What we know about the Trump administration’s plan to share Medicaid data with ICE
AI-generated summary reviewed by our newsroom.
- Trump administration enables ICE to access Medicaid data of 79 million enrollees
- HHS defends legality, citing fraud prevention; Democrats warn of privacy risks
- Legal Aid NC reports concerns from immigrants; dis-enrollment fears intensify
Under a new information-sharing policy, the Trump administration will allow Immigration and Customs Enforcement to access the personal data of the 79 million people enrolled in Medicaid across the country.
The policy, outlined in an agreement between the Centers for Medicare and Medicaid Services (CMS) and the Department of Homeland Security that was first reported last week by the Associated Press, has since been confirmed by the Department of Health and Human Services (HHS).
The agreement will give ICE officials access to data that will include home addresses and ethnicities for enrollees, and give the agency the ability to find “the location of aliens,” reported the AP, which said it had obtained a copy of the new policy.
In a statement to The News & Observer, HHS said it was focused on “identifying waste, fraud, and systemic abuse” within Medicaid, the joint federal and state program that provides health insurance coverage to low-income people.
There are more than 3.1 million people currently enrolled in the program in North Carolina, according to state data.
HHS defended the legality of sharing data with ICE, saying that the department “acted entirely within its legal authority — and in full compliance with all applicable laws — to ensure that Medicaid benefits are reserved for individuals who are lawfully entitled to receive them.”
The N.C. Department of Health and Human Services (NC DHHS) told The N&O that as of Thursday, it hadn’t received any details about the data-sharing agreement from CMS, and added that NC Medicaid hasn’t been asked to provide any data directly to ICE either.
The N&O also asked the offices of Gov. Josh Stein and Attorney General Jeff Jackson about the agreement, both of which referred questions to DHHS.
Two Democrats who represent North Carolina in Congress, meanwhile, strongly criticized the administration for giving ICE access to the data of Medicaid enrollees.
“Once again, the Trump administration is illegally attempting to access sensitive and personal data to enact an extreme agenda and attack immigrant communities across the country,” said U.S. Rep. Deborah Ross. “If this plan moves forward, it will not only result in a serious violation of the privacy of the millions of Americans who rely on Medicaid, but it will also prevent people from accessing the emergency care they need.”
Giving ICE access to Medicaid recipients’ data
U.S. Rep. Valerie Foushee said that allowing ICE to access the data of Medicaid recipients “is a shameful violation of personal rights in an attempt to terrorize and single out members of our communities.”
“This administration has showed no restraint in their efforts to target immigrants, and they are well aware that undocumented families are not eligible for Medicaid but may access care in emergency situations,” Foushee said. “This information sharing will cause people to put their families at risk just to see a doctor — and people will lose their lives.”
In its statement, HHS said the agreement to share data with ICE “is not unprecedented” and said CMS, the agency that administers Medicaid at the federal level, “is aggressively cracking down on states that may be misusing federal Medicaid funds to subsidize care for illegal immigrants.”
HHS criticized states that allow non-citizens to enroll in their Medicaid programs, and said the Biden administration “opened the floodgates for illegal immigrants to exploit Medicaid — and forced hardworking Americans to foot the bill.”
In June, the Trump administration sought personal data on millions of Medicaid enrollees from seven states (California, New York, Washington, Oregon, Illinois, Minnesota, and Colorado) that have expanded Medicaid coverage to include non-citizens. Those states started offering Medicaid coverage to non-citizens during the Biden administration, and said they wouldn’t charge the federal government to cover the costs of including those immigrants in the program, the AP reported.
That initial effort prompted 20 states to sue the administration, the AP reported, claiming that the sharing of Medicaid data with DHS from the seven states that were targeted violated federal health privacy protection laws, including the Health Insurance Portability and Accountability Act (HIPAA).
The agreement, according to the AP, states that “ICE will use the CMS data to allow ICE to receive identity and location information on aliens identified by ICE.”
The data being shared with ICE will include the names, addresses, birth dates, ethnic and racial information, and Social Security numbers for all Medicaid enrollees, the AP reported last week. ICE officials won’t be allowed to download the data, the AP reported, but will instead have limited access to it between 9 a.m. and 5 p.m., Monday through Friday, until Sept. 9.
How could data-sharing with ICE impact Medicaid enrollment in NC?
Nicholas Riggs, director of Legal Aid NC’s Navigator Project and the NC Navigator Consortium — a statewide, federally funded nonprofit that helps North Carolinians find and enroll in affordable health coverage — said that beyond what’s been reported by the AP, the organization has not received additional guidance from the federal government.
Riggs said that in North Carolina, undocumented immigrants are not eligible for full Medicaid coverage, but their citizen children are. Undocumented immigrants are only eligible for emergency Medicaid, which provides coverage in very limited circumstances for short durations, he said.
“The people who this may affect, if it’s true, are undocumented parents of children who are citizens,” he said. Many families across the nation and in North Carolina are mixed-status, meaning some members are citizens while others are not.
He said that typically, when there are policy changes like those mentioned by the AP, the U.S. Department of Health and Human Services usually sends information on the policy changes and data-sharing agreements. He said they have not “heard any communication from HHS on this.”
But, he said that the organization has received calls “from individuals who are concerned.”
Without confirmation of a policy change, the information they can currently provide is, “If they dis(enroll from Medicaid, it won’t change anything, because their information — if it’s true — has still been shared.”
“We do worry that it (the policy) might encourage folks to dis-enroll from Medicaid,” he said.
For those considering enrolling who have concerns, Riggs said, “Without official guidance from HHS, there’s only so much we can say.”
“We’ll continue to try to get information from HHS and other state and national partners. And as guidance changes from HHS, we will update the communities we serve,” he said.
This story was originally published July 27, 2025 at 1:20 PM.
