.

The Centers for Medicare and Medicaid Services (CMS) said Tuesday that it is implementing a nationwide effort to weed out illegal immigrants from Medicaid and the Children’s Health Insurance Program (CHIP). CMS officials announced the new system for greater oversight of public health programs. The move is seen as one of the more aggressive steps yet taken by the Trump administration during its second term to ensure that taxpayer-funded health benefits are going to eligible U.S. citizens and legal residents only.

CMS will start by providing monthly enrollment reports to every state. The reports will identify Medicaid and CHIP beneficiaries who cannot be verified in federal databases as to immigration or citizenship status. The databases are used by state Medicaid agencies to enroll children and families in both programs.

The databases that will be checked for verifying immigration and citizenship status include one operated by the Social Security Administration, as well as the Department of Homeland Security’s Systematic Alien Verification for Entitlements (SAVE) program.

“The first set of these reports is being sent out today,” the CMS said in a statement. “Throughout the month, each state will receive its report and must review its list of cases and report the results of its reviews to CMS.”

In a statement, Health and Human Services Secretary Robert F. Kennedy Jr. said, “We are tightening oversight of enrollment to protect taxpayer dollars and ensure that these critical programs serve only those who are eligible under the law.”

CMS Administrator Dr. Mehmet Oz stated, “The Trump administration is committed to ensuring that taxpayer dollars support programs as intended and are not misspent on those ineligible for benefits. Every dollar misspent is a dollar diverted from an eligible, vulnerable individual in need of Medicaid and CHIP.”

The agency’s announcement is part of a broad effort by the Trump administration to restrict illegal immigrants from gaining access to federally funded benefits. Tighter eligibility checks for public programs have been a long-running priority for Republican leaders in Washington. As President Donald Trump began his second term in office last year, his administration pursued a series of policy shifts in that area.

In one of his first executive orders this term, for example, Trump ordered a review of all federal benefit programs in February. The move was designed to put in place executive actions that would ensure non-citizens are not unlawfully receiving benefits in violation of the 1996 Personal Responsibility and Work Opportunity Reconciliation Act.

A few weeks later, the Department of Health and Human Services took another action, broadening the definition of government benefits subject to verification. The list of what the department views as public benefits expanded from 31 to 44 programs.

Legal Battles, Political Pushback

CMS’s announcement on increased eligibility checks for Medicaid and CHIP comes as the federal government is in a state of heightened partisan tension over public benefit programs and immigration enforcement. Last month, a federal judge ordered the Health and Human Services Department to stop sending information about Medicaid and CHIP enrollees to immigration authorities. The Trump administration was sharing that data with Immigration and Customs Enforcement (ICE) to assist in the identification of people to deport. The court found the data sharing went beyond the agency’s legal authority.

At the same time, states are now subject to a new set of statutory requirements under Republican spending legislation passed last month. The legislation requires states to conduct eligibility checks on Medicaid enrollees twice a year, up from the prior requirement of once a year. While supporters of the spending legislation say that this level of oversight will help reduce fraud and abuse, others say that it will create layers of red tape for vulnerable families to navigate.

A coalition of more than 20 Democratic attorneys general has also sued the administration over the new rules. The coalition, which is led by New York Attorney General Letitia James, has taken issue with mandatory verification of immigration status for federally funded public programs, saying that access to vital services for millions of residents is now at stake.

“For decades, states like New York have built health, education, and family support systems that serve anyone in need,” James stated last month. “These programs work because they are open, accessible, and grounded in compassion. Now, the federal government is pulling that foundation out from under us overnight, jeopardizing cancer screenings, early childhood education, primary care, and so much more. This is a baseless attack on some of our country’s most effective and inclusive public programs, and we will not let it stand.”

The lawsuit shows how divided Republican leaders in Washington and Democratic-led states are over immigration policy and safety-net programs. Supporters of the CMS announcement argue that the move will ensure taxpayer-funded benefits go to those legally entitled to them. Opponents say it is designed to make it more difficult for vulnerable communities to access care.

The first set of reports on ineligible immigrants is set to go out this month from CMS, but the fight over access to public benefits for immigrants will continue on in the courts and Congress. Republicans in Washington are emphasizing program integrity, while Democrats are focusing on issues of accessibility and compassion, and Medicaid and CHIP have once again become a battleground in the larger national immigration debate.