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In a new policy that is expected to affect almost all state Medicaid programs, the Centers for Medicare and Medicaid Services (CMS) said on Tuesday that it is cracking down on the eligibility of illegal immigrants to enroll in Medicaid and the Children’s Health Insurance Program (CHIP).

CMS announced the new oversight system that will involve monthly enrollment reports that CMS will provide to all states. It will list Medicaid and CHIP enrollees whose immigration or citizenship status cannot be verified in federal databases. One of the databases includes the Department of Homeland Security’s Systematic Alien Verification for Entitlements (SAVE) program.

“CMS is taking action to better ensure that taxpayer dollars are used as intended – to provide coverage to eligible individuals,” CMS Administrator Chiquita Brooks-LaSure said in a statement.

“We are tightening oversight of enrollment to safeguard taxpayer dollars and guarantee that these vital programs serve only those who are truly eligible under the law,” U.S. Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. said in a statement.

CMS to Send State Monthly Enrollment Reports

The monthly enrollment reports CMS will send to states will show “CHIP and Medicaid enrollees for whom immigration or citizenship status could not be verified using federal databases,” according to a CMS statement. “States will have to review cases where federal data could not be verified,” the statement continued, adding that the “process should help ensure that the benefits go to those who are legally eligible.”

States were required to provide CMS with reports on April 1 on immigrants who were not eligible for Medicaid and CHIP programs because of their immigration status.

It was also reported that agency officials told reporters on Monday evening that the first of such enrollment reports was delivered on Tuesday. The agency will continue to send each state its own enrollment report each month. They will then be required to conduct a review. States are required to report on enrollees after the review. The information is needed to confirm whether the enrollees are legal residents who are eligible for Medicaid and CHIP, or if they need to be removed from the program.

CMS officials stated that the review reports from states could be required daily, rather than on a monthly schedule.

CMS is the first government department to start enforcing one of the dozens of executive orders signed by President Donald Trump earlier this year. In the order, the President directed all federal agencies to review federal benefit programs and take action against anyone receiving benefits in a manner that is inconsistent with the Personal Responsibility and Work Opportunity Reconciliation Act of 1996.

In another action related to the President’s executive order, the Department of Health and Human Services (HHS) issued a rule in March that expanded a list of government programs that have been deemed to be public benefits from 31 programs to 44 programs. This means more public programs would be subjected to checks. CMS’s action is just one of many enforcement actions that the President has ordered the federal government to take. This is to make sure that non-citizens who are living illegally in the U.S. are not receiving government benefits illegally.

Court Battle Brewing Over Illegal Immigrant Enrollment in Medicaid

A federal court battle is already brewing over illegal immigrant enrollment in Medicaid. Last month, a federal judge ordered HHS to cease sharing enrollee information with immigration enforcement authorities. The Trump administration had ordered the department to share enrollee information with Immigration and Customs Enforcement (ICE) to assist in its immigration enforcement efforts.

The judge ruled that the agency was exceeding its authority in passing information to ICE. At the same time, states are now subject to statutory requirements imposed by a spending bill passed by Republicans last month. This is in a dispute between state and federal authorities on illegal immigrant eligibility requirements for Medicaid.

The Republican bill requires states to check the eligibility of Medicaid enrollees at least twice a year. This is an increase from what was required previously. However, while the administration has only required twice-annual eligibility checks, states have not set specific policies on how this would be enforced.

A group of more than 20 Democratic attorneys general has also sued the administration over the new rule changes. The coalition of Democratic attorneys general was led by New York Attorney General Letitia James. James and her coalition are concerned that verifying the immigration status of applicants for federally funded programs is required. This, according to them, would hurt access to essential services for millions of residents.

“Our states have built health, education, and family support systems that work for everyone who needs them. We built them that way on purpose,” New York Attorney General Letitia James was quoted as saying by The Guardian.

James continued: “We designed them to be open, accessible, and welcoming – because we know that our residents will always rise to the occasion when given the opportunity, but only if they have the tools they need to succeed. For decades, we have been doing the hard work of making that a reality for the people we serve. But now, overnight, the federal government is trying to take that foundation away. By intentionally withholding critical support, or by making its receipt contingent on unlawful conditions, they are undermining our most effective and inclusive public programs. And we will not let that happen.”

Immigrant Enrollment in Medicaid and CHIP to Be Reviewed

A number of programs have been created for low-income children and adults over the years. CHIP, for instance, is aimed at providing low-income children with health insurance, while the Earned Income Tax Credit (EITC) provides a refundable tax credit to eligible low-income workers.

CMS and President Trump are cracking down on illegal immigrants’ enrollment in Medicaid and CHIP. This was after many Democrats argued that the CMS’s move would prevent immigrants from availing themselves of social benefits that they are entitled to.