In a controversial move that has drawn sharp criticism from public health officials and privacy advocates, the Trump administration has quietly signed a data-sharing agreement granting U.S. Immigration and Customs Enforcement (ICE) access to the personal information of up to 79 million Medicaid recipients, according to documents obtained by The Associated Press.
The agreement, signed on Monday, July 14, between the Centers for Medicare and Medicaid Services (CMS) and the Department of Homeland Security (DHS), allows ICE to access recipients’ names, addresses, dates of birth, Social Security numbers, and racial and ethnic backgrounds. While ICE agents won’t be allowed to download the data, they will be able to view it during business hours, from 9 a.m. to 5 p.m., Monday through Friday.
Purpose and Justification: Tracking Undocumented Immigrants
The White House says the goal is straightforward: identify and locate individuals who may be living in the U.S. illegally.
“ICE will use the CMS data to allow ICE to receive identity and location information on aliens identified by ICE,” the agreement states.
While the administration has not publicly announced the deal, officials claim it is part of a broader effort to root out fraud in federal assistance programs, suggesting that undocumented individuals may be improperly receiving Medicaid benefits.
"This is about program integrity and enforcing the law," said a senior administration official, speaking on background. "Taxpayer dollars should only support those legally entitled to receive them."
Internal Pushback: “They Are Trying to Turn Us into Immigration Agents”
However, the policy has sparked deep internal dissent within CMS. Several staff members told the AP they were alarmed by the implications of handing over personal health-related data to immigration authorities.
“They are trying to turn us into immigration agents,” said one CMS official, who spoke anonymously due to lack of authorization to discuss internal matters.
Privacy advocates argue that the move could discourage vulnerable populations from seeking medical care or applying for Medicaid benefits—even if they are eligible.
“This kind of data-sharing has a chilling effect,” said Sarah Carlsen, a healthcare privacy expert at the Center for Public Integrity. “People may forgo essential medical services out of fear that their information could be used for immigration enforcement.”
A New Front in the Immigration Crackdown
The Medicaid data-sharing initiative represents a new front in the Trump administration’s aggressive immigration enforcement agenda. Over the past year, the President has ramped up ICE operations nationwide, pushing for 3,000 daily arrests—a target that internal DHS documents reportedly called “unsustainable” and harmful to morale.
The administration has previously explored using Social Security data and housing records to identify undocumented individuals, but this is believed to be the first time a federal health agency has been drawn into such efforts on this scale.
Legal and Ethical Questions
Critics also question whether the data-sharing arrangement violates federal health privacy laws, such as the Health Insurance Portability and Accountability Act (HIPAA).
“There is no precedent for using CMS data in this way,” said Dr. Miguel Hernández, a former CMS senior adviser. “We’re now in uncharted legal territory.”
Health and Human Services (HHS) officials have argued that the agreement complies with federal guidelines because the data is not being used for health care purposes but to investigate potential Medicaid fraud. However, that interpretation is expected to be challenged in court.
Several civil liberties organizations, including the ACLU and the National Immigration Law Center, are reportedly preparing to file lawsuits demanding the immediate suspension of the agreement.
What Happens Next?
For now, the data-sharing agreement is in effect, and ICE has begun limited access to CMS databases. But the long-term consequences—legal, ethical, and practical—are far from settled.
As health agencies face increasing pressure to cooperate with immigration enforcement, many in the public health community worry about the erosion of trust between providers and patients.
