CMS launches noncitizen Medicaid enrollment ‘oversight initiative’

By Jakob Emerson / August 19, 2025

The Trump administration is rolling out a Medicaid enrollment oversight initiative that will direct states to remove individuals who cannot verify their citizenship or immigration status.

CMS said Aug. 19 it has started providing states with reports identifying Medicaid and CHIP beneficiaries whose status could not be confirmed through federal databases, such as the Department of Homeland Security’s SAVE system.

As states receive reports over the course of a month, they will be required to review the flagged cases, request additional documentation if needed and adjust coverage when individuals are found ineligible. CMS said it will monitor progress and expects “quick action.”

Non-citizens are generally ineligible for full Medicaid benefits but may receive limited emergency services.

The One Big Beautiful Bill Act, signed into law on July 4, included major changes to the Medicaid program, including new work requirements for able-bodied adults, more frequent eligibility redeterminations, and tighter restrictions on coverage for non-citizens.