Twenty states, led by California, sued the Trump administration Tuesday after federal health officials shared sensitive data about Medicaid recipients with the Department of Homeland Security, which oversees immigration enforcement.
“The Trump Administration has upended longstanding privacy protections with its decision to illegally share sensitive, personal health data with ICE,” said California Attorney General Rob Bonta in a statement announcing the lawsuit.
“In doing so, it has created a culture of fear that will lead to fewer people seeking vital emergency medical care,” Bonta said.
The data transfer, which happened last month, was first reported by The Associated Press. Top Health and Human Services officials directed the Centers for Medicaid & Medicare Services (CMS) to share data with DHS from California, Illinois, Washington and Washington, DC, about millions of their Medicaid recipients, according to the AP’s report.
Those jurisdictions allow some low-income immigrants, including some without legal status, who do not qualify for Medicaid to access state-funded health programs.
States routinely must share extensive data about Medicaid enrollees with CMS, including names, addresses, Social Security numbers, immigration status and healthcare information — but say that data is supposed to stay confidential.
The suit, which was filed in federal court in San Francisco, asks the court to stop HHS from sharing Medicaid data with any other federal agency and to stop DHS, any other federal agency, or the White House’s Department of Government Efficiency (DOGE) from using the data for immigration enforcement or “population surveillance.”
It also asks the court to order the “impoundment, disgorgement, and destruction of all copies of any Medicaid data containing personally identifiable, protected health information that has already been unlawfully disclosed to DHS and DOGE.”
Bonta and almost all the other state attorneys general bringing the federal lawsuit are Democrats.
DHS spokesperson Tricia McLaughlin sent NPR a statement that said, in part: “CMS and DHS are exploring an initiative to ensure that illegal aliens are not receiving Medicaid benefits that are meant for law-abiding Americans.”
The Department of Health and Human Services said it does not comment on litigation, but last month, spokesperson Andrew Nixon said in a statement that the data transfer was legal, and that CMS is “aggressively cracking down on states that may be misusing federal Medicaid funds to subsidize care for illegal immigrants.”
“This oversight effort — supported by lawful interagency data sharing with DHS — is focused on identifying waste, fraud, and systemic abuse,” Nixon said in the same statement. “We are not only protecting taxpayer dollars — we are restoring credibility to one of America’s most vital programs.”
All states, however, receive emergency Medicaid funds that reimburse hospitals for emergency care regardless of someone’s immigration status.
The lawsuit comes the same day the Senate passed deep cuts to Medicaid and other federal benefit programs in President Trump’s signature domestic policy bill. The sweeping bill now heads to the House for a final vote.
The other states joining the lawsuit are Arizona, Colorado, Connecticut, Delaware, Hawaii, Illinois, Massachusetts, Maine, Maryland, Michigan, Minnesota, Nevada, New Jersey, New Mexico, New York, Oregon, Rhode Island, Vermont, and Washington.
The Trump administration, led by the DOGE effort, has taken unprecedented steps to access and aggregate data across the federal government, and more recently, from states. Critics have raised security, privacy and legal concerns about the effort, and there are more than a dozen federal lawsuits against the administration alleging privacy law violations.
“It has been widely reported that the Department of Government Efficiency (DOGE) has been amassing federal benefit data, such as Social Security recipient information, and individuals’ tax information, to build a searchable database of Americans’ information for several purposes, including to assist ICE in immigration enforcement actions,” the lawsuit said.
