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In a major development that could lead to more illegal immigrants losing their public health insurance, CMS announced Tuesday that it is developing a new process to help states identify and remove ineligible immigrants from Medicaid and the Children’s Health Insurance Program (CHIP).

CMS’s new initiative, which was first reported by our own Travis Waldron, is among the Trump administration’s most aggressive moves yet on Medicaid eligibility as it looks to make the Trump administration’s second term a “law and order” one. Since the first of the year, the Trump administration has redoubled its efforts to prevent illegal immigrants from receiving taxpayer-funded public benefits, including by expanding the universe of federal programs that states must verify during the enrollment process.

The new CMS effort, which Waldron reported last week, will make it easier for states to check and confirm the immigration or citizenship status of Medicaid and CHIP applicants. CMS will provide every state with monthly enrollment reports that will highlight any individual enrolled in Medicaid or CHIP who cannot be “automatically verified” using federal databases. Databases the agency will use include those from the Social Security Administration and the Department of Homeland Security’s Systematic Alien Verification for Entitlements (SAVE) system.

On Tuesday, CMS sent the first of those reports to every state, according to the agency. The states will receive monthly reports throughout the year and are then tasked with verifying the immigration or citizenship status of any enrollee highlighted on that report. They must then respond to CMS about the results of their reviews and confirm whether those enrollees are eligible to continue in the program.

“To better protect taxpayer dollars and ensure these programs are reserved for those who are lawfully eligible to receive benefits, CMS is tightening oversight of enrollment in Medicaid and CHIP,” Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. said in a statement. “The individuals’ income must also be within the eligibility range.”

CMS Administrator Dr. Mehmet Oz added, “We are committed to ensuring program integrity in Medicaid and CHIP to make sure taxpayer dollars are used appropriately and benefits are reserved for eligible individuals. Every dollar misspent on an ineligible individual is a dollar taken away from an eligible, vulnerable individual who needs Medicaid and CHIP.”

CMS’s new data collection comes as President Trump has repeatedly said he wants to ensure illegal immigrants are not receiving taxpayer-funded public benefits, a key Republican talking point for years. In February, Trump signed an executive order instructing all federal agencies to review all federal benefit programs and take steps to ensure they were not distributing taxpayer-funded benefits to individuals in violation of federal immigration law. The order, one of Trump’s first in his second term, came less than a month after he was sworn in for his second term. It was the latest move in a campaign by Republican lawmakers to crack down on illegal immigrant access to federal benefits, including Medicaid.

Under a new law Republicans in Congress passed in March, states must now verify that all Medicaid enrollees are eligible for the program at least twice per year. Before the law, states had to conduct eligibility verification at least once every three years. The law was supported by Republicans because it would help reduce fraud and abuse, but critics of the move have decried the law’s verification requirements as creating administrative burdens for states.

Last month, a group of 20+ Democratic attorneys general said they would sue the Trump administration over its decision to move forward with those new requirements. Led by New York Attorney General Letitia James, the coalition of attorneys general filed a lawsuit in federal court in Manhattan, claiming that the administration’s mandatory verification requirement for immigration status for federally funded programs threatens access to “essential public benefits for millions of New Yorkers and all residents of the State.”

“These vital programs work precisely because they are open and accessible to all in need and provide access to services that keep families safe and healthy,” James said at the time. “And for decades, we have built them that way, rooted in data, expertise, and compassion. But that foundation is now being ripped out from under us, on a government-wide scale and overnight. New York will not stand for this unmoored and baseless attack on some of our nation’s most effective and inclusive public programs, and we will not hesitate to take action to protect our residents.”