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President Trump last week released a  directing relevant agencies to update procedures, guidance or regulations to ensure that ineligible non-citizens do not receive means-tested public benefits, including Medicaid. “Currently, agencies are not adequately enforcing these requirements,” the order states. “Some agencies have insufficient procedures and guidance for implementing these reimbursement and deeming requirements of the immigration laws. For example, the Department of Health and Human Services has not adequately issued guidance on either sponsor reimbursement or sponsor deeming for the Medicaid program.” The Immigration and Nationality Act requires the sponsor of a non-citizen to reimburse the cost of any unreimbursed means-tested public benefits the non-citizen receives, and deems the sponsor’s income and resources those of the non-citizen for purposes of determining their benefit eligibility and amount.