.

The Centers for Medicare and Medicaid Services (CMS) on Tuesday unveiled a new nationwide initiative to crack down on public health insurance programs and eliminate illegal immigrants from Medicaid and the Children’s Health Insurance Program (CHIP). CMS on Tuesday said it will begin reporting all of the monthly enrollment information to states, which will be required to terminate individuals who cannot be verified by federal immigration databases. The change, which was first reported by CMS officials on Tuesday, is one of the broadest moves yet by the Trump administration in its second term to ensure taxpayer-funded benefits are limited to eligible Americans.

CMS said in a statement that every month, it would automatically send each state its own report listing all Medicaid and CHIP enrollees whose citizenship or immigration status could not be verified through federal databases. States would then have the “obligation to review” the cases and notify CMS of the results of their investigations.

The enrollment system will check multiple federal databases, according to the agency. These include the Social Security Administration and the Department of Homeland Security’s Systematic Alien Verification for Entitlements (SAVE) program.

States are still waiting for the first of the expected monthly lists from CMS, and it was delivered on Tuesday. Every state will receive its own copy throughout the month. Each state will then be required to review each flagged case. That review would then be reported back to CMS to confirm or deny if enrollees are, in fact, illegally enrolled in the program.

Health and Human Services Secretary Robert F. Kennedy Jr. said CMS was “tightening oversight of enrollment to safeguard taxpayer dollars and guarantee that these vital programs serve only those who are truly eligible under the law.”

CMS administrator Dr. Mehmet Oz noted that it was “important to maintain the integrity of our nation’s safety-net health programs.” “Every dollar misspent is a dollar taken away from an eligible, vulnerable individual in need of Medicaid and CHIP,” Oz added.

The announcement marks the latest step by the Trump administration to tighten benefits for illegal immigrants and ensure the laws are not violated by those who are in the country illegally. President Donald Trump’s second term began last year with a series of policy changes designed to tighten eligibility requirements on federal benefits programs. One of Trump’s first executive orders of his second term, signed in February, directed federal agencies to review all benefit programs under their jurisdiction and ensure that only citizens were receiving the benefits. That rule was created to ensure the federal government was in compliance with the 1996 Personal Responsibility and Work Opportunity Reconciliation Act, which was designed to limit public benefits to non-citizens.

About a month later, the Department of Health and Human Services added additional government programs to the list of “public benefits.” Previously, there were 31 programs on the list, but that number was extended to 44 following the HHS update. As a result, additional government programs would now be subject to increased federal verification and oversight.

Law, Court Battles, Spending Legislation

The CMS announcement comes as the administration faces several court challenges on the issue of access to public benefits for illegal immigrants. Last month, a federal judge issued a ruling ordering the Department of Health and Human Services to cease the sharing of enrollee information with immigration officials.

The Trump administration had been passing along enrollment data to Immigration and Customs Enforcement (ICE) to help identify individuals to be deported, but the court ruled that this was outside of the department’s jurisdiction. The Department of Health and Human Services also said in recent weeks that states now have additional reporting requirements tied to the Republican spending legislation. Last month, Congress and the White House passed a package that included a provision requiring states to conduct eligibility verification for Medicaid enrollees at least twice a year, an increase from previous levels.

Supporters of the new rules argue that they are needed to combat fraud and abuse, while opponents claim that the additional requirements will cause burdensome barriers for low-income families. A coalition of more than 20 Democratic attorneys general has filed a lawsuit against the Trump administration over the new eligibility rules. The coalition, led by New York Attorney General Letitia James, has argued that mandatory eligibility verification of immigration status for federally funded programs will undermine access to those programs for many state residents.

“For decades, states like New York have built health, education, and family support systems that serve anyone in need,” James said. “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 first reports have already been sent out, but the legal challenges to the administration’s changes to public benefit programs will continue both in the courts and in Congress in the months ahead. While Republicans in Washington are focused on ensuring the integrity of those programs, Democrats are emphasizing the need for access to care and programs for all individuals.