U.S. Immigration and Customs Enforcement (ICE) is using Medicaid enrollment data to facilitate deportations of people illegally in the United States.
A coalition of 20 states, mostly Democrat-run, is suing the federal government to prevent ICE from accessing Medicaid enrollee data from the Center for Medicare and Medicaid Services (CMS). Plaintiffs include California, Colorado, and Illinois.
The U.S. Department of Health and Human Services (HHS) authorized giving ICE such access in June. The CMS database will provide to ICE officials the names, addresses, birth dates, ethnic and racial information, and Social Security numbers of Medicaid enrollees.
ICE officials have access to the data only from 9 a.m. to 5 p.m. on weekdays until September 9.
Health Care for Law Breakers
The lawsuit argues the decision to provide access to medical data was a violation of federal law. The suit names the HHS and the U.S. Department of Homeland Security (the department that includes ICE) as defendants.
The Trump administration argues its actions have followed applicable laws and are necessary to protect eligible beneficiaries.
“[President Trump] promised to protect Medicaid for eligible beneficiaries,” said DHS Assistant Secretary Tricia McLaughlin in a statement. “To keep that promise after Joe Biden flooded our country with tens of millions of illegal aliens, CMS and DHS are exploring an initiative to ensure that illegal aliens are not receiving Medicaid benefits that are meant for law-abiding Americans.”
States Find Workarounds
Though federal law prohibits illegal immigrants from enrolling in Medicaid, states such as California, Colorado, and Oregon have extended Medicaid eligibility to illegal immigrants by using state tax dollars. Some states are now scaling back those programs. Illegal immigrants can also access Medicaid through the program’s reimbursements for emergency room visits.
The Congressional Budget Office states at least 1.4 million people are receiving health care through state-funded programs that extend Medicaid eligibility to illegal immigrants.
Colorado is one of the states diverting money to people illegally in the country, says Rep. Gabe Evans (R-CO).
“There are 21,000 illegal immigrants receiving taxpayer-funded health care in Colorado,” Evans said on X. “That’s money that could be going toward care for seniors and people with disabilities.”
Privacy Limits
The lawsuit raised questions about protecting confidential medical information.
“There is no privacy right for committing a crime,” said Jane Orient, M.D., the executive director of the American Association of Physicians and Surgeons.
“Applying for a benefit to which one is not entitled is a crime, as is being in a country without permission,” said Orient. “A person taking services without paying for them is forcing other people to pay. This has been legalized for citizens.”
Privacy is a tricky concept when it concerns how taxpayer funds are used, whether legal citizens or those in the country illegally, says Twila Brase, cofounder and president of the Citizens’ Council for Health Freedom (CCHF) and author of Big Brother in the Exam Room.
“Medicaid is a program funded by state and federal taxpayers,” said Brase. “Individuals whose care is being funded by taxpayers cannot expect to have the same privacy rights against government access to their data as individuals who are using their own resources to pay for medical care.”
HIPAA Provides No Protection
Government as payer is the litmus test for privacy protection, says Brase.
“People who receive charitable medical care have more privacy rights against government access than those receiving government-funded care,” said Brase. “No one who receives government-funded medical care should expect that they have any privacy rights against the government knowing about any services the government is paying for. Government access to demographic, eligibility, and treatment data is due diligence to the taxpayer.”
Electronic medical records and HIPAA disclosure requirements do not protect any service for which an insurance claim is permitted, says Orient. “No beneficiary of Medicare, Medicaid, or other government program has any meaningful privacy, as his record is (or can be) closely scrutinized, searching for fraud,” said Orient. “Of course, the doctor will be held guilty, not the patient, but the patient still has no privacy.”
Payers’ Rights
In any payment system, the payer has a right to demand relevant information, says Brase.
“No one pays bills blindly,” said Brase. “Even in the private sector, if a person asks another person to pay for something, the person paying will not pay a dime until they know what they are paying for.”
“It is why people who use health insurance as a third-party payer cannot often get a straight answer on the charge for a service or item,” said Brase. “They are not paying the bill.”
Another Way
Brase says payers’ lack of transparency is why her organization advocates for “affordable medical indemnity policies that pay patients directly for catastrophic and insurable events so patients can themselves pay the doctor and the hospital.” Currently, the Affordable Care Act does not allow for catastrophic coverage, and considers indemnity policies “supplemental.”
Indemnity plans would provide a lower-cost private option that is more reliable than Medicaid, says Brase.
“Ultimately, it’s a dangerous game to rely on government health care services, especially if you are illegally in the United States,” said Brase.
Harry Painter ([email protected]) writes from Oklahoma.
Internet info:
Attorney General Rob Bonta, “CA v. HHS, Complaint 7.1.25,” Jul 1, 2025: https://oag.ca.gov/system/files/attachments/pressdocs/CA%20v.%20HHS%2C%20Complaint%207.1.25.pdf
Congressional Budget Office, “Energy & Commerce, Subtitle D, Part I – Medicaid,” May 9, 2025: https://d1dth6e84htgma.cloudfront.net/E_and_C_Markup_Subtitle_D_Part_I_5_12_25_4628d60c2a.pdf
Harry Painter ([email protected]) writes from Brooklyn, New York.
