The Trump administration’s aggressive efforts to monitor who is benefiting from government assistance programs have had what critics say is their desired effect—pushing more than a million children off Medicaid and the Children’s Health Insurance Program in less than two years.

Between December 2017 and June 2019, according to the New York Times, about three percent of children enrolled in Medicaid or CHIP were dropped from the program.

Seema Verna, President Donald Trump’s administrator in charge of Medicaid and Medicare, claimed in April that the huge decline in coverage is the result of a thriving economy.

“It would be appalling if even a single child was uninsured, much less for the number to be in the millions—and rising.”
—Adam Gaffney, Physicians for a National Health Plan

“Under President Trump’s leadership, the American economy is thriving,” Verna said. “Unemployment remains low, wage growth is up, and we now see fewer people relying on public assistance. That’s something to celebrate.”

However, that claim doesn’t square with the fact that between 2016 and 2018, the number of children without any health insurance rose by about 400,000—with the biggest declines in GOP-controlled states Tennessee, Georgia, Texas, and Idaho.

In Tennessee, according to the Tennessee Justice Center, counties with the highest unemployment rates also have the highest numbers of uninsured children.

Fears of the Trump administration’s aggressive anti-immigration policies have reportedly led immigrant communities to avoid applying for government assistance, while new policies requiring states to frequently check families’ eligibility for Medicaid have caused mass confusion and led to many eligible households being kicked off the rolls.

“This is not people reaching self-sufficiency. This is just cruelty and exclusion,” tweeted Rep. Pramila Jayapal (D-Wash.) in response to the Times‘ report.

States with the largest declines in children’s Medicaid coverage implemented new rules requiring families to fill out more paperwork and give proof of income more often—which can be challenging for a population in which people frequently move to new homes and change jobs.