Poli Alert Politics & Civics
Related Articles
Immigration and Customs Enforcement (ICE) officials will gain access to the personal data of over 79 million Medicaid enrollees under a new agreement signed Monday between the Centers for Medicare and Medicaid Services (CMS) and the Department of Homeland Security (DHS), according to an agreement obtained by The Associated Press.
The arrangement, not yet publicly disclosed, will allow ICE to obtain names, addresses, birth dates, ethnicities, Social Security numbers, and other personal information of Medicaid recipients. According to the agreement, ICE will use the data “to receive identity and location information on aliens identified by ICE.”
The move marks a dramatic expansion of the Trump administration’s immigration enforcement efforts and raises significant legal and ethical concerns among health officials, lawmakers, and privacy advocates.
Background: Tracking Medicaid Recipients for Immigration Enforcement
The agreement is part of a broader Trump administration initiative to arrest 3,000 people per day for immigration violations. While federal law prohibits most undocumented immigrants from enrolling in full Medicaid, they are eligible for emergency Medicaid, which covers urgent hospital care. Many states also offer expanded coverage to lawfully present non-citizens, which has become a flashpoint for the administration.
In recent months, Trump officials have demanded that CMS release Medicaid enrollee data from seven states—California, New York, Illinois, Washington, Oregon, Minnesota, and Colorado—that expanded eligibility to include non-citizens. These states have said they do not request federal reimbursement for those services.
Legal Questions and Internal Resistance
According to internal CMS emails reviewed by the AP, agency legal officers expressed serious concern about the legality of sharing such sensitive health data for immigration enforcement. One CMS official, speaking anonymously due to fear of retaliation, said, “They are trying to turn us into immigration agents.”
An internal message titled “Hold DHS Access — URGENT” reveals CMS chief legal officer Rujul H. Desai suggested the Department of Justice should intervene to pause the data transfer. However, an HHS lawyer responded that DOJ was “comfortable with CMS proceeding.”
Despite the legal objections, the agreement allows ICE to access the CMS database during limited hours—9 a.m. to 5 p.m. on weekdays—through September 9. However, ICE is not permitted to download the data.
Government Response: “Ensuring Lawful Use of Medicaid”
The Department of Homeland Security defended the agreement, stating it ensures that taxpayer-funded benefits are reserved for eligible individuals. “The two agencies are exploring an initiative to ensure that illegal aliens are not receiving Medicaid benefits that are meant for law-abiding Americans,” DHS spokesperson Tricia McLaughlin said in a statement.
Andrew Nixon, a spokesperson for the Department of Health and Human Services (HHS), would not directly address the latest agreement but previously stated, “HHS acted entirely within its legal authority – and in full compliance with all applicable laws.”
The administration has framed the data-sharing as a cost-saving measure to prevent improper Medicaid usage, not explicitly as a deportation tool—despite the language of the agreement.
Public Outcry and Political Fallout
The revelation has sparked outrage among immigrant advocacy groups, privacy experts, and elected officials. Critics argue the agreement violates medical privacy laws and undermines public trust in government health programs.
“The massive transfer of the personal data of millions of Medicaid recipients should alarm every American,” said Sen. Adam Schiff (D-Calif.), who led a letter demanding the practice be halted. “It will harm families across the nation and only cause more citizens to forego lifesaving access to health care.”
Hannah Katch, a former CMS adviser under the Biden administration, called the move “unthinkable,” warning that families could avoid hospitals and clinics out of fear of deportation. “It violates the trust of the very people this agency is supposed to serve,” she said.
Broader Context: Medicaid, Immigration, and the Trust Gap
Medicaid, a state and federally funded program, provides health coverage to low-income individuals, including millions of children. While undocumented immigrants are generally ineligible for full benefits, emergency Medicaid must be provided regardless of immigration status under federal law.
Immigrant communities already report avoiding hospitals, schools, and courthouses due to fear of ICE enforcement. Health experts worry that this data-sharing could further discourage individuals from seeking care—even for critical medical emergencies.
“This creates a chilling effect not just for undocumented individuals but for entire communities,” said Dr. Alicia Ramos, a public health researcher at UCLA.
Next Steps: Lawsuits, Legislation, and Uncertainty
Twenty states have filed lawsuits seeking to block the federal government from accessing Medicaid enrollee data, arguing the policy violates the Health Insurance Portability and Accountability Act (HIPAA) and other privacy laws. The legal battle is ongoing.
Congressional Democrats are also preparing legislation to restrict law enforcement access to federal health databases.
Meanwhile, CMS insiders say discussions continue about how to proceed. “This is far from settled,” said one senior official. “We’re bracing for a constitutional showdown.”
As of now, it remains unclear whether ICE has begun using the data—but the agreement paves the way for sweeping surveillance of health records in the name of immigration enforcement.
