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CMS on Tuesday announced a new system that will require states to better scrutinize public health insurance enrollment and purge illegal immigrants from Medicaid and the Children’s Health Insurance Program. The Centers for Medicare and Medicaid Services (CMS) officials first revealed the plan to the Washington Examiner ahead of its Tuesday afternoon announcement. The new system is the latest and most sweeping move yet by the Trump administration in its second term to prevent illegal immigrants from receiving taxpayer-funded benefits. Illegal immigrants are not eligible for the Medicaid and CHIP programs, but in the past could enroll without their immigration or citizenship status being verified.

Under the new system, CMS will start sending out monthly enrollment reports to each of the 50 states. Each report will include Medicaid and CHIP enrollees whose eligibility for the programs could not be verified using existing federal databases. Databases that will be queried include those of the Social Security Administration, as well as the Department of Homeland Security’s Systematic Alien Verification for Entitlements (SAVE) program.

“On Tuesday, the first of these reports was sent to states,” a CMS spokesperson said. “Each week, for the remainder of the month, we will issue a monthly report, tailored to each state, containing a list of individuals for whom citizenship or immigration status could not be verified. States will then have the opportunity to review these cases and report back to CMS with the outcome of their review, confirming that the individual is, in fact, eligible for enrollment.”

“This action will protect taxpayer dollars by increasing enrollment verification to ensure that federal health care safety-net programs serve only those who are eligible under the law,” the agency said.

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

CMS Administrator Dr. Mehmet Oz also released a statement supporting the move. “Program integrity is vital to ensuring that every dollar is spent as intended and that access to safety-net health programs is protected for eligible, vulnerable individuals who need them most,” he said. “We have a responsibility to make sure that every dollar misspent is a dollar taken away from an eligible, vulnerable individual in need of Medicaid and CHIP. This action will help to uphold the integrity of these programs.”

The order represents the latest in a series of moves the administration has taken to limit illegal immigrants’ access to federal benefits since President Donald Trump was sworn in for his second term last month. One of the first orders Trump signed in February was one that called for all federal departments to review all existing federal benefit programs and figure out how to ensure non-citizens are not receiving benefits illegally under the Personal Responsibility and Work Opportunity Reconciliation Act of 1996.

In March, the Department of Health and Human Services under Trump expanded the definition of government programs considered “public benefits.” The number of government programs now considered “public benefits” has increased from 31 to 44.

Fight in Courts, Congress

The administration is currently involved in a fight in the courts over whether to share Medicaid enrollment data with ICE. A federal judge ordered the Department of Health and Human Services to stop sharing enrollee information with ICE last month. The Trump administration had started sharing data with ICE in an effort to make it easier for the agency to deport illegal immigrants. The court ruled the sharing of that information exceeded the department’s authority.

States are also under a new mandate following the passage of a Republican spending package last month. That package requires states to conduct eligibility verification on Medicaid enrollees at least twice a year. Previously, only one verification check was required. Advocates of the new requirement say the measure is needed to ensure Medicaid fraud and abuse are minimized. Opponents say the measures are a waste of resources and will erect new barriers to care.

A group of more than two dozen Democratic attorneys general has also filed a lawsuit to stop the government from enforcing the new eligibility verification requirements. The coalition of state attorneys general, led by New York Attorney General Letitia James, said federal agencies need congressional approval to require such verification and that mandatory verification for immigration status tied to federally funded programs will harm access to services for millions of Americans.

“For decades, states like New York have built health, education, and family support systems that serve anyone in need,” James said 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 administration’s move to share Medicaid information with ICE and its CMS program for verifying the citizenship status of Medicaid and CHIP enrollees is already in the courts. And now with the new requirements tied to the omnibus spending package Republicans in Congress passed last month, Medicaid and CHIP are set to be part of the new battles over immigration the Trump administration will face in Congress.