.

In a first-of-its-kind move Tuesday, the Centers for Medicare and Medicaid Services (CMS) announced a new effort to crack down on access to Medicaid and the Children’s Health Insurance Program (CHIP) by illegal immigrants. CMS officials will require states to identify all enrollees in the Medicaid and Children’s Health Insurance Program who are unable to verify their citizenship or immigration status, in a bid to reduce the number of people illegally using public health insurance.

CMS officials announced the move earlier this month and said that the effort was one of the most significant to date by the Trump administration’s second term to stem the flow of taxpayer-funded benefits to ineligible recipients. As part of the effort, CMS will begin to require states to send monthly enrollment reports to the federal agency. These reports will highlight all Medicaid and CHIP enrollees who are unable to be matched in federal databases with proof of citizenship or immigration status. Some of the databases to be checked, CMS said, would include Social Security Administration records, as well as the Department of Homeland Security’s Systematic Alien Verification for Entitlements (SAVE) system.

The first such report, the agency said, was sent Tuesday. States, under the new CMS requirement, will receive monthly reports and are expected to conduct their own analysis to determine if the enrollee in question is legally allowed to remain in Medicaid and CHIP. States are then tasked with reporting the results of that analysis back to CMS. CMS did not say what would happen if an undocumented immigrant were found to be using Medicaid or CHIP.

“This rule will help ensure these important programs serve those who are eligible under the law and truly need their help while protecting hardworking American taxpayers,” said Secretary of Health and Human Services Robert F. Kennedy Jr. in a statement.

CMS Administrator Dr. Mehmet Oz, in his own statement, echoed that same message. “We must maintain the integrity of these critical safety-net health programs and continue to protect taxpayer dollars by ensuring they are used as intended for eligible individuals,” Oz said. “Taxpayer dollars misspent on an individual who does not qualify for a program means fewer resources for the eligible and vulnerable individuals who need Medicaid and CHIP.”

Tuesday’s announcement is the latest in a series of moves this year by the Trump administration to cut back on access to benefits by illegal immigrants. One of Trump’s first executive orders in his second term, a February directive, required federal agencies to review every benefit program to determine whether non-citizens were improperly enrolled in violation of the 1996 Personal Responsibility and Work Opportunity Reconciliation Act.

Several weeks later, the Department of Health and Human Services announced an expansion of the definition of “public benefits” by agencies across the federal government. The list, officials said, grew from 31 programs to 44, effectively meaning more programs are subject to additional verification.

CMS Launch Puts Agency in Crosshairs

The latest move by CMS comes as the Trump administration faces both legal pushback and partisan backlash over what some see as an excessive use of public benefit programs as a weapon in the president’s war on illegal immigration. Last month, a federal judge ordered Health and Human Services to immediately cease its ongoing practice of handing over information about Medicaid enrollees to immigration authorities.

President Trump, whose administration has made a renewed push this year on illegal immigration, had ordered CMS, along with other agencies, to share enrollee data with Immigration and Customs Enforcement (ICE) to facilitate deportations of illegal immigrants in the country. U.S. District Judge David Campbell, however, ruled in the case that HHS was not legally authorized to share such information with ICE, which is effectively a direct part of the Department of Homeland Security.

States are also now subject to additional verification requirements as part of a broader budget package Republicans were able to pass last month. The bill requires states to check the eligibility of Medicaid recipients at least twice per year, up from previous requirements. Supporters of the bill in both Congress and the administration say it is needed to reduce fraud and improper use of Medicaid. Opponents say it will be an onerous requirement for states to fulfill.

The group of more than 20 attorneys general, all Democrats, has filed a lawsuit to stop these new rules from going into effect. Led by New York Attorney General Letitia James, the lawsuit argues that mandatory verification of federal status for the receipt of federal money is an undue hardship on many states. James, in a statement at the time, cast the new CMS rule as an existential threat to states’ ability to provide help to residents.

“For decades, states like New York have built health, education, and family support systems that serve anyone in need,” James said in a statement. “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.”

Tuesday’s CMS announcement is the latest development in an ongoing dispute between Republicans and Democrats over eligibility for public programs that will likely continue in federal court, state houses, and Congress in the coming weeks and months. Republicans in Washington have made a point of passing more restrictive policies on the use of federal money by illegal immigrants, while Democrats in states have stressed the need for as many people as possible to receive vital services from Medicaid and CHIP.