ICE is getting unprecedented access to Medicaid data
136 comments
·July 18, 2025duxup
This just seems like a power grab to empower federal level personal thugs for the executive branch.
Most of these departments have rules about how they use our data. ICE now gobbles it all up and can use it without rules by a department that operates with little regard and lots of exceptions to typical protections for citizens afforded by the constitution.
The majority in SCOTUS does not seem to care (it’s ok as long as their guy does it). Whatever rules we thought there were seem to be out the window because someone magically moved data or ICE got to do it or so on ...
onlyrealcuzzo
> The majority in SCOTUS does not seem to care (it’s ok as long as their guy does it).
I doubt they'd care if a democratic president wanted to do the exact same thing...
Their job isn't to be benevolent.
Their job is to determine what is ACCORDING to the laws. The reality is, many legal protections only apply to US citizens - and it is EXPLICITLY for these reasons that they do.
The Privacy Act of 1974 applies only to citizens. The Patriot Act opened up a can of worms ripe for abuse that will probably never be sealed.
The executive branch can almost get away with murder by saying, "Well, we thought they were a terrorist, so..." Which does appear to be the defense they're trying to set up, saying anyone in any, way, shape or form related to Mexican gangs is a terrorist.
The Supreme Court doesn't really seem to be exceptionally awful.
They're obviously bias, if you look at how they vote.
But the larger problem is that we have bad laws.
It's not the Supreme Court's job to override laws passed by congress because they're terrible or anti-American.
It's our job as voters to start caring about what matters.
dmix
> lots of exceptions to typical protections for citizens afforded by the constitution
Almost the entire US constitution applies to non-citizens in the country, with some small exceptions like voting and holding public office.
TimorousBestie
You’re technically correct, but in the last few decades a great deal of legal scholarship has gone into convincing the relevant parties that this isn’t so.
avgDev
On paper, but the average citizen and current admin disagree. The check & balances also don't seem to work.
lsidllljjjj
I'm an average citizen and I believe non-citizens have rights. And so do most of the people I know. So if you believe that, then recognize that that's just the consensus in your clique.
phkahler
Since medicade wasn't established by the constitution, how do resident aliens get coverage? Maybe they do, maybe they don't. I'd like to know.
skybrian
Does anything other than due process rights help for people facing deportation?
nonethewiser
Im confused. What else could there possibly be than due process? Force?
ItCouldBeWorse
Turns out the law is just two in the ink, one in the pinky finger in the air "I swear!". But in the end, the law is in people, the society is in people, not in paper, not in officials, not in institutions.
If the people carry something and change their minds and moods, have fun holding back that energy with a creaking dam made of paper. Even this Ice nightmare, was voted in democratic and will be one day, when the mood has swung again, pushed back by the people in some colorful revolution.
xdennis
There are some differences for illegal immigrants, though. For example they don't have the right to due process under expedited removal (passed by Bill Clinton in 1996).
wombatpm
How do you prove you are not an illegal immigrant when picked up off the street? Surely there must be some due process around the determination of your illegal status.
empath75
This is a little misleading. Under Clinton, they could basically just turn them around at a port of entry. Eventually (2004) this was expanded to people within 100 miles of a border within 2 weeks of entering the country, and then in 2020 they _dramatically_ expanded this to people anyone who has been here for less than 2 years, and that has not been tested in court, really.
This is sort of a classic example of a slippery slope, FWIW. As soon as you deny anybody due process, the category of people that applies to will just constantly expand.
Now, there's basically nothing stopping immigration officials from immediately deporting anybody they want, citizen, non-citizen, illegal or legal immigrant.
wlesieutre
Getting access to Medicaid data for public health research is a giant pain in the ass with layers upon layers of red tape and IRBs and training about how you are allowed to handle it.
fnordpiglet
Only if it’s done in compliance. There was been little to show this administration follows the constitution, laws, or judicial orders let alone regulation. Especially when it comes to Stephen Miller there’s a significant “move fast and break the law” effort knowing judicial or legislative remedy can take a long time and is not assured given the penetration of captured justices and congressional independence. Especially in something like this where you have to establish standing, do discovery, etc, it’s an uphill battle to ensure compliance and the out of compliance stuff happens behind closed doors. With most of the federal government oversight functions either gutted or entirely captured by politically partisan sycophants, I would not hold my breath expecting any boundaries or relief.
This is what a real deep state looks like. “He who smelt it dealt it” seems to be a natural law.
wlesieutre
Yes, I am assuming that ICE is not being held to the same (or any) standards and this is a real heap of bullshit
cosmicgadget
> The majority in SCOTUS does not seem to care
Well plain 'rules' are going to be firmly within the executive's discretion to change. So what you need is statutes.
Statutes might not help much though, due to the immunity/pardon hack. And we may even be seeing SCOTUS reexamine if the president is bound by statute.
This is fine.
Joeri
(it’s ok as long as their guy does it)
You put that between parentheses as if it was just a detail, but it is the fundamental question that nobody is talking about: what happens after their guy is gone?
Are they really ok with president AOC getting all of Trump’s powers? Or do they secretly hope democracy in the U.S. comes to a halt?
moogly
> Or do they secretly hope democracy in the U.S. comes to a halt?
Hope? They're working on it. And they're not being particularly secretive about it.
jpadkins
can you share some of these plans to halt democracy?
davidcbc
If a democratic president is elected they will reverse their decisions until a GOP president is elected again.
colpabar
I doubt that very much. I think what will happen is that the dems will run on doing that, get elected to do that, and then not do any of it, and nobody will really care or even remember. Everything will be cool because it’ll be a cool dem president and all the problems will be the republicans fault, just like obama.
TimorousBestie
I’m pretty tuned in to the conservative water cooler, and I’ve heard three realistic theories on post-Trump executive power. To be clear, these are real opinions I’ve heard self-described Trump voters espouse—not my opinions:
1. Most of the federal judges and SCOTUS will overturn bits and pieces of executive power once a Democrat tries to use them. See Biden and school loan forgiveness. They firmly believe that Thomas and Alito will retire during this administration, and they hope Sotomayor or Kagan retires or dies. I’ve also heard noise about impeaching Barrett.
2. Democrats are too skittish to use executive power to do anything revolutionary with it. Even when they had a trifecta during the first Obama term they barely did anything with it.
3. Regardless of the other two points, it’s very unlikely for the Republicans to lose control of House and Senate again, and the Senate can revert to being effective when the executive is a Democrat. A Republican House can constantly submit articles of impeachment and a Democrat president will get bogged down dodging the accusations, even if they’re spurious.
stuaxo
Secretly?
zimpenfish
> Are they really ok with president AOC getting all of Trump’s powers?
I can confidently predict that whatever out-the-arse-shadow-docket rulings SCOTUS have made for Trump will suddenly not apply to a Democratic president and the office will be hamstrung by executive limits pretty darn toot suite.
api
This isn't new at all and has been happening for decades, a continuous ratcheting up of Presidential and Executive Branch power since the dawn of the Cold War. Usually it's because of "national security," and it happens when both parties are in power. The march pretty much began with the National Security Act of 1947, though some might place it earlier with FDR and the New Deal. An argument can be made for both, with the left tending to blame the former and the right the latter. (I think the real answer is both to some extent but the National Security Act is the more significant of the two.)
An argument can be made after things like the second Iraq war that we have already entered the decadent empire phase of US history and the President effectively does have a great deal of dictatorial power. It's not supposed to be possible to wage a war like that without a congressional declaration, making such wars a pretty huge abdication of power by the legislative branch. If the President can just start a war on a whim, that power can be used to drag along the entire rest of the government.
Now, with ICE, we are establishing a lawless executive branch police force. This is just the unilateral power of the President to wage war coming home and being applied to domestic affairs. It will soon be possible, if it isn't already, for the President to order their own independent police to do anything, and if it is considered illegal the power of the pardon can be used to make that go away.
When the ratchet gets far enough down this path we may indeed see a president remain in power forever like Xi Xinpeng. Trump may or may not be that person. If it's not him it might be the next, or the next. It could just as easily be a left-wing populist demagogue as a right-wing one depending on which way the winds happen to be blowing when the final ratchet click happens.
krapp
>Are they really ok with president AOC getting all of Trump’s powers? Or do they secretly hope democracy in the U.S. comes to a halt?
They aren't even being remotely secretive about it.
micromacrofoot
Indeed seems this way. Also consider the recent budget bill increased ICE's budget 3X and it's now more funded than the entire federal prison system.
This is roughly on the level of post Pearl Harbor internement of Japanese people, with potential to grow larger.
strnjrloops
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michael1999
I think HIPAA always had a carve-out for LE. Trump is lawless, but this might not be.
michael1999
This sounded like a straight-forward HIPAA violation, but I checked. There's a carve out for LE.
You can see the bones of a stronger limit during drafting (as "required" by warrants), but then weakened to allow mere "administrative requests".
> Law Enforcement Purposes. Covered entities may disclose protected health information to law enforcement officials for law enforcement purposes under the following six circumstances, and subject to specified conditions: (1) as required by law (including court orders, court-ordered warrants, subpoenas) and administrative requests; (2) to identify or locate a suspect, fugitive, material witness, or missing person; (3) in response to a law enforcement official's request for information about a victim or suspected victim of a crime; (4) to alert law enforcement of a person's death, if the covered entity suspects that criminal activity caused the death; (5) when a covered entity believes that protected health information is evidence of a crime that occurred on its premises; and (6) by a covered health care provider in a medical emergency not occurring on its premises, when necessary to inform law enforcement about the commission and nature of a crime, the location of the crime or crime victims, and the perpetrator of the crime.
https://www.hhs.gov/hipaa/for-professionals/privacy/laws-reg...
adolph
Additionally from the article the data seems limited to identification information and not medical information.
Language in the agreement says it will allow ICE to access personal
information such as home addresses, phone numbers, IP addresses, banking
data, and social security numbers. (Later on in the agreement, what ICE is
allowed to access is defined differently, specifying just “Medicaid
recipients” and their sex, ethnicity, and race but forgoing any mention of IP
or banking data.) The agreement is set to last two months. While the document
is dated July 9, it is only effective starting when both parties sign it,
which would indicate a 60-day span from July 15 to September 15.diamond559
You still think this is just about immigrants? They are coming for the dissenters next, they will just make excuses as to why.
Geeek
They are coming? They are already here. RE: What the president said about Rosie O'donnell last week. Norms have been eroded and we are now clearly in the laws-are-being-eroded territory.
hcurtiss
What evidence do you have to believe that’s true?
pksebben
the 1950s comes to mind...
mrexroad
… and 2/19/1942.
Two thirds of those required to report to camps for internment, per the Executive Order, were US citizens.
bigyabai
Deportations without due-process, for a start. Why not deprive you of due process, too?
miltonlost
Trump just said he's going to try to take Rosie O Donnell's citizenship away.
phkahler
Do people still take his comments like that seriously?
throwawaymaroon
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loourr
The inevitable end of all government compiled lists of people
mlinhares
Its the other way around, authoritarian governments will now compile even more and larger lists of everything they can possibly get from their citizens. North Korea would be proud of what this administration is doing.
bl0b
I think they meant 'end' as in the 'ultimate destination' rather than 'conclusion'.
skybrian
Trump getting elected wasn’t inevitable. There were unusual events during the 2016 election campaign that could have resulted in a different outcome if their timing had been different.
giantg2
What they're saying is that government lists get abused. That's true no matter who is in power.
leptons
Sorry but both sides are not the same.
gosub100
Billionaires paid for Hillary, dems couldn't be bothered to listen to the people. Took 0 responsibility for it. Just took her campaign war chest and dumped it into a media smear campaign.
bigyabai
Client Side Scanning tried to hash your files to help the government find any "child predators" using iPhone.
You know, the same federal government that refused to assign a special prosecutor to the Epstein files. You can rest assured Apple and the Fed are very interested in protecting the children. Anyone who refuses to allow that sort of process is probably a criminal anyways, right?
xdennis
But the lists were compiled before Trump took office. Countries that have experience with totalitarianism don't make those lists to begin with.
That's why in France, for example, it's illegal for the government to keep track of people's race or religion. When the Nazis occupied France they used such documents to figure out who the Jews were.
freedomben
We really don't seem to like learning the lessons of history
ktallett
No government agency should get access to any private data without the appropriate protocols in place. Even more so considering the many issues surrounding ICE and their actions already, this will not improve things. Let alone the moral problem of trying to deport people which have been used by American companies for cheap labour to build the nation they want and supposedly are. Now of course that is ignoring the ludicrous view that undocumented migrants are the key issue, as opposed to so many other home made issues in the US, such as unfair wealth disparity, and a lack of fundamental basic rights for citizens.
tastyfreeze
That is the danger of central data collection. I know we like to pretend that federal departments are discrete units. At the end of the day the federal government owns the data. No subpoena needed if your boss already owns the data. You just have to ask nicely.
kevingadd
I don't understand why ICE would need access to Medicaid data. You need to be a citizen or lawful permanent resident to access that program, not to mention all the other additional criteria. The idea of illegal immigrants somehow bypassing all the checks and balances successfully en masse feels a little silly to me.
Just a quick check of the official website to try and get onto Medicaid in WA state shows that it requires a social security number and citizenship information: https://www.wahealthplanfinder.org/us/en/health-coverage/get...
prometheus76
They have a pamphlet available one more click away from the link you shared that gives detailed information on how undocumented immigrants can get free/reduced-cost health care, and what all of their options are: https://www.wahealthplanfinder.org/content/dam/wahbe-assets/...
kevingadd
This is not what the federal website for Medicaid says, though.
prometheus76
Couple of notes: Medicaid DOES cover emergency services for undocumented immigrants, to the tune of 16.2 billion dollars during the Biden administration. (Reference: https://budget.house.gov/imo/media/doc/cbo_on_medicaid_for_i...)
Just because it's illegal doesn't mean it isn't happening. From a May 25, 2025 article on the official CMS website: "The Centers for Medicare & Medicaid Services (CMS) announced today increased federal oversight to stop states from misusing federal Medicaid dollars to cover health care for individuals who are in the country illegally. Under federal law, federal Medicaid funding is generally only available for emergency medical services for noncitizens with unsatisfactory immigration status who would otherwise be Medicaid-eligible, but some states have pushed the boundaries, putting taxpayers on the hook for benefits that are not allowed."
From this article: https://www.cms.gov/newsroom/press-releases/cms-increasing-o...
arrosenberg
> I don't understand why ICE would need access to Medicaid data.
It’s a class war. Once they’ve run out of immigrants to harass and deport, they’ll be going after the poor.
yakz
They are:
- significantly raising taxes on imported goods - letting ACA subsidies expire - reducing access to medicaid - allowing medical debt on credit reports - resuming collections/garnishment for student loans - reducing options for student loan repayment / forgiveness
they're going after the poor
pstuart
> they're going after the poor
That's just a bonus feature
The tariffs serve 2 purposes:
1. They can replace income taxes and protect the wealthy (per their reasoning)
2. They are a tool for power over other countries and a mechanism to compel them to pay personal tribute to The King of America™
standardUser
The important thing is they go after someone.
dmix
There's something called "Qualified Non-citizens", federal funding is prohibited for non-citizens but states could optionally cover it
https://www.medicaid.gov/medicaid/enrollment-strategies/down...
so ultimately there is some source of non-citizen data to be gleaned
giantg2
Some states have different requirements for undocumented persons. Most states permit medicaid for emergency situations. Some permit it for pregnant people.
thomas_ma
Are there any states where Medicaid funds "emergency situations" for people who are not otherwise eligible for Medicaid? I've never heard of that. EMTALA requires hospitals to treat anyone in emergency situations, but doesn't to my knowledge provide a mechanism to pay for those treatments. The patient still gets billed and hospital likely just doesn't get paid.
xdennis
> undocumented persons
> pregnant people
Jesus Christ, it's like American English is two different languages.
kevingadd
My understanding from reading the federal website is that this would not be Medicaid, it would be a different program. So they would not be in the Medicaid database, right?
delfinom
Several blue states expanded their medicaid programs to allow illegals. This was with the intention to pay for it with state dollars instead of federal dollars.
Some states even allow legal temporary visa visitors like students to sign up for their state level funded medicaid. NY is constitutionally required to do so.
ICE however is making a play to obtain all of that state level data.
joshuaheard
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AlotOfReading
California gives medi-cal to undocumented migrants, paid for by the California general fund. The same program also administers federal medicaid funds for eligible Californians. It's a very different reality than you're trying to present.
aerostable_slug
That's not true, and it's why clinics are panicking over the new requirement to demonstrate citizenship. The theory was Federal monies were always largely denied to undocumented migrants, but in fact there was significant admixture between state and Federal funding and clinics were reimbursed out of Federal accounts for undocumented migrant care (because California just didn't track who was a citizen and who wasn't).
With that threatened there's a lot of worry here in California, especially about ERs being overrun by undocumented migrants seeking care and claiming it's an emergent issue (because where else can they go?).
burningChrome
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unethical_ban
I don't care. There are reasons we firewall private information from blanket surveillance by law enforcement. This is wrong.
saubeidl
The term "illegal aliens" is dehumanizing hate speech.
ktallett
What bastards?! How dare they help keep those migrants that are essential for many key jobs in the US healthy?!
jvanderbot
Only an uncharitable reading of GP would find some implication that this is wrong (or right). Just impartial commenting on how benefits are indeed available to non-citizens.
klooney
Lots of people with no papers buy social security numbers so they can work legit jobs- and you could presumably get benefits too. Presumably they're looking for people who don't make sense- receiving benefits in two states, live in Minnesota but get benefits in Arizona, that sort of thing.
libraryatnight
I live in AZ and your example is awful because we're literally full up on Minnesota snowbirds 6 months out of the year.
jasonlotito
The amount of precedent being set here for big government and overreach is amazing. I'm not really surprised though that Conservatives and other small/limited governemnt people worked to enact this massive overreach of power.
davidcbc
The GOP is not a party of small/limited government people. It's a party of people who want absolute control and use the language of small/limited government to gain power.
gosub100
Both parties are the same. Democrats want to make it illegal to protect myself from a violent attacker, enact legislation designed to block poor people from starting businesses, buy votes by promising handouts. They are both filthy and dirty and serve corporations.
buckle8017
Well you gotta be a citizen for Medicaid, so they shouldn't find anything interesting.
Right? /s
cosmicgadget
Oh good, so they are raiding databases that predominatly contain personal information on people they aren't looking for.
ch4s3
States can have supplements for non-citizens that don't use federal dollars and several do.
hcurtiss
It’s not all state dollars though. There’s a Medicaid match for ACA expansion populations. The OBBB reduces that match by 10% for states that expanded the population to include unauthorized immigrants. In Oregon, to maintain that program Oregonians are going to have to pony up hundreds of millions more per year. Much of the country is fine with that.
buckle8017
Nobody believes those programs isolate state and federal funds effectively.
At the very least they're using federal funds for administrative costs.
adgjlsfhk1
From TFA:
> Medicaid, state and federally government-funded health care coverage for the country’s poorest, is largely available only to some non-citizens, including refugees and asylum seekers, survivors of human trafficking, and permanent residents. Some states, like New York, provide Medicaid coverage for children and pregnant people, regardless of their immigration status. States report their Medicaid expenditures and data to the federal government, which reimburses them for some of the costs.
The Trump admin is aggressively deporting refugees and asylum seekers who entered legally.
aerostable_slug
California provides full coverage to undocumented migrants. This is who the administration is targeting.
As a related aside, Federally-funded California clinics are about to start requiring proof of citizenship. This is causing a panic.
Also, due to the massive cost of providing care to undocumented migrants, Newsom is about to freeze all registrations for Medi-Cal (so the message is get in now before the gates close). He's also proposing charging undocumented migrants a modest premium.
lcfcjs6
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dfilppi
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monero-xmr
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mlinhares
Most of the time when you submit paperwork for someone that is applying for a VISA here you'll provide information from a citizen/permanent resident, so they likely want to find the person that helped/sponsored your paperwork so they can get to you. Might be a good way to find bogus Medicaid fraud and strip you from your permanent residency or citizenship or just say you're abetting a criminal (someone living here illegaly), there are plenty of uses for this data if you're evil enough.
jepj57
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https://web.archive.org/web/20250718155208/https://www.wired...
https://archive.ph/a9KaW