The administration of former U.S. President Donald Trump faced intense scrutiny following revelations that it shared personal data of millions of Medicaid enrollees with deportation authorities, including their immigration status. This move, part of a broader immigration crackdown, has significant implications for immigrant communities nationwide.
Documents obtained by The Associated Press, including an internal memo and emails, showed that Medicaid officials attempted unsuccessfully to prevent data transfer to the Department of Homeland Security (DHS), citing legal and ethical concerns. Despite these objections, two senior advisors to Health Secretary Robert F. Kennedy Jr. ordered the data to be handed over. Alarmingly, officials at the Centers for Medicare & Medicaid Services (CMS) had only 54 minutes to comply with the directive.
The Data at Risk
The information shared included names, addresses, social security numbers, and medical claim details. This primarily affected individuals residing in California, Illinois, Washington state, and Washington, D.C., where state Medicaid programs allow non-citizens to receive healthcare coverage funded solely by state resources. The data transfer coincided with increased immigration raids in Southern California, raising further concerns about the use of the shared information.
Legal and Ethical Concerns
Sara Vitolo, Medicaid's deputy director, issued a June 6 memo warning that sharing such information "would violate various federal laws, including the Social Security Act and the Privacy Act of 1974." Vitolo emphasized that "several federal legal and regulatory authorities do not permit CMS to share this information with entities outside of CMS" and that it should only be used for the direct administration of the Medicaid program. Still, four days later, senior officials at the Department of Health and Human Services (HHS) ordered the data be delivered to DHS by 5:30 p.m. Eastern Time, as per emails obtained by AP.
State Reactions
From California, Governor Gavin Newsom voiced his concern: “We deeply value the privacy of all Californians. This potential data transfer brought to our attention by the AP is extremely troubling and, if true, potentially illegal.” He added, “This should deeply concern all of us. Targeting families based on immigration status is a dangerous breach, and we are exploring all avenues to protect their information.”
Federal Representative Laura Friedman also condemned the move: “We should never use a person’s need to see a doctor against them. This will only lead to more chaos and pain in our communities.” Health officials in Illinois echoed similar sentiments, emphasizing that they understand the data is protected by the Privacy Act of 1974 and other federal regulations safeguarding Americans' sensitive personal and health data.
Official Justification: Restricting Benefits to Eligible Individuals
Andrew Nixon, HHS spokesperson, defended the legality of the data sharing. "HHS acted entirely within its legal authority—and in full compliance with all applicable laws—to ensure that Medicaid benefits are reserved for individuals legally entitled to receive them,” he stated.
From DHS, Deputy Secretary Tricia McLaughlin explained that Trump “promised to protect Medicaid for eligible beneficiaries. To fulfill that promise after former President Joe Biden flooded our country with tens of millions of illegal immigrants, CMS and DHS are exploring an initiative to ensure illegal immigrants do not receive Medicaid benefits intended for law-abiding Americans.”
Impact on Immigration and Healthcare Policy
Experts warn that these data could not only facilitate the location of immigrants for detention but may also be used “to thwart the hopes of those wishing to obtain legal residency, permanent residence, or naturalize if they ever received federally funded Medicaid benefits.”
Moreover, there is concern that this policy might deter collaboration between states and the federal government. As Vitolo noted in her memo, sharing information with DHS could lead states “to withhold information” to avoid legal or political repercussions.
Federal officials and former employees highlighted the unusual nature of this maneuver. Jeffrey Grant, a former career employee of CMS, commented: “The DHS has no role in anything related to Medicaid.”
The controversy extends to other areas as well. In May, a federal judge allowed the Internal Revenue Service (IRS) to share immigrants’ tax information with the Immigration and Customs Enforcement (ICE) to help locate individuals without legal status.
State Programs Under Threat
Seven states and the District of Columbia have established state programs that enable immigrants without legal status to receive full medical coverage through state funds. All have Democratic governors. Some of these programs are already facing budgetary challenges: California has frozen enrollment, and in July, Illinois will close its program covering about 30,000 individuals.
Meanwhile, other states like New York, Oregon, Minnesota, and Colorado have yet to share identifiable data with CMS. According to The Associated Press, public health officials in these states are meticulously reviewing federal requests to protect their residents' information.
Key Questions About Medicaid Data and Immigration
What data was shared with the DHS?
The shared data included names, addresses, social security numbers, and medical claim details of Medicaid enrollees.
Why did the Trump administration share Medicaid data with the DHS?
The Trump administration aimed to ensure that Medicaid benefits were reserved for individuals legally entitled to them, as part of a broader immigration enforcement strategy.
What legal concerns were raised about the data sharing?
Legal concerns included potential violations of federal laws such as the Social Security Act and the Privacy Act of 1974, which protect sensitive personal and health data.