Medicaid data-sharing agreement with ICE raises privacy questions—what to know
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A federal data-sharing agreement signed by the Trump administration is drawing attention for granting Immigration and Customs Enforcement (ICE) access to personal information from the nation’s Medicaid database.
The agreement allowed ICE officials to view data from approximately 79 million enrollees, including names, birthdates, addresses, Social Security numbers, and ethnicity information.
According to documents obtained by the Associated Press (AP), the arrangement between the Centers for Medicare and Medicaid Services (CMS) and the Department of Homeland Security (DHS) was not publicly announced.
While officials cited the goal of verifying Medicaid eligibility, the agreement also stated ICE would use the data to identify and locate individuals living in the US without legal status.
ICE access outlined in a formal agreement
The signed document states: “ICE will use the CMS data to allow ICE to receive identity and location information on aliens identified by ICE.”
Access was granted on weekdays during business hours, and ICE was not permitted to download or retain the data permanently.
The agreement was in place through September 9.
HHS officials have maintained that the purpose of the initiative was to ensure that Medicaid benefits are reserved for individuals who qualify under federal law.
DHS assistant secretary Tricia McLaughlin said the agencies were “exploring an initiative to ensure that illegal aliens are not receiving Medicaid benefits that are meant for law-abiding Americans.”
Also read: Taxpayers stand to save $30 billion with Medicaid reform
Officials and advocates express concern
While the agencies involved cited cost and eligibility verification as the primary focus, some lawmakers and healthcare experts have raised privacy and policy concerns.
“It’s unthinkable that CMS would violate the trust of Medicaid enrollees in this way,” said Hannah Katch, a former CMS adviser.
She added that personally identifiable health information has historically been shared only in limited circumstances—typically to investigate fraud, waste, or abuse.
An unnamed CMS official told the AP, “They are trying to turn us into immigration agents,” expressing discomfort with the data-sharing arrangement.
Also read: Is your healthcare at risk? Millions could lose coverage if Medicaid cuts become law
Impact on emergency care and coverage
Federal law prohibits most undocumented immigrants from enrolling in full Medicaid coverage.
However, all states are required to provide Emergency Medicaid, which covers urgent, lifesaving care regardless of immigration status.
According to the AP, people accessing Emergency Medicaid—including lawfully present and undocumented immigrants—may have had their data included in the CMS database made available to ICE.
Also read: The truth about Medicaid cuts and the misinformation spreading online
Data requests expanded to seven states
Prior to the broader agreement, Trump officials requested data from seven Democratic-led states—California, New York, Washington, Oregon, Illinois, Minnesota, and Colorado—that had expanded Medicaid programs to cover certain noncitizens.
These states had agreed to cover costs using state funds and did not seek federal reimbursement.
The request and agreement prompted backlash from governors, advocacy groups, and members of Congress.
At least 20 states have filed lawsuits, alleging the arrangement violates federal health privacy laws.
Also read: Lynda Carter breaks her silence—What the Wonder Woman star just said about ICE and the LA riots will shock you
Legal debate and internal government discussions
Internal communications show some CMS officials attempted to delay the agreement’s implementation.
In one email thread labeled “Hold DHS Access — URGENT,” CMS chief legal officer Rujul H. Desai recommended seeking White House input through the Department of Justice.
However, HHS attorney Lena Amanti Yueh responded that the Justice Department was “comfortable with CMS proceeding.”
Senator Adam Schiff of California also criticized the policy, stating: “The massive transfer of the personal data of millions of Medicaid recipients should alarm every American. This massive violation of our privacy laws must be halted immediately. It will harm families across the nation and only cause more citizens to forego lifesaving access to health care.”
Also read: All in on one shot? HHS redirects $500 million to new vaccine project—what this unusual move means
Agencies defend the decision
In response to the lawsuits, HHS spokesperson Andrew Nixon said, “HHS acted entirely within its legal authority – and in full compliance with all applicable laws—to ensure that Medicaid benefits are reserved for individuals who are lawfully entitled to receive them.”
While it remains unclear how extensively ICE accessed the database or how the information was used, the agreement has raised broader questions about data sharing, government oversight, and individual privacy.
Also read: Is your city next? How Trump’s shocking legal move could affect you
Ways to stay informed and protect your information:
As litigation unfolds, privacy advocates and healthcare officials continue to monitor the situation.
For now, there are no confirmed plans for future data-sharing agreements, but the precedent has sparked interest in how federal health data may be accessed or used in other contexts.
Read next: What’s next for federal health programs? Proposed cuts raise questions
What do you think? Do you believe government agencies should be allowed to use healthcare data for immigration enforcement? Or should access to medical information remain strictly limited?
Share your thoughts in the comments below—we welcome your questions, concerns, and experiences.
The agreement allowed ICE officials to view data from approximately 79 million enrollees, including names, birthdates, addresses, Social Security numbers, and ethnicity information.
According to documents obtained by the Associated Press (AP), the arrangement between the Centers for Medicare and Medicaid Services (CMS) and the Department of Homeland Security (DHS) was not publicly announced.
While officials cited the goal of verifying Medicaid eligibility, the agreement also stated ICE would use the data to identify and locate individuals living in the US without legal status.
A new report raises questions about how Medicaid data has been shared with immigration authorities under a federal agreement. Image Source: YouTube / ABC 7 Chicago.
ICE access outlined in a formal agreement
The signed document states: “ICE will use the CMS data to allow ICE to receive identity and location information on aliens identified by ICE.”
Access was granted on weekdays during business hours, and ICE was not permitted to download or retain the data permanently.
The agreement was in place through September 9.
HHS officials have maintained that the purpose of the initiative was to ensure that Medicaid benefits are reserved for individuals who qualify under federal law.
DHS assistant secretary Tricia McLaughlin said the agencies were “exploring an initiative to ensure that illegal aliens are not receiving Medicaid benefits that are meant for law-abiding Americans.”
Also read: Taxpayers stand to save $30 billion with Medicaid reform
Officials and advocates express concern
While the agencies involved cited cost and eligibility verification as the primary focus, some lawmakers and healthcare experts have raised privacy and policy concerns.
“It’s unthinkable that CMS would violate the trust of Medicaid enrollees in this way,” said Hannah Katch, a former CMS adviser.
She added that personally identifiable health information has historically been shared only in limited circumstances—typically to investigate fraud, waste, or abuse.
An unnamed CMS official told the AP, “They are trying to turn us into immigration agents,” expressing discomfort with the data-sharing arrangement.
Also read: Is your healthcare at risk? Millions could lose coverage if Medicaid cuts become law
Impact on emergency care and coverage
Federal law prohibits most undocumented immigrants from enrolling in full Medicaid coverage.
However, all states are required to provide Emergency Medicaid, which covers urgent, lifesaving care regardless of immigration status.
According to the AP, people accessing Emergency Medicaid—including lawfully present and undocumented immigrants—may have had their data included in the CMS database made available to ICE.
Also read: The truth about Medicaid cuts and the misinformation spreading online
Data requests expanded to seven states
Prior to the broader agreement, Trump officials requested data from seven Democratic-led states—California, New York, Washington, Oregon, Illinois, Minnesota, and Colorado—that had expanded Medicaid programs to cover certain noncitizens.
These states had agreed to cover costs using state funds and did not seek federal reimbursement.
The request and agreement prompted backlash from governors, advocacy groups, and members of Congress.
At least 20 states have filed lawsuits, alleging the arrangement violates federal health privacy laws.
Also read: Lynda Carter breaks her silence—What the Wonder Woman star just said about ICE and the LA riots will shock you
Legal debate and internal government discussions
Internal communications show some CMS officials attempted to delay the agreement’s implementation.
In one email thread labeled “Hold DHS Access — URGENT,” CMS chief legal officer Rujul H. Desai recommended seeking White House input through the Department of Justice.
However, HHS attorney Lena Amanti Yueh responded that the Justice Department was “comfortable with CMS proceeding.”
Senator Adam Schiff of California also criticized the policy, stating: “The massive transfer of the personal data of millions of Medicaid recipients should alarm every American. This massive violation of our privacy laws must be halted immediately. It will harm families across the nation and only cause more citizens to forego lifesaving access to health care.”
Also read: All in on one shot? HHS redirects $500 million to new vaccine project—what this unusual move means
Agencies defend the decision
In response to the lawsuits, HHS spokesperson Andrew Nixon said, “HHS acted entirely within its legal authority – and in full compliance with all applicable laws—to ensure that Medicaid benefits are reserved for individuals who are lawfully entitled to receive them.”
While it remains unclear how extensively ICE accessed the database or how the information was used, the agreement has raised broader questions about data sharing, government oversight, and individual privacy.
Also read: Is your city next? How Trump’s shocking legal move could affect you
Ways to stay informed and protect your information:
- Know your rights: Learn how your personal and health information is protected under federal and state laws.
- Ask questions: If you're enrolled in Medicaid or another government program, you can ask how your data is used and stored.
- Contact your representatives: If you have concerns, you can share your thoughts with state or federal lawmakers.
- Watch for updates: Legal outcomes may shape future data-sharing policies.
As litigation unfolds, privacy advocates and healthcare officials continue to monitor the situation.
For now, there are no confirmed plans for future data-sharing agreements, but the precedent has sparked interest in how federal health data may be accessed or used in other contexts.
Read next: What’s next for federal health programs? Proposed cuts raise questions
What do you think? Do you believe government agencies should be allowed to use healthcare data for immigration enforcement? Or should access to medical information remain strictly limited?
Share your thoughts in the comments below—we welcome your questions, concerns, and experiences.
