States are accusing the federal government of breaching long-standing laws protecting Medicaid recipients’ private health data by secretly sharing it with federal immigration authorities.
California Attorney General Rob Bonta recently filed a lawsuit on the part of a multistate coalition challenging the U.S. Department of Health and Human Services' (HHS) decision to provide “unfettered access to individual personal health data to the Department of Homeland Security (DHS),” arguing that it violates federal law, “threatens to erode trust in the healthcare system, and deters vulnerable populations from seeking care.”
For over 70 years, federal law has treated Medicaid beneficiaries' personal and medical information as confidential, to be shared only in limited circumstances that support public health or the integrity of the program.
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However, in June 2025, this policy was upended when the Centers for Medicare & Medicaid Services (CMS) under the HHS allegedly transferred sensitive health data from states such as California, Illinois and Washington to the Department of Homeland Security without notifying the public or following proper procedures.
The states argue that this mass transfer of health data occurred without beneficiaries' consent and violated multiple federal statutes, including the Administrative Procedure Act.
They further claim this was done under the Trump administration without proper justification or legal authority, undermining the protections Congress established for Medicaid data.
HHS has defended its actions by stating that data sharing helps ensure that Medicaid benefits are only for eligible individuals. However, states contend this rationale is misleading.
Congress has already authorized emergency Medicaid for all U.S. residents, regardless of immigration status; states routinely verify eligibility using federally approved systems. They insist there is no precedent or legal basis for the type of cross-agency data sharing CMS is now enabling.
Adding to the concern is the broader context. Reports suggest the Department of Government Efficiency (DOGE) is compiling a vast, searchable database of Americans’ personal information—including tax and Social Security data—to aid in immigration enforcement.
Technology company Palantir Technologies Inc. (NASDAQ:PLTR) is reportedly assisting in this effort.
Critics warn that centralizing such sensitive data dramatically increases the risk of misuse, even with the best intentions.
The states involved in the lawsuit say they are taking action to safeguard their Medicaid programs and shield their residents from harm.
They warn that such data sharing could prompt fear among immigrants, causing them to opt out of Medicaid enrollment—even when they are eligible—leading to a loss of federal funding, a strain on state safety net hospitals, and adverse public health outcomes.
States are asking the court to issue immediate relief to stop the unauthorized sharing and uphold the longstanding principles of the state-federal Medicaid partnership.
"The Trump Administration has upended longstanding privacy protections with its decision to illegally share sensitive, personal health data with ICE. In doing so, it has created a culture of fear that will lead to fewer people seeking vital emergency medical care," said AG Bonta in a statement on Tuesday.
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