Do I-864 sponsors have to pay medical bills?

ID-100258091 Here's a question I get frequently from I-864 sponsors: if the person I sponsors gets into a serious accident, am I going to have to pay the medical bill? Short answer: probably not.

There are two different financial promises made by a person who signs a Form I-864, Affidavit of Support. The first is to ensure the beneficiary has income at or above 125% of the Federal Poverty Guideline. There is a lot of information about the obligation available on this site (start here to learn more).

The second promise is the one that creates concern about medical bills. Here's the language in the Form I-864 itself:

If a Federal, State or local agency, or a private agency provides any covered means-tested public benefit to the person who becomes a permanent resident based on the Form I-864 that you signed, the agency may ask you to reimburse them for the amount of the benefits they provided. If you do not make the reimbursement, the agency may sue you for the amount that the agency believes you owe.

In other words, if the I-864 beneficiary receives certain public benefits, the sponsor can be sued for the cost of those benefits. Let's take a closer look at how this works.

What is meant by means-tested public benefits?

"Means-tested public benefits" is a legal term of art. Generally, these are a type of federally-funded public benefit programs, loosely referred to sometimes as "welfare". (The term welfare is so broad it really doesn't mean anything, and it's not a legal term).  According to the Department of State's description of means-tested benefits, they include:

  • Food stamps;
  • Supplemental Security Income (SSI);
  • Medicaid;
  • Temporary Assistance for Needy Families (TANF); and
  • State Child Health Insurance Program (CHIP).

Importantly, notice what's not on that list: general debt. So let's say the I-864 beneficiary goes out and buys a flat screen TV on credit, then doesn't pay the bill. The government isn't going to swoop in and sue the sponsor, because the TV debt has absolutely nothing to do with a means-tested public benefits program.

What about medical debt? That really depends on how the medical care was delivered. The government can come after the I-864 sponsor only if there was a means-tested public benefit. If an I-864 beneficiary is enrolled in Medicaid and has a car accident, definitely the I-864 sponsor could be sued for a huge amount of money.

But the government cannot sue the sponsor merely because a hospital provided expensive services to the I-864 beneficiary. Again, if the beneficiary didn't receive a means-tested benefit, the government cannot come after the sponsor.

Could a medical provider sue the sponsor directly?

So far we've been talking about the government getting involved to seek repayment of benefits. Can a medical provider sue an I-864 sponsor if the beneficiary has medical debt?

Remember there are two promises in the I-864: (1) ensuring income to the beneficiary; and (2) repaying means-tested public benefits. Looking at the first promise, a hospital could say that the sponsor's income should be available to the beneficiary to repay medical bills.

First off, I have never heard of a medical provider suing an I-864 sponsor. Moreover, it is unlikely that such a lawsuit would succeed. The I-864 is a contract between the sponsor and the United States government. In contract law terms, the immigrant is a "third-party beneficiary" of the I-864. This means that she has the ability to enforce rights under the contract even though she isn't a party to the contract (meaning she wasn't one of the parties entering into the agreement... it was just made for her benefit).

The I-864 makes very clear that the immigrant is a third-party beneficiary with rights to enforce the contract. So does the federal statute that creates the I-864. But there are no similar provisions for medical providers. It would take some very creative arguments by a hospital to explain why they have the legal ability to enforce rights under the I-864 contact.

I won't go on the record saying this sort of lawsuit is completely impossible, but success seems unlikely. If you've heard of such a suit, please let me know!

Bottom line.

Here's the bottom line:

  1. The government gets involved only if there are means-tested public benefits. The government can't sue the I-864 sponsor just because the I-864 beneficiary has general debt, including medical debt.
  2. There is no obvious way that a medical provider could sue the I-864 sponsor directly, since the I-864 doesn't say that such third-parties can enforce the contract.
Footnote: government suits against sponsors seem to be rare.

Even in cases where an I-864 beneficiary does receive public benefits, it is rare for the sponsor to be sued. I'm not aware of a single case in my home state of Washington where an I-864 sponsor has been sued by government agencies. In the recent past there were some efforts made to collect the cost of benefits from I-864 sponsors on the East Coast, including New York. But I haven't heard any reports of such cases in the past year.

Certainly a sponsor cannot assume he won't be sued. Government agencies have the right to seek repayment of means-tested public benefits, so sponsors shouldn't rest too easily just because this doesn't happen all the time. The point is only that it appears to be relatively rare that this happens.

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