Medicaid can share knowledge with ICE, sparking worry for individuals who want care : NPR

For many years, individuals making use of for Medicaid had been advised their private data — together with their names, addresses and immigration standing — wouldn’t be used for immigration enforcement.

However a December court docket ruling modified that. And that change has despatched ripples of worry via households and communities.

“My daughter’s life depends upon Medicaid,” says P., who requested that NPR determine her by her first preliminary solely.

P. and her household have authorized immigration standing, however she fears that the medical health insurance retaining her medically fragile daughter alive might additionally put her household susceptible to being detained or deported by immigration authorities.

For many years Medicaid promised eligible immigrants they would not share data with immigration authorities. It was even explicitly written on authorities web sites. These commitments are not on the Medicaid web site.

The promise was meant to guarantee eligible immigrants “to really feel snug that they’ll entry their care with out worry of placing their immigration standing into jeopardy,” says Cindy Mann, who oversaw Medicaid through the Obama administration and now works on the authorized and consulting agency Manatt Well being.

Mann calls the change, which the Trump administration started quietly final yr, a “180-degree reversal of longstanding coverage.”

“Anxiousness each day”

P.’s 11-year-old daughter has Rett Syndrome, a uncommon neurological situation that makes it laborious for her to eat, breathe, stroll and speak.

“She receives in-home assist,” P. says, together with frequent visits to cardiologists, pulmonologists and different specialists. “She additionally receives [physical therapy], [occupational therapy], speech, aquatic remedy on a weekly foundation.”

All this care would price tens of 1000’s of {dollars} with out Medicaid — the joint state and federal medical health insurance program for greater than 70 million individuals with low-incomes or disabilities.

P. says she and her husband are allowed to work within the U.S. legally and have non-public medical health insurance via their jobs. They’ve two youngsters who qualify for Medicaid protection due to disabilities.

“It brings us an quantity of hysteria each day,” P. says. She’s had buddies detained by immigration authorities and she or he worries about her household’s security. That is the case despite the fact that everybody in P.’s household has authorized standing, together with two of their youngsters who’re residents.

Uncommon requests 

Twenty-two states have sued to cease federal well being businesses from sharing Medicaid knowledge with the Division of Homeland Safety, together with Arizona, Michigan and New Jersey. For the time being, following the December ruling in federal court docket in San Francisco, Medicaid can share names, addresses and different figuring out data for people who find themselves within the nation unlawfully with immigration officers. Within the remaining 28 states together with Texas, Kentucky and Utah, there are not any limits on what Medicaid knowledge could be shared with Immigration and Customs Enforcement and different entities.

Another latest federal actions are elevating new alarms.

One former state Medicaid director advised NPR they acquired what they described as a extremely uncommon request from the federal authorities in summer time 2025 — an inventory of largely Latino-looking final names, with directions to examine solely immigration standing.

The director, who spoke on situation of anonymity as a result of they weren’t licensed to debate federal communications, mentioned that is not how these critiques usually work. Normally, states are requested to evaluation all standards — revenue, incapacity and immigration standing — to find out eligibility for this system, not single out one issue.

The director says they had been floored. After reviewing the instances, they discovered everybody on the checklist remained eligible to proceed with Medicaid.

Final August, the federal company that oversees Medicaid, the Facilities for Medicare & Medicaid Providers (CMS), began a new initiative to evaluation immigration standing of Medicaid enrollees. The company mentioned in a press launch it might begin sending month-to-month enrollment experiences with names of individuals it wanted states to confirm.

The Division of Homeland Safety didn’t reply to NPR’s questions on whether or not the information has been used for immigration enforcement. In the Federal Register and in a memo issued in October 2025, ICE says that it’s rescinding a 2013 coverage that mentioned CMS and HHS knowledge wouldn’t be used for immigration enforcement. The Related Press first reported on the Trump administration’s change in July 2025.

Selecting between care and worry

At Venice Household Clinic in Los Angeles, employees say sufferers are more and more asking whether or not it is secure to stay on Medicaid.

Pattie Lopez manages the clinic’s medical health insurance division. She says one affected person turned so apprehensive in regards to the coverage change that she dropped her protection — solely to return after struggling with out it.

“She discovered it extremely laborious to go with out well being protection,” Lopez says. “Now she’s right here taking a threat as a result of she wants her treatment.”

Venice Household Clinic is certified to obtain particular federal funding to take care of weak communities, and 80% of its 45,000 sufferers depend on Medicaid. If individuals drop protection however nonetheless want care, the clinic might face monetary pressure. It has already frozen hiring and is on the lookout for different methods to chop prices.

Andrew Cohen, an lawyer with Well being Legislation Advocates in Massachusetts, mentioned that for individuals already enrolled in Medicaid or different applications, the federal authorities probably has their data already.

“So remaining on protection could also be no further threat,” he mentioned. “However there are situations the place it is probably not secure for everyone.”

Some immigrants could also be weighing whether or not to enroll or proceed protection. For P., although, strolling away from Medicaid is not doable.

“We haven’t any different possibility,” she says about dropping protection for her severely disabled daughter. “We should threat that.”

With out the protection, she says, it is her daughter’s life that may be in danger.