The Trump administration has finalized a data-sharing agreement that allows Immigration and Customs Enforcement (ICE) to access limited Medicaid data in order to locate and verify the identities of undocumented immigrants, according to an Associated Press report.
The deal, made with the Centers for Medicare & Medicaid Services (CMS), gives ICE permission to cross-check information such as names and addresses provided by migrants who have accessed taxpayer-funded Medicaid services — typically through emergency room visits or state-funded clinics. ICE will not receive full data sets but will be allowed to request specific identity verifications during regular business hours.
Tricia McLaughlin, assistant secretary at the Department of Health and Human Services, confirmed the initiative. In a statement, she said the agencies are working together “to ensure that illegal aliens are not receiving Medicaid benefits that are meant for law-abiding Americans.”
The agreement marks a significant shift from prior administrations, which generally prohibited ICE from using Medicaid data for immigration enforcement. Critics say the move could damage public trust and deter vulnerable individuals from seeking life-saving care.
“It’s unthinkable that CMS would violate the trust of Medicaid enrollees in this way,” said Hannah Katch, a former CMS official under President Biden. She noted that personal data has historically only been shared in cases involving fraud or abuse, not immigration enforcement.
Internal emails obtained by the AP show there was debate within federal agencies over the legality and ethics of the move. CMS’s top lawyer had suggested a pause to review the matter, but the Department of Justice ultimately gave the green light for CMS to proceed with sharing access.
Currently, federal law mandates that all states provide emergency Medicaid coverage for life-threatening conditions, regardless of immigration status. In addition, seven Democrat-led states — California, New York, Washington, Colorado, Oregon, Illinois, and Minnesota — offer full Medicaid benefits to noncitizens at their own expense, without seeking reimbursement from the federal government. These programs were expanded during the Biden administration.
Twenty Democratic-led states have filed lawsuits challenging the federal government’s new cooperation with ICE, arguing that it undermines healthcare access and misuses sensitive personal data.
Rep. Pramila Jayapal (D-WA), an immigrant herself, called the agreement “the weaponization of data, full stop.”
The controversial decision comes as tensions continue to mount over immigration policy, with Democrats accusing Trump’s administration of targeting vulnerable communities and undermining healthcare privacy.
