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CMS, the federal agency that oversees Medicaid and the Children’s Health Insurance Program, announced a new initiative this week to help states root out ineligible immigrants from the federal programs. Beginning in July, CMS said, it would automatically send each state monthly reports on enrollees who can’t be confirmed as citizens or legal residents.

CMS officials said that the new reporting system was the next logical step in a broader administration-wide effort to more carefully monitor eligibility for taxpayer-funded federal benefits. Since Trump’s second term began, his administration has issued several initiatives intended to ensure that federal benefits are not improperly distributed to illegal immigrants.

In February, Trump issued an executive order directing all federal agencies to review public programs and take action where needed to close loopholes that might allow illegal immigrants to access benefits, in violation of the 1996 Personal Responsibility and Work Opportunity Reconciliation Act.

Four weeks later, the Trump administration directed the states to expand their definitions of public benefits so that more programs would be subject to verification. Previously, HHS said, only 31 federal programs were on the list. The new directive added 13 more and will require the states to verify and review them as well.

CMS Initiative Faces Immediate Political Headwinds

CMS Administrator Dr. Mehmet Oz said the move was consistent with the president’s overall goals. “This action reaffirms our commitment to the integrity of these critical safety net programs that support some of our most vulnerable Americans,” he said in a statement.

CMS said that its new program will begin rolling out this month. The first reports have already gone out to the states, and new ones will be distributed throughout the year. Each state will receive its own customized report and will be expected to work with enrollees to confirm citizenship or legal status, and then report the results back to CMS.

The decision to put the reporting system in place was announced just days after a federal judge ordered the Department of Health and Human Services to stop sharing information with immigration authorities. The Trump administration had begun sharing enrollee data with ICE in recent months to assist with deportation efforts, but U.S. District Judge Michael P. Simon ruled in May that the practice exceeded the government’s legal authority.

The lawsuit, brought by the states of California and Oregon, is still pending, and both sides are awaiting a trial date. Meanwhile, CMS said the new reporting initiative will be an ongoing effort.

CMS is not the only federal agency to expand verification and oversight requirements for Medicaid enrollees in recent months. CMS is not the only federal agency to expand verification and oversight requirements for Medicaid enrollees in recent months.

The move reflects ongoing tensions over eligibility and verification, which have been central issues in the current welfare reform law. The CMS initiative, which has already gone out to the states, is the latest front in an emerging war between the Republican-controlled federal government and state legislatures, many of which are led by Democrats.

GOP Expands Eligibility Reviews

CMS said Tuesday that it was acting in part to implement requirements of the current GOP spending bill. The package, which was approved by Congress and signed into law last month, requires states to perform eligibility reviews for Medicaid enrollees at least twice per year, rather than the annual reviews that were previously required.

The changes have drawn fire from a coalition of Democratic attorneys general who have filed a lawsuit arguing that the new eligibility rules are both impractical and likely to lead to a significant loss of coverage for legal residents and citizens.

The dispute between the states and the federal government began when the Trump administration, as part of its current spending package, required state governments to conduct additional eligibility reviews and documentation for Medicaid recipients at least twice per year.

States were given the option to verify Medicaid eligibility using several methods, including in-person interviews, verification through additional documents, and confirmation by federal agencies. CMS officials said that each of those verification options was adequate, but that the new reviews were needed to ensure that they were being done.

CMS has been actively engaged in the immigration verification battle since last year, when it updated its agency manual to require states to share more information with DHS about public assistance enrollees. CMS also said that new “sufficiency determinations” for Medicaid eligibility reviews are now in effect.

CMS has also been engaged in other verification efforts in recent years. CMS has also been engaged in other verification efforts in recent years. Most notably, the agency directed all states to adopt new income verification systems before the Affordable Care Act was passed.

Democrats Fight Back

CMS’s move was announced just hours after a federal judge ordered the department to stop sharing Medicaid enrollee data with ICE. In a lawsuit brought by the state of California and supported by a coalition of more than 20 state attorneys general, the judge had ordered CMS to immediately stop the practice.

California and Oregon had argued that the decision to share enrollee data violated the federal-state relationship and put enrollees at risk of deportation. At the time, CMS had said that it was acting within its rights, but the judge’s ruling cast doubt on that claim.

CMS’s decision to move forward with the new reporting system was the latest in a series of moves by the agency in recent months to expand eligibility reviews for Medicaid enrollees. CMS, for example, last year changed its long-standing policy on eligibility requirements for Medicaid, directing the states to start considering all applicants, even those who failed to meet the federal eligibility standards.