturalizations has grown
     dramatically. In fiscal year 1996 alone, more than 1 million immigrants
     became naturalized-an all-time high. In August of the same year, the
     Personal Responsibility and Work Opportunity Reconciliation Act of 1996
     (commonly known as the welfare reform law) made noncitizen immigrants
     ineligible for certain federal public assistance benefits. You expressed
     concern that some immigrants may be seeking naturalization for the
     purpose of obtaining or retaining access to such benefits. This report
     responds to your request that we provide information on (1) the number of
     recently naturalized citizens receiving benefits from four major public
     assistance programs (Supplemental Security Income (ssI), Medicaid,
     Temporary Assistance for Needy Families (TANF), and Food Stamps)
     compared with that of the native-born population in 1997 and (2) the
     estimated annual cost to the federal and state governments of providing
     such benefits to these naturalized citizens.

     In preparing this report, we obtained data from the Immigration and
     Naturalization Service (INS) on about 927,000 immigrants who were
     recently naturalized-during fiscal years 1996 and 1997.' We obtained
     nationwide data on the ssI program from the SSA.2 For the Medicaid and
     Food Stamp programs, we obtained data from the five states (California,
     Florida, Illinois, New York, and Texas) that together account for about
     three-quarters of the recently naturalized individuals. 3 For the TANF
     program, we obtained data from four of those five states (California,
     Florida, New York, and Texas). 4 To determine the number and proportion


     'Those for whom we could find a valid Social Security number (SSN). A unique identifier, such as a
     valid SSN, is necessary for computer matching.
     2
      Of the four programs we examined, we could obtain national data only for SSI because it is the one
     program administered by the federal government. The other three programs are administered by the
     states and every state would have to be contacted to obtain complete data.
     :'About 703,000 of the 927,000 individuals we identified who were naturalized in fiscal years 1996 and
     1997 reside in California, Florida, Illinois, New York, and Texas.
     'We were unable to include TANF data from Illinois because of data format constraints.



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                   of recently naturalized citizens who received public assistance benefits,
                   and the cost of the benefits provided to them, we matched the naturalized
                   citizen data against these federal and state public assistance records. To
                   compare the naturalized citizens' rate of participation in the ssI, Medicaid,
                   and TANF programs with that of the native-born population, we used
                   calendar year 1997 data from the Bureau of the Census' March 1998
                   Current Population Survey (cPs) for native-born citizens aged 18 years or
                   older. 5

                   We conducted our work between April 1998 and April 1999 in accordance
                   with generally accepted government auditing standards. See appendix I for
                   a more detailed description of our scope and methodology.


Results in Brief   Our analysis shows that the recently naturalized citizens we identified
                   generally used ssI, Medicaid, and TANF benefits at a higher rate in 1997 than
                   the native-born population. Nationally, out of the 927,338 immigrants who
                   were recently naturalized, we found that about 8.3 percent received ssI
                   benefits during 1997. This rate is higher than the rate of 2.4 percent for the
                   nation's native-born citizens. Also, the rate of benefit receipt for recently
                   naturalized citizens in the Medicaid and TANF programs was higher than
                   the cPs-based estimate for the native-born population in several of the
                   states we examined, although the magnitude of difference varied across
                   some states. For example, we found that 9.6 percent of the recently
                   naturalized citizens in Texas received Medicaid compared with 6.1 percent
                    of the native-born population, while 23.7 percent of the recently
                    naturalized citizens in California received such benefits compared with
                    8.2 percent of the native-born population. We found similar patterns of
                    difference for the TANF program in the states we examined. Because we
                    compared estimates derived from administrative data for recently
                    naturalized citizens with estimates derived from self-reported survey data
                    for native-born citizens, the actual variation between the two populations'
                    receipt of public assistance may differ somewhat from our estimates.
                    Nevertheless, these estimates are the most accurate we could calculate
                    given the data available. In addition, a variety of factors may contribute to
                    differences in the benefit receipt rates between the recently naturalized
                    citizens and the native-born population. These include individuals'
                    decisions to apply for benefits, as well as program eligibility factors such
                    as income.


                     We only examined native-born citizens aged 18 years or older because the population of naturalized
                    5

                    citizens we examined consisted of individuals aged 18 or older. (Federal regulations require that
                    immigrants seeking naturalization be at least 18.)


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             The benefits paid by the federal and state governments in 1997 to the
             recently naturalized citizens included in our review totaled about
             $735 million for the four programs. This figure reflects nationwide data for
             the ssI program, as well as data from five states for the Medicaid and Food
             Stamp programs (representing 76 percent of all the recently naturalized
             citizens in our review 6 ), and from four states for the TANF program
             (representing 71 percent of all the recently naturalized citizens in our
             review). Overall, the percentage of benefits paid to recently naturalized
             citizens in each program was about 1 percent or less of the total benefits
             paid to all recipients.


Background   Naturalization is the process by which those born outside of the United
             States can obtain U.S. citizenship. To become a naturalized citizen, an
             immigrant must fulfill certain requirements set forth in the Immigration
             and Nationality Act and federal regulations. Generally, these naturalization
             provisions specify that an immigrant be at least 18 years of age; have
             resided in the country continuously for at least 5 years; have the ability to
             speak, read, and write the English language; have knowledge of the U.S.
             government and history; and be of good moral character. Some of these
             requirements (such as the language requirement) are waived for older
             individuals and those who are unable to comply because of physical,
             mental, or developmental disabilities.7

             Naturalized citizens enjoy most of the same legal rights and
             responsibilities as native-born citizens, including the right to apply for
             public assistance. Historically, legal permanent residents (noncitizens) of
             the United States have also been eligible to apply for various public
             assistance benefits. However, the Personal Responsibility and Work
             Opportunity Reconciliation Act of 1996 contained several public
             assistance benefit restrictions. Title IVof the Act made noncitizens
             ineligible for certain federal welfare benefits and gave states the option to
             provide or restrict their access to other federal, state, or local benefits.
             Eligibility restrictions were greatest for those who entered the country on
             or after August 22, 1996, the date of enactment.

             The major federal- and state-administered public assistance programs
             affected by the welfare reform law were ssi, TANF (formerly Aid to Families

             "Among the 927,338 naturalized citizens we identified nationally who became citizens in fiscal years
             1996 and 1997.
             7
              The language requirement and civics test are waived in some cases for older immigrants who have
             resided in the United States for an extended period.



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  With Dependent Children), Medicaid, and Food Stamps. These programs
  provide either cash or in-kind benefits to individuals who meet the
  eligibility criteria. The law initially barred immigrants, with some
  exceptions, from receiving ssI or food stamps and generally prohibited
  new immigrants from receiving TANF or Medicaid benefits during their first
  5 years in the United States. In addition, the law gave states the option of
  denying TANF benefits and Medicaid eligibility to most prereform
  immigrants and to new immigrants8 even after 5 years of U.S. residency.
  Subsequently, the Balanced Budget Act of 1997 largely restored eligibility
  for ssI to many noncitizens who were affected by the welfare reform law.
  In addition, the Agricultural Research, Extension, and Education Reform
  Act of 1998 restored Food Stamp eligibility for prereform immigrants who
  were younger than 18, aged 65 and older, or were receiving benefits or
  assistance for blindness or disability as of August 22, 1996. Moreover, most
  states have also chosen to continue providing federal TANF and Medicaid
  benefits to new immigrants after 5 years of U.S. residency. 9

  Since the mid-1990s, the number of naturalizations each year has
  increased significantly, with over 1 million immigrants becoming U.S.
  citizens in 1996 alone (see figure 1). According to INS, several factors likely
  have contributed to this recent, rapid increase in naturalizations. They
  cited the following:

* A "Green Card Replacement Program" initiated by INS in 1992 required
  long-term residents to replace their permanent resident alien cards with
  new, more counterfeit-resistant cards; many immigrants chose to become
  naturalized rather than incur the cost of applying for a new card.
* The passage of the Immigration Reform and Control Act of 1986 (IRCA)
  resulted in about 2.7 million illegal aliens being granted legal permanent
  resident status. In 1994, the first IRCA immigrants became eligible for
  naturalization (see app. II for more detailed information on the
  IRcA-naturalized citizens in our review).
* The Citizenship USA initiative, implemented in August 1995, was designed
  to streamline the naturalization process.
* Legislative efforts restricted public benefits for noncitizens at the state and
  federal levels.




  8
      Those immigrants entering the country on or after the date of enactment of the welfare reform law.
  9
    Welfare Reform: Many States Continue Some Federal or State Benefits for Immigrants
   (GAO/HEHS-98-132, July 31, 1998).

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Figure 1: Number of People
Naturalized (Fiscal Years 1911-97)   1,200,000      Number of immigrants naturalized


                                     1,000,000


                                      800,000


                                      600,000


                                      400,000


                                      200,000




                                                     lb                                                                co



                                                 Year


                                     Source: INS.




Recently Naturalized                 We estimate that, in general, the recently naturalized citizens included in
                                     our review received ssI, Medicaid, and TANF benefits at a higher rate in
Citizens Received                    1997 than did the native-born population.'0 Nationally, recently naturalized
Benefits at a Higher                 citizens received ssI benefits at a rate higher than that of the native-born
Rate Than                            population. Similarly, the recently naturalized citizens in our review
                                     received Medicaid and TANF benefits at a higher rate than the native-born
Native-Born Citizens                 population in several of the five states we examined-California, Florida,
in 1997                              Illinois, New York, and Texas-although the difference in the rate of
                                     benefit receipt between naturalized citizens and native-born citizens
                                     varied across states." A variety of factors may contribute to differences in
                                     the benefit receipt rates between the recently naturalized citizens and the
                                     native-born population. These include individuals' decisions to apply for
                                     benefits, as well as program eligibility factors such as income. We
                                     identified naturalized citizens receiving Food Stamp benefits in all five

                                     "'Our cPs-based estimates for the native-born population have standard errors associated with them.
                                     See appendix I for a discussion of these standard errors.

                                     "The difference between the recently naturalized citizens' rate of benefit receipt and that of
                                     native-born citizens was not statistically significant in three instances: Medicaid benefits in Illinois, and
                                     TANF benefits in Florida and Texas (see table 1.2 in app. I).



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                    states, but lacked sufficient data to compare their benefit use with that of
                    the native-born population for this program. In addition, we analyzed
                    IRcA-naturalized citizens (a subset that represented almost 30 percent of all
                    the recently naturalized citizens in our review) separately to determine if
                    their pattern of benefit receipt differed from that of all other recently
                    naturalized citizens (see app. II).


SSI                 For calendar year 1997, we identified 76,823 recently naturalized citizens
                    who received ssI benefits. These individuals represent 8.3 percent of the
                    927,338 recently naturalized citizens in our review-a rate higher than the
                    comparable figure of 2.4 percent for the native-born population. Overall,
                    the recently naturalized citizens who received ssI benefits represent about
                    1.2 percent of the total population of about 6.6 million ssI recipients
                    nationwide in 1997.

                    We also analyzed a more comprehensive group of about 2.7 million
                    naturalized citizens who obtained citizenship between 1970 and 1995 to
                    determine if individuals who were naturalized in earlier years received
                    benefits at the same rate as those who were naturalized recently. About
                    4.2 percent of all the individuals who were naturalized during this 25-year
                    period (112,140) received ssI benefits in 1997. The immigrants who were
                    naturalized between 1970 and 1995 received benefits in 1997 at about half
                    the rate of the group of recently naturalized citizens.12 This suggests the
                    possibility that the rate of ssI benefit receipt among recently naturalized
                    citizens may not be representative of the benefit receipt rate among all
                    naturalized citizens. We could not, however, determine what factors
                    contributed to the difference in receipt rates between the two groups.


Medicaid and TANF   Of the 702,560 recently naturalized citizens who resided in five
                    states-California, Florida, Illinois, New York, and Texas-we found that
                    135,681 (19.3 percent) received Medicaid benefits. In four of the five
                    states, these naturalized citizens received Medicaid benefits in 1997 at a
                    higher rate than that of the native-born citizen population.3 The largest
                    difference between the two populations' use of benefits was in California,
                    where 23.7 percent of the recently naturalized citizens received Medicaid,
                    while our analysis of cps data indicates that 8.2 percent of the native-born


                    12We were able to make this comparison for the SSI program only, because it is the one program we
                    reviewed that has the nationwide data on program participants essential for our analysis.

                    '3The difference between the recently naturalized citizens' rate of benefit receipt and that of
                    native-born citizens was not statistically significant in Illinois. See table 1.2 in app. I.



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citizens in California received such benefits. By comparison, Texas
exhibited a much smaller difference in rates of receipt, with 9.6 percent of
the naturalized citizens receiving benefits in 1997 compared with
6.1 percent of the native-born population (see table 1).

We also identified 30,052 individuals receiving TANF benefits in four
states-California, Florida, New York, and Texas-or about 4.6 percent of
all the recently naturalized citizens residing in those states. Recently
naturalized citizens used TANF benefits at a higher rate than native-born
citizens in two of the four states.14 As with Medicaid, the difference
between the two populations' use of benefits varied from one state to the
next. We found that 5.8 percent of recently naturalized citizens with valid
SSNS in California received TANF-a considerably higher rate than that of
the native-born population (2 percent). By comparison, New York
exhibited a somewhat smaller difference in rates of receipt, with
4.7 percent of the recently naturalized citizens receiving benefits in 1997
compared with 2.2 percent of the native-born population. See table 1 for a
summary of naturalized and native-born citizens' use of benefits in each
state.




14The difference between the recently naturalized citizens' rate of benefit receipt and that of
native-born citizens was not statistically significant in Florida and Texas. See table 1.2 in app. I.



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Table 1: Rates of Public Assistance
Receipt by Recently Naturalized and                                                                     Estimated
Native-Born Citizens, Calendar Year                                                                 percentage of          Estimated
1997                                                                                                     recently      percentage of
                                                                                                      naturalized        native-born
                                                                                               citizens receiving citizens receiving
                                      Program                         Source of data                      benefits          benefitsa
                                      SSI                             National                                   8.3                    2.4
                                      Medicaid                        Calif.                                   23.7                     8.2
                                                                      Fla.                                      18.7                    6.2
                                                                      III.                                       7.5                    6.0 b
                                                                      N.Y.c                                     17.3                    9.6
                                                                      Tex.                                       9.6                    6.1
                                             d
                                      TANF                            Calif.                                     5.8                    2.0
                                                                      Fla.                                       1.8                    1.lb
                                                                      N.Y.                                       4.7                    2.2
                                                                      Tex.                                       1.5                    1.2b
                                      aEstimates based on March 1998 CPS data, which reflect survey responses for public assistance
                                      receipt during calendar year 1997.
                                      bThe CPS-based estimate for the native-born population is not statistically different from the
                                      estimate for the recently naturalized citizens, which was calculated using administrative data.
                                      CNew York Medicaid data are for fiscal year 1997, rather than calendar year 1997.
                                      dWe were unable to use Illinois' TANF data in our review due to formatting problems.




Food Stamps                           We found that 77,351 recently naturalized citizens (11 percent) in the five
                                      states received Food Stamp benefits. Similar to the other programs we
                                      analyzed, receipt of food stamps by recently naturalized citizens varied
                                      widely among the five states. We found the highest rate of receipt in
                                      Florida, where 17.6 percent of the recently naturalized population
                                      accessed benefits, followed by New York (14.6 percent), Texas
                                      (13.1 percent), California (7.9 percent), and Illinois (5.7 percent).
                                      However, we were unable to compare the naturalized and native-born
                                      populations' use of this program because cPs survey data measure food
                                      stamp receipt by households, not individuals.


Comparing Benefit Rates               Our estimates of benefit receipt by recently naturalized citizens and the
Using Administrative Data             native-born population are likely to be affected by substantive differences
and CPS Data Requires                 between, and limitations in, the administrative program data and the cPs
Caution                               survey data. For example, because the data on naturalized citizens only



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                        include individuals for whom we could find a valid SSN, our data may not
                        be representative of all naturalized citizens in the country. If all naturalized
                        citizens in the country were included in our analysis, the proportion of this
                        population that we identified as receiving public assistance could change.
                        Moreover, a variety of factors may contribute to differences in the rate of
                        public assistance receipt between these populations, including individuals'
                        decisions to apply for benefits and program eligibility factors such as
                        income.

                        According to a Census Bureau official, the cps data we used to estimate
                        the native-born population's use of public assistance benefits may
                        understate the true proportion of individuals receiving such benefits,
                        largely because these data are self-reported. This official indicated that
                        survey respondents frequently underreport this type of information, thus
                        lowering the estimated percentage of individuals who receive public
                        assistance. Moreover, because the cPs survey analyzes sample data to
                        estimate characteristics of the entire population, the estimates we based
                        on cps data have sampling errors associated with them (see app. 1).


Recently Naturalized    We estimate that the benefits paid' 5 by the federal and state governments
                        to the recently naturalized citizens included in our review for ssI,
Citizens Received       Medicaid,     TANF,   and food stamps totaled about $735 million in 1997. This
About $735 Million in   figure is based on national data for the ssI program; data from California,
Benefits in 1997        Florida, Illinois, New York, and Texas for the Medicaid and Food Stamp
                        programs; and data from four of the states (excluding Illinois) for the TANF
                        program.' 6 The percentage of benefits received by the recently naturalized
                        citizens in each program was 1.3 percent or less of the total benefits paid
                        to all recipients in those programs and states. In addition, the amount of
                        benefits received by these recently naturalized citizens was generally
                        proportional to their representation in the recipient populations for each
                        of the four programs.'7

                        Total ssI benefits paid nationwide to 76,823 recently naturalized citizens
                        equaled $331 million, or about 1.3 percent of the benefits paid to all


                        '5Our estimates do not include administrative costs for these programs.

                        l'As indicated previously, about three-quarters of all the immigrants who were naturalized in recent
                        years reside in the five states we examined.

                        '7The naturalized citizens we identified as receiving benefits in each of the programs represent about
                        1.2 percent of all SSI recipients nationwide; 0.8 percent and 0.6 percent of all Medicaid and food stamp
                        recipients, respectively, in the five states we examined; and 0.5 percent of all TANF recipients in four
                        of the states (excluding Illinois).



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                                         program recipients in 1997. By comparison, the 112,140 immigrants on the
                                         ssI rolls who were naturalized between 1970 and 1995 received about
                                         $489 million in ssI benefits in 1997. Although the recently naturalized
                                         citizens represent about 26 percent of all the immigrants who were
                                         naturalized between 1970 and 1997,18 the recently naturalized citizens
                                         received about 40 percent of the $820 million in ssI benefits that went to all
                                         immigrants who were naturalized between 1970 and 1997.

                                         Medicaid claims for recently naturalized citizens totaled about
                                         $317 million, representing about 0.6 percent of all Medicaid benefits paid
                                         in the five states we examined. TANF benefits paid to recently naturalized
                                         citizens totaled about $42 million, or 0.5 percent of all the benefits paid to
                                         recipients in the four states for which we had data, while Food Stamp
                                         benefits totaled about $45 million, or 0.7 percent of all Food Stamp
                                         benefits paid by the five states in our review. Table 2 shows the benefits
                                         received by the naturalized citizens in each state we examined for the
                                         Medicaid, TANF, and Fobd Stamp programs.

Table 2: Recently Naturalized Citizens
Receiving Medicaid, TANF, and Food       State                                              Medicaid                 TANF         Food stamps
Stamp Benefits by State in Calendar      California            Recipients                     81,686                20,079              27,349
Year 1997
                                                               Benefits                $125,442,072          $27,758,412           $15,324,541
                                         Florida               Recipients                      17,591                 1,737              16,537
                                                               Benefits                 $42,925,584            $2,691,765          $10,598,000
                                         Illinois              Recipients                     3,311                           a          2,493
                                                               Benefits                 $10,572,484                           a     $1,478,937
                                         New York              Recipients                      27,226                 7,342              22,962
                                                               Benefits                $121,601,682           $11,178,877          $13,254,328
                                         Texas                 Recipients                       5,867                   894                8,010
                                                               Benefits                  $16,676,456             $362,828           $4,126,632
                                         Note: The number of recipients should not be totaled across programs because some recipients
                                         may have received benefits from more than one program.
                                         aNo data on TANF were usable because of formatting problems.


                                         It is likely that the benefits received by the naturalized citizens in our
                                         review represent a substantial part of the total benefits received by all
                                         recently naturalized citizens in the four programs in 1997. This is because
                                         the ssI data we cite are national, and the states we examined represent
                                         about three-quarters of all immigrants nationwide who became citizens in

                                         '8 Out of a total of 3.6 million citizens who were naturalized between 1970 and 1997, about 927,000 were
                                         naturalized recently (during fiscal years 1996 and 1997).


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                   fiscal years 1996 and 1997. However, because our analysis is limited to
                   benefits received during calendar year 1997, we are unable to comment on
                   longer-term patterns of benefit receipt by naturalized citizens.


Agency Comments    We provided a draft of this report to administrators at the federal agencies
                   and states that supplied us with data, or that have administrative or
and Our Response   oversight responsibility for the public assistance programs we discussed.
                   These include the Administration for Children and Families in the
                   Department of Health and Human Services (responsible for the TANF
                   program); the Census Bureau in the Department of Commerce; Food and
                   Nutrition Services in the Department of Agriculture (responsible for the
                   Food Stamp program); the Health Care Financing Administration in the
                   Department of Health and Human Services (responsible for the Medicaid
                   program); INS in the Department of Justice; SSA (responsible for the ssI
                   program); and California, Florida, Illinois, New York, and Texas. We
                   received comments from program administrators at the Census Bureau,
                   the Department of Health and Human Services, Food and Nutrition
                   Services, INS, California, Florida, and New York.

                   Although our report cautions readers to consider the data limitations we
                   discuss when interpreting the data, some program administrators raised
                   concerns about these limitations, and why certain analyses were not done.
                   For example, some program administrators questioned the validity of
                   comparing the administrative data used for the recently naturalized
                   citizens' receipt of public assistance benefits to the cPs-based data used for
                   the native-born population's use of such benefits-a limitation we had
                   discussed. Another commentor raised questions about the statistical
                   significance of some of our findings.

                   We have modified the report where appropriate to reflect some of these
                   concerns, particularly with respect to the statistical significance of some
                   of our findings. We were aware of the data limitations noted by these
                   program administrators, and have sought to overcome these limitations
                   throughout our review. Moreover, certain analyses were not possible
                   because the necessary data were not available. Finally, we believe that we
                   have fairly and accurately characterized the data and findings in our report
                   and have provided the most accurate calculations possible given the
                   quality and availability of the data.

                   Program administrators in SSA and the states of Illinois and Texas
                   reviewed the report and told us that they did not have any comments.



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We are sending copies of this report to the agencies who supplied data,
provided comments, or have administrative or oversight responsibility for
the public assistance programs discussed, and will make copies available
to others upon request.

Please contact Jeremy Cox, Evaluator-in-Charge, or me at (202) 512-7215 if
you have any questions concerning this report or need additional
information. Other major contributors to this report are listed in appendix
III.

Sincerely yours,




Cynthia M. Fagnoni
Director, Education, Workforce,
  and Income Security Issues




 Page 12                          GAO/HEHS-99-102 Benefits to Naturalized Citizens
Page 13   GAO/HEHS-99-102 Benefits to Naturalized Citizens
Contents


Letter                                                                                                 1
Appendix I                                                                                           16
Scope and
Methodology
Appendix II                                                                                           24
Benefit Use by
Immigration Reform
and Control Act of
1986 Naturalized
Citizens
Appendix III                                                                                          27
Major Contributors to
This Report
Tables                  Table 1: Rates of Public Assistance Receipt by Recently                        8
                          Naturalized and Native-Born Citizens, Calendar Year 1997
                        Table 2: Recently Naturalized Citizens Receiving Medicaid, TANF,              10
                          and Food Stamp Benefits by State in Calendar Year 1997
                        Table I.1: Comparison of Administrative Data and CPS Data                     21
                        Table 1.2: Confidence Intervals Associated With CPS-Based                     22
                          Estimates of Public Assistance Receipt
                        Table II.1: Benefits Received by IRCA-Naturalized Citizens in                 26
                           1997

Figure                  Figure 1: Number of People Naturalized                                         5




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 Contents




Abbreviations

CIS         Central Index System
cPS         Current Population Survey
HCFA        Health Care Financing Administration
INS         Immigration and Naturalization Service
IRCA        Immigration Reform and Control Act of 1986
MSIS        Medicaid Statistical Information System
SSA         Social Security Administration
ssI         Supplemental Security Income
SSN         Social Security number
SSR         Supplemental Security Record
TANF        Temporary Assistance for Needy Families


Page 15                            GAO/HEHS-99-102 Benefits to Naturalized Citizens
Appendix I

Scope and Methodology


                To estimate the number of naturalized citizens receiving public assistance,
 Introduction   we obtained data from several federal and state sources. We acquired data
                on individuals who were naturalized in fiscal years 1996 and 1997 from the
                Immigration and Naturalization Service (INS). In addition, SSA provided
                data (originating from a master database supplied by INS) that identified all
                individuals with valid Social Security numbers (SSN) who were naturalized
                between 1900 and 1996.19 Together, the INS and SSA databases represent the
                universe of naturalized citizens in the country as of 1997 for whom we
                could find a valid SSN. We obtained individual-level public assistance data
                for four major programs: Supplemental Security Income (ssI), Temporary
                Assistance for Needy Families (TANF), Medicaid, and Food Stamps. We
                                                                                      20
                 obtained ssI data from SSA and data for the three remaining programs
                 from five states 2 1-California, Florida, Illinois, New York, and
                 Texas-where about three-quarters of all the immigrants who were
                 naturalized recently reside.

                We matched naturalized citizen data against administrative records from
                the four public assistance programs to determine whether these
                individuals received benefits in calendar year 1997, and if so, the amount
                of benefits provided to them by the federal and state governments. We also
                compared our estimates of the naturalized citizens' rate of benefit use for
                each program against estimates we calculated from the Census Bureau's
                March 1998 Current Population Survey (cPs) for the native-born
                                                                                       22
                population's use of such benefits (for individuals aged 18 or older).
                However, certain limitations in the data we used to estimate both
                 naturalized and native-born citizens' use of public assistance should be
                 noted. Our data include only those naturalized citizens for whom we could
                 identify a valid SSN. As a result, our estimates may not be representative of
                 the extent to which all naturalized citizens in the country use public
                 assistance. In addition, our analysis of naturalized citizens' use of public
                 assistance was based on administrative program data, whereas the cPs
                 data we used to estimate the native-born population's use of such benefits
                 are self-reported. Thus, because we compared estimates derived from


                 "9INS originally prepared this master database for SSA to assist the agency in implementing provisions
                 of the welfare reform act that affected noncitizens' eligibility for the SSI program.
                 20
                   Medicaid data for California and Florida were obtained centrally from the Health Care Financing
                 Administration's (HCFA) Medicaid Statistical Information System (MSIS). Also, New York Medicaid
                 data are for fiscal year 1997, rather than calendar year 1997.

                  'Because of data limitations, we could not use TANF data from Illinois. As a result, our analysis of this
                 2

                 program is limited to the four remaining states that provided us with data.
                 22
                   We examined only native-born citizens 18 years or older because the population of naturalized
                 citizens we examined consisted of individuals over 18 years-the minimum age for naturalization.



                 Page 16                                         GAO/HEHS-99-102 Benefits to Naturalized Citizens
                                Appendix I
                                Scope and Methodology




                               administrative data to estimates derived from self-reported survey data,
                               the variation between the two populations' use of public assistance may
                               differ somewhat. Moreover, because we have not controlled for possible
                               variation in income and socioeconomic characteristics of the two
                               populations, we could not determine the extent to which such variation
                               may explain the differences we found in the two populations' receipt of
                               benefits.

                               We tested the accuracy of the naturalized citizen and public assistance
                               data used in our report with the appropriate federal and state agencies. In
                               general, we found that our data were accurate.

Naturalized Citizen Data       To identify the number of immigrants who were recently naturalized (in
Provided by INS and SSA        fiscal years 1996 and 1997), we first obtained data on naturalized citizens
                            from INS' Central Index System (cIS) and Redesigned Naturalization
                            Application Casework System. The files provided by
                                                                                     INS contained about
                             1.5 million unique records, which represented complete data for fiscal
                                                                                                       year
                             1996 and partial data for fiscal year 1997.23 For each record, we obtained
                            several pieces of information, including the naturalized citizen's name,
                            date of birth, INS "A" (alien) number, naturalization date and location,
                                                                                                     as
                            well as country of origin. We obtained valid SSNs for as many of these
                            individuals as possible using SSA's Enumeration Verification System, which
                            uses key variables (such as name and date of birth) to verify any SSNS
                            provided with data entered into the system, or to determine a correct
                                                                                                     SSN if
                            none is provided. Of the original 1.5 million records, we identified valid
                            SSNS for 927,338 records.


                           To supplement the 1996 and 1997 data, we also obtained data from SSA
                                                                                                       on
                           about 3.2 million individuals with valid SSNs who were naturalized between
                            1900 and 1996. The two files were combined, resulting in a master file
                                                                                                      of
                           individuals with valid SSNS who were naturalized between 1900 and 1997.
                           After we combined the two files, tested the accuracy of the data, and
                           eliminated duplicate records, our population contained about 3.7 million
                           individuals. We then eliminated all records prior to 1970,24 which resulted
                           in a final population of about 3.6 million naturalized citizens with valid

                           2
                            'Complete data for newly naturalized citizens in fiscal year 1997 were
                                                                                                   not available at the time of our
                           review because not all INS field offices had provided their reports
                                                                                               on newly naturalized citizens to INS
                           headquarters. The offices that had not reported such data tended to
                                                                                                be smaller, rural offices.
                           24
                             According to INS officials, agency data on immigrants and naturalized
                                                                                                   citizens from 1970 forward
                           may be more accurate than data from prior years due to the advent of
                           they advised us to exclude immigrants who were naturalized before 1970the automated CIS. Therefore,
                                                                                                     from our review. In doing so,
                           we eliminated about 100,000 cases-about 3 percent of all immigrants
                                                                                                  with valid SSNs we identified.


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                          Appendix I
                          Scope and Methodology




                          SSNS  who became citizens between 1970 and 1997.25 Included in this
                          population were about 343,000 naturalized citizens who originally were
                          illegal immigrants and were granted amnesty under the Immigration
                          Reform and Control Act of 1986 (IRCA). See appendix II for details on this
                          subpopulation of IRcA-naturalized citizens.


Public Assistance Data    We calculated recently naturalized citizens' receipt of public assistance
Obtained From Federal     benefits using calendar year 1997 program administrative data. We
and State Agencies        obtained nationwide ssI benefit data from SSA's Supplemental Security
                          Record (SSR), the central database used to administer the ssI program. We
                          obtained TANF eligibility data from state agencies in California, Florida, and
                          Texas, and payment data from New York. We also obtained Medicaid
                          payment data for California and Florida from HCFA, and from state
                          agencies in Illinois, New York, and Texas. Finally, we obtained Food
                          Stamp eligibility data from California, Florida, Illinois, New York, and
                          Texas.2 6


Identifying Naturalized    Our analysis of public assistance use by the 3.6 million naturalized citizens
Citizens Using Public      with valid SSNS in our review was limited to the ssi program because it is
Assistance Benefits                                            has a national database containing
                           the only program in our review thatsuch,
                           information on all participants. As      we asked SSA to match the
                           population of 3.6 million cases against the SSR to determine the number of
                           naturalized citizens using ssI nationally. Also, we matched the ssI data
                           against two subgroups of naturalized citizens to compare their rates of
                           benefit receipt: (1) the 927,338 immigrants who recently were naturalized
                           in fiscal years 1996 and 1997 and (2) the remaining 2.7 million immigrants
                           who were naturalized between 1970 and 1995. Nationwide matches of the
                           other public assistance programs were impractical because these
                           programs are administered by the states, and we lacked the nationwide
                            data essential for our analysis. Instead, we focused on the five states,
                            discussed above, where more than three-quarters of the recently
                            naturalized citizens reside. We established a state of residence for the
                            recently naturalized citizens in our review based on their location at the
                            time they were naturalized (as indicated by a unique INS naturalization


                             Included in the total population of 3.6 million were about 2.7 million immigrants who were
                            25

                            naturalized between January 1970 and September 1995.
                                                                                                                               benefits
                             'The numbers of naturalized citizens we identified as using Food Stamp benefits and the total
                            2

                            paid to these individuals are our estimates based on states' program eligibility files. The total number
                                                                                                                               of
                            of individuals we cite as receiving benefits is based on each state's estimate of the percentage
                            eligible individuals who  actually participate in the program each month.  Similarly, the total benefits
                                                                                                                                  state.
                            attributed to these individuals are estimated based on the average payment per recipient in each


                            Page 18                                          GAO/HEHS-99-102 Benefits to Naturalized Citizens
                           Appendix I
                           Scope and Methodology




                          location code).2 7 We matched all the recently naturalized citizens with
                          valid SSNs against the TANF, Medicaid, and Food Stamp beneficiary
                          databases provided to us by the states.

                          A match was considered valid if (1) the individual received benefits at
                          some point in 1997 after the date of naturalization and (2) the INS location
                          code indicated that the individual resided in the state. The following
                          hypothetical case illustrates those two criteria. A comparison of our
                          naturalized citizen data with state administrative records reveals 100
                          matches of individuals receiving benefits. Only 90 individuals received
                          benefits after their date of naturalization. Moreover, only 85 of those 90
                          individuals displayed an INS location code for that state, so our final match
                          count for the program in that state would be 85 individuals.


Calculation of Benefit    We calculated the amount of benefits provided to the naturalized citizens
Costs Incurred by the     by the federal and state governments over a 1-year period-calendar year
Federal and State         1997.28 We obtained individual-level benefit payment data from the ssI
                          program and from the Medicaid programs in each state. In other cases
Governments               (such as California Food Stamp data and California, New York, and Texas
                          TANFdata), we used program eligibility data along with information on the
                         average monthly benefit per individual to estimate the annual value of the
                         benefits. As discussed, our analysis included only benefit payments that
                         occurred in 1997 in the months following each individual's date of
                         naturalization. For example, if an individual obtained Medicaid benefits for
                         each month in calendar year 1997, and was naturalized in July 1997, we
                         calculated the value of the benefits provided to that individual for the
                         period of August through December. In addition, we calculated only the
                         estimated value of the benefits provided to the naturalized citizens;
                         program administrative costs were not included in our analysis.




                         27
                          We lacked sufficient data to determine a state of residence for all 3.6 million naturalized
                                                                                                                      citizens in
                         our review.
                         28
                           Medicaid data from New York were only available for fiscal year 1997.



                         Page 19                                         GAO/HEHS-99-102 Benefits to Naturalized Citizens
                              Appendix I
                              Scope and Methodology




Comparison of                 We compared the naturalized citizens' use of public assistance benefits to
Administrative Data With      data from the March 1998 cPs for the native-born population, as well as to
CPS Data on Native-Born       1998 cps data for the foreign-born citizen (naturalized) population. These
and Foreign-Born              comparisons were conducted on the national level for the ssI program, and
       (Naturaliegd)-Citizn   on the state level for the Medicaid and TANF programs for each state that
(Naturalized) Citizen         provided data for our review.2 9 Table 1.1 compares our estimates of the
Populations                   recently naturalized citizens' use of these programs based on
                              administrative data to our estimates based on cPs data for both the
                              native-born and foreign-born citizen populations.

                              The estimates we provide have limitations. For example, our estimates of
                              naturalized citizens' use of public assistance benefits are based solely on
                              those individuals for whomwe could identify a valid SSN. Therefore, the
                              naturalized citizens in our review may not be representative of all
                              naturalized citizens in the nation, and may not represent the level of public
                              assistance received by all naturalized citizens. Moreover, the cPs data for
                              the native- and foreign-born citizen populations' use of the three programs
                              are survey projections based on statistical sampling. According to the
                              Census Bureau, the cPs data are subject to certain factors that may affect
                              the accuracy of such estimates, including (1) underreporting by the target
                              population on questions concerning public assistance and (2) sampling
                               error.

                               Underreporting of assistance means that survey respondents have failed to
                               report receipt of assistance, have underreported the amount of assistance
                               received, or have misclassified the assistance received. The Census
                               Bureau notes that cps survey respondents underreport their receipt of cash
                               assistance from programs such as Aid to Families With Dependent
                               Children or TANF (although estimates for ssI tend to be more accurate).
                               Underreporting of noncash benefits such as food stamps is also evident,
                               although the extent to which this occurs has been more difficult to assess,
                               according to the Census Bureau.




                                 We could not compare the naturalized and native-born citizens' use of the Food Stamp program
                                29

                                because the CPS data we analyzed only contained household-level data.



                                Page 20                                     GAO/HEHS-99-102 Benefits to Naturalized Citizens
                                   Appendix I
                                   Scope and Methodology




Table 1.1: Comparison of
Administrative Data and CPS Data                                                                         CPS-based data
                                                                                                                          Percentage of
                                                                                                                           foreign-born
                                                                         Percentage of                                     (naturalized)
                                                                  recently naturalized              Percentage of               citizens
                                                  Source of         citizens receiving        native-born citizens            receiving
                                   Program        data                        benefits         receiving benefits               benefits
                                   SSla            National                           8.3                         2.4                 3.2
                                   Medicaidb      Calif.                             23.7                         8.2                 8.7
                                                  Fla.                               18.7                         6.2                 8.3
                                                  III.                                7.5                         6.0                 2.9
                                                  N.Y.c                              17.3                         9.6                11.9
                                                  Tex.                                9.6                         6.1                 8.9
                                   TANFb          Calif.                              5.8                         2.0                 1.2
                                                  Fla.                                 1.8                        1.1                0.9 d
                                                  N.Y.                                4.7                         2.2                 1.8
                                                  Tex.                                1.5                         1.2                 1.1
                                   aGAO's estimate for the SSI program is based on all 3.6 million naturalized citizens with valid
                                   SSNs who were naturalized since 1970.

                                   bGAO's estimate for Medicaid and TANF programs is based on 927,338 naturalized citizens with
                                   valid SSNs who were naturalized during fiscal years 1996 and 1997. TANF data for Illionis were
                                   not available for our review.

                                   CNew York Medicaid data are for fiscal year 1997 rather than calendar year 1997.
                                   dEstimate is based on March 1997 CPS, which reflects responses about receipt of public
                                   assistance benefits in calendar year 1996.


                                   The cps uses a sample of the population to estimate the characteristics of
                                   both the native-born and foreign-born populations; therefore, our
                                   cPs-based estimates of benefit use by these populations have degrees of
                                   imprecision known as standard errors associated with them. A standard
                                   error is a measure of the variation that may occur by chance because a
                                   sample, rather than the entire population, was analyzed. The size of the
                                   standard error reflects the imprecision of the estimate. The smaller the
                                   standard error, the more precise the estimate. The standard error can be
                                   used to calculate a confidence interval around each estimate that indicates
                                   the degree of imprecision in that estimate. For each of our cPs-based
                                   estimates, we calculated a 95-percent confidence interval. This means that
                                   there is a 95-percent chance that the actual population percentage of
                                   interest falls within that interval (see table 1.2). The Food Stamp program
                                   is excluded because the cps does not collect information on individuals'
                                   use of these benefits.



                                   Page 21                                       GAO/HEHS-99-102 Benefits to Naturalized Citizens
                                      Appendix I
                                      Scope and Methodology




Table 1.2: Confidence Intervals
Associated With CPS-Based Estimates   Numbers in Percent
of Public Assistance Receipt          Source of data                                        Native-born                      Foreign-born
                                      SSI (national)
                                      SSA                                                  2.4 (2.2 to 2.6)                  3.2 (1.9 to 4.5)
                                      Medicaid
                                      Calif.                                               8.2 (7.9 to 8.5)                 8.7 (4.1 to 13.3)
                                      Fla.                                                 6.2 (4.6 to 7.8)                 8.3 (2.1 to 14.5)
                                      Ill.                                                 6.0 (4.3 to 7.7)                   2.9 (1.3 to 5.6)
                                      N.Y.                                               9.6 (7.9 to 11.3)                 11.9 (6.1 to 17.7)
                                      Tex.                                                6.1 (4.6 to 7.6)                  8.9 (0.2 to 17.6)
                                      TANF
                                      Calif.                                               2.0 (1.2 to 2.8)                   1.2 (0.7 to 1.8)
                                      Fla.                                                 1.1 (0.4 to 1.8)                   0.9 (0.3 to 2.1)a
                                      N.Y.                                                 2.2 (1.3 to 3.1)                   1.8 (1.1 to 2.8)
                                      Tex.                                                 1.2 (0.5 to 1.9)                   1.1 (0.2 to 2.8)
                                      aEstimate and standard error based on data from March 1997 CPS, which reflects responses
                                      given for TANF use in calendar year 1996.




Data Verification                     To test the accuracy of the data used in our analysis, we obtained
                                      independent verification from INS and each state that provided us with
                                      public assistance data.3 0 To verify the INS data on naturalized citizens, we
                                      selected a random sample of 50 records and compared the electronic data
                                      to data from each individual's certificate of naturalization. Similarly, to
                                      verify the data from the state public assistance programs, we selected a
                                                                                               31
                                      random sample of 30 cases per program in each state. We supplemented
                                      each random sample with five judgmentally selected cases, focusing on
                                      very large payment amounts. We asked the states to verify the accuracy of
                                      specific identifying variables, including name, SSN, and date of birth, as
                                      well as the benefits paid to each individual in the sample.

                                       The results of our verification process indicate that, overall, the data were
                                       accurate. INS confirmed the citizenship status of all 50 cases we sent them.
                                       With respect to the state public assistance data, we found only one case in
                                       which the identity of an individual was in question. A small number of
                                       additional cases displayed surnames that did not match. However, upon

                                       30
                                         We did not ask SSA to verify the SSI data we used because they are subject to SSA's internal
                                       verification procedures.

                                       "1 Food Stamp data were verified by our Kansas City Regional Office.



                                       Page 22                                        GAO/HEHS-99-102 Benefits to Naturalized Citizens
 Appendix I
 Scope and Methodology




 review, state officials determined that in each case it was the same
 individual; discrepancies were attributed to changes in marital status, or
 the "Americanization" of certain surnames. With respect to benefit
 payments, overall, state officials concurred with the accuracy of the data.
 Some discrepancies were found in the payment amounts we estimated for
 a limited number of cases in the random samples verified by the states.
 State officials indicated that such discrepancies were attributable to a
 number of factors, including differences in the dates on which calculations
 were made.

In four cases for the Medicaid program in Florida, some of the HCFA data
we used showed benefits to be substantially lower than the state records
indicated. Florida officials attributed these differences to apparent
discrepancies between the MSIS data reported to HCFA that we used for our
review and the state records used to verify our sample of cases. Therefore,
the payments for Medicaid services received by naturalized citizens in
Florida could be higher than our estimate.




Page 23                           GAO/HEHS-99-102 Benefits to Naturalized Citizens
Appendix II

Benefit Use by Immigration Reform and
Control Act of 1986 Naturalized Citizens

                        We examined the portion of the naturalized citizen population composed
                        of formerly illegal aliens who were granted amnesty under the Immigration
                        Reform and Control Act of 1986 (IRCA). This act was passed in an effort to
                        stem the flow of illegal aliens into the United States, and adopted two
                        strategies to accomplish this objective: (1) sanctions against employers
                        who knowingly hire illegal aliens and (2) enhanced border enforcement to
                        slow the flow of illegal aliens entering the country. In addition, IRCA
                        legalized the status of illegal aliens who met certain requirements. Overall,
                        about 2.7 million illegal aliens who demonstrated that they had resided
                        continuously in the United States since before January 1, 1982, were
                        granted legal permanent resident status under IRCA. In 1994, the first of the
                        IRCA immigrants became eligible for naturalization. Moreover, the IRCA
                        immigrants have represented an increasing proportion of all the
                        immigrants naturalized each year between 1994 and 1997. As such, the IRCA
                        immigrants have apparently contributed to the increase in the overall
                        number of naturalizations since the mid-1990s. We analyzed this group's
                        receipt of public assistance benefits separately from all other naturalized
                        citizens to determine how their rate of benefit receipt compared to their
                        overall representation in the population of recently naturalized citizens.

                        Of the total group of 927,338 recently naturalized citizens with valid SSNS,
                        we found that 274,309 (29.6 percent) were IRcA-naturalized citizens. The
                        percentage of the IRcA-naturalized citizens who received some form of
                        public benefit varied from state to state. However, overall, the proportion
                        of IRcA-naturalized citizens receiving benefits-as well as the amount of
                        benefits they received-was somewhat lower than their representation in
                        the population of recently naturalized citizens.


Supplemental Security   Out of the 76,823 recently naturalized citizens we identified who received
                        Supplemental Security Income (ssI) benefits in calendar year 1997, we
Income                  found that 5,181 (6.7 percent) were IRcA-naturalized citizens.
                        IRcA-naturalized citizens made up a relatively small proportion of all
                        recently naturalized ssI recipients we identified. In total, these
                        IRcA-naturalized recipients were paid about $21 million in benefits during
                        this period, or roughly 6.3 percent of the $331 million in benefits paid to all
                        recently naturalized citizens during 1997. Thus, the benefits received by
                        the IRcA-naturalized citizens were roughly proportional to their
                        representation in the population of all recently naturalized citizens who
                         received benefits in this program (see table II.1).




                         Page 24                            GAO/HEHS-99-102 Benefits to Naturalized Citizens
               Appendix II
               Benefit Use by Immigration Reform and
               Control Act of 1986 Naturalized Citizens




Medicaid      We found that 28,884 (21.3 percent) of the 135,681 recently naturalized
              citizens we identified receiving Medicaid benefits in five
              states-California, Florida, Illinois, New York, and Texas-were
              IRcA-naturalized citizens. The majority of these individuals (21,737) resided
              in California, with the smallest number (789) living in Illinois. Overall,
              these IRCA-naturalized citizens received $43 million (13.6 percent) of the
              $317 million received by all recently naturalized citizens. Thus, the
              proportion of benefits the IRcA-naturalized citizens received was somewhat
              lower than their representation in the five-state population of recently
              naturalized Medicaid recipients (see table II.1).


TANF          Of the 30,052 recently naturalized individuals we identified as receiving
              TANF benefits in four states-California, Florida, Texas, and New
              York-we found that 8,233 (27.4 percent) were IRcA-naturalized citizens.
              The greatest number of these individuals (6,371) resided in California, with
              the smallest number (429) living in Texas. Overall, these IRCA-naturalized
              citizens received almost $10.5 million (25 percent) of the total $42 million
              in TANF paid to all recently naturalized citizens in our review. As such, the
              proportion of benefits received by these individuals is almost the same as
              their representation in the four-state population of all recently naturalized
              TANF recipients (see table II.1).



Food Stamps   Of the 77,351 recently naturalized individuals we identified as receiving
              Food Stamp benefits in all five states, we found that 18,178 (23.5 percent)
              were IRcA-naturalized citizens. Similar to the pattern exhibited in the
              population of IRCA Medicaid recipients, the majority (9,837) lived in
              California, and the smallest number (696) lived in Illinois. Overall, these
              IRCA recipients obtained $9.2 million (20 percent) of the Food Stamp
              benefits paid to all naturalized citizens in our review. Similar to the pattern
              in other programs, the amount of Food Stamp benefits received by these
              IRCA individuals is roughly proportional to their representation in the
              population of all recently naturalized citizens receiving such benefits (see
              table II.1).




              Page 25                                 GAO/HEHS-99-102 Benefits to Naturalized Citizens
                                    Appendix II
                                    Benefit Use by Immigration Reform and
                                    Control Act of 1986 Naturalized Citizens




Table 11.1: Benefits Received by
IRCA-Naturalized Citizens in 1997                                                                                               Percentage
                                                                                                             Percentage               of all
                                                                                                    Total          of all          recently
                                                                         Number                 benefits        recently        naturalized
                                                             Source of         of            (millions of    naturalized          recipient
                                    Program                  data      recipients               dollars)a     recipients           benefits
                                    SSI                      National       5,181                  $20.8              6.7                6.3
                                    Medicaid                 Calif.b           21,737               22.5            26.6                17.8
                                                             Fla.b              1,704                  3.1            9.7                7.2
                                                             III.                 789                  2.0          23.8                18.6
                                                             N.Y.C              3,176                11.7            11.7                9.6
                                                             Tex.                1,478                 4.1           25.2               24.6
                                    Subtotal                                   28,884               43.4             21.3   d
                                                                                                                                        13.6 d
                                    TANFe                    Calif.             6,371                  8.2           31.7               29.6
                                                             Fla.                 442                  0.6           25.4               24.0
                                                              N.Y.                 991                 1.5           13.5               13.2
                                                             Tex.                  429                 0.2           48.0               46.5
                                     Subtotal                                    8,233               10.5            27.4 d             25.0 d
                                     Food stampse             Calif.             9,837                5.1            36.0               33.4
                                                              Fla.               1,935                 1.0           11.7                9.3
                                                              III.                 696                 0.3           27.9               23.5
                                                              N.Y.               2,480                 1.3           10.8                9.9
                                                              Tex.               3,230                 1.4           40.3               34.0
                                     Subtotal                                   18,178                 9.2           23.5c              20.5c

                                     Total                                                          $83.9
                                     aSum of entries may not total because of rounding.
                                     bMedicaid data for California and Florida were obtained from HCFA's Medicaid Statistical
                                     Information System.
                                     CMedicaid data for New York are for fiscal year 1997.

                                     dAverage across the states that provided data for this program.

                                     eFood Stamp and TANF data are estimates based on average payment per recipient, per month.




                                     Page 26                                       GAO/HEHS-99-102 Benefits to Naturalized Citizens
Appendix III

Major Contributors to This Report


               Jeremy Cox, Evaluator-in-Charge, (202) 512-7215
               Paula Bonin
               Robert DeRoy
               Abbey Frank
               Carol Dawn Petersen
               Vanessa Taylor
               Wayne Turowski
               Jim Wright
               Fred Yohey




(207036)       Page 27                         GAO/HEHS-99-102 Benefits to Naturalized Citizens