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A sign in support of Medicaid rests in a walking device on the steps of the U.S. Capitol in Washington, on April 27, 2025. Bryan Dozier/Middle East Images/AFP via Getty Images
A federal judge has allowed Immigration and Customs Enforcement (ICE) to obtain basic Medicaid data on illegal immigrants as part of its enforcement operations.
In a preliminary injunction on Dec. 29, U.S. District Judge Vince Chhabria said that federal law allowed the Department of Health and Human Services (HHS) to share basic biographical, location, and contact information with ICE. Chhabria’s order stopped short of allowing other information to be shared, stating that ICE was too vague in its explanation of what other types of information it would seek and its reasons for doing so.
This injunction was the third Chhabria has issued over the course of litigation between the Trump administration and more than 20 blue or purple states. Medicaid, a joint state and federal government program, generally forbids benefits for illegal immigrants but contains exceptions for emergency care and other programs funded only by states.
In July, an initial group of states alleged that sharing the data with ICE would cause them to “lose federal funds as fear and confusion stemming from the disclosures cause noncitizens and their family members to disenroll, or refuse to enroll, in emergency Medicaid for which they are otherwise eligible, leaving States and their safety net hospitals to foot the bill for federally mandated emergency healthcare services.”
Moreover, they said, the federal government through its data access policies violated multiple limits on data sharing, as well as requirements of the Administrative Procedure Act for implementing new policies.
According to ICE, the agency has not historically requested information from the Centers for Medicare and Medicaid Services (CMS), which administers Medicaid for HHS.
However, it started requesting that information after President Donald Trump issued a series of executive orders designed to curb illegal immigration. ICE also sought to use data from the Internal Revenue Service but encountered a judicial block in November.
An ICE official said in July that his agency provided CMS with a list of approximately 7.6 million individuals and requested addresses and phone numbers for any immigrants CMS had data on in its Medicaid system. CMS returned 2.1 million entries, although about half were duplicates.
Chhabria in an initial block in August ruled that the administration’s data sharing betrayed a longstanding CMS policy of using patients’ personal information only in connection with health programs. Chhabria said at the time that the record before him did not show the type of reasoned decision-making process required by the Administrative Procedure Act.
ICE later submitted a memo outlining its reasons for obtaining the data. Among other reasons, it said that “having access to additional data points for address corroboration can help law enforcement confirm the whereabouts of criminal aliens, suspects, witnesses, or victims, ensuring that ICE resources and investigative efforts are focused on the right locations.”
That Oct. 27 memo also rescinded the Obama administration’s policy barring the use of health data for civil immigration enforcement actions.
“It unnecessarily restricts ICE’s use of information that is available and functionally useful for immigration enforcement purposes,” the agency said of the rescinded policy. “ICE is not required by law to refrain from using such HHS information as a basis for pursuing civil immigration enforcement action; instead, ICE made a policy choice to do so in 2013.”
Chhabria took issue with a portion of the Oct. 27 memo that sought to consider the use of data outside of basic biographical, contact, and location information. He said in his Dec. 29 ruling that neither the ICE memo nor a separate notice by CMS “address why a more narrowly tailored policy, focused on the basic biographical information ... would not suffice for immigration enforcement purposes.”
Chhabria’s order only applies to the states that sued the administration, and circumstances could change as litigation unfolds. He said that ICE could seek other types of basic information but would need to seek a modification of his ruling before obtaining that information from HHS.
