A not publicly announced agreement between the Centers for Medicaid and Medicare Services (CMS) and the Department of Homeland Security (DHS) allows ICE to access personal data of up to 79 million people affiliated with MedicaidThe stated goal is to make it easier to locate immigrants residing in the United States without authorization, according to documents obtained by Associated Press.
Although the agreement does not allow for data downloads, it does authorize ICE to access the information during limited hours: Monday through Friday, between 9 a.m. and 5 p.m., until September 9.
“They’re trying to turn us into immigration agents,” said a CMS official who spoke on condition of anonymity. Legislators, civil rights advocates, and state officials have expressed concern about the legality of the measure, and at least 20 states have filed lawsuits alleging violations of medical privacy laws.
Effect on North Carolina
In North Carolina, attorney Kate Woomer-Deters, Senior Attorney, of the Immigrant & Refugee Rights Project of the North Carolina Justices Center in North Carolina, was emphatic: “This agreement is completely illegal. There are laws that have existed for years that prohibit the disclosure of this type of information,” she told Enlace Latino NC “It took us by surprise. We always knew and said that information from health agencies was not shared with other authorities. This is shocking and illegal.”
Woomer-Deters warned that the measure "does a lot of harm to people in the first place" and that lawsuits for violations of confidentiality laws are already anticipated.
He also explained that the agreement raises several worrying scenarios. On the one hand, it allows for the disclosure of personal data on all Medicaid enrollees, regardless of their immigration status. On the other hand, he noted that North Carolina is not one of the states that offers regular Medicaid to undocumented immigrants. However, some immigrants do access emergency Medicaid, which covers only lifesaving services and pregnant women and is mandatory in all states.
Related: Primary health care for undocumented immigrants in community clinics is at risk
States that offer Medicaid to undocumented immigrants
Several states offer Medicaid or state-funded health coverage or to some undocumented immigrants, primarily children and pregnant people, and some have expanded coverage to adults. These states include California, Colorado, Connecticut, Illinois, Maine, Massachusetts, Minnesota, New Jersey, New York, Oregon, Rhode Island, Utah, Vermont, Washington, and the District of Columbia.
Opens the door to racial profiling
Woomer-Deters clarified that when filling out the registration forms for children—whether citizens or eligible residents—it's not necessary to include the parents' immigration information. "Only income and address information are requested, but immigration status can be left blank. And that's not evidence that someone is undocumented," she explained.
However, under the current situation, he said he fears that if ICE reviews forms where that information is missing and sees names like "María García" or "José Pérez" (to name a few), it could misinterpret them as a "red flag," even though such an omission is not in itself proof of the parents' immigration status.
The lawyer also called for calm: “Families who are already enrolled, whose children already receive Medicaid, should not stop using it. The government already has that information. This doesn't change anything.”
Regarding new enrollments, the attorney recommends that each family weigh their risks: "Now, each family must evaluate their situation whether or not to enroll their citizen children in Medicaid. No one can tell them whether they should do it or not. The important thing is to weigh their risks and needs."
Related>> Sheriff's cooperation with ICE in North Carolina: Attorney clarifies all your questions
Impact on North Carolina
In North Carolina, more than 2.8 million people are enrolled in Medicaid, between the traditional program and the recent expansion. Of these:
- More than 61,700 Hispanic members.
- Forty-three percent of enrollees are minors, and in rural areas, nearly half of the children rely on Medicaid, according to North Carolina Central University.
- Among enrolled Hispanics, 54.6% are between 19 and 29 years old, and 58.6% are women.
- There are more than 1.4 million children enrolled.
Related: How will Trump's federal cuts to Medicaid impact North Carolina?
Pressure on states that do not use federal funds
The agreement was pushed by former President Donald Trump's team, which seeks to restrict access to public services for undocumented immigrants, the Associated Press reported. In recent weeks, the administration demanded access to Medicaid data from seven states—all led by Democratic governors—that provide full coverage to non-citizen immigrants. Although these states do not bill the federal government, they faced pressure to hand over the data.
CMS officials tried to stop the transfer. In an internal email chain, they asked the Department of Justice to intervene and request a pause from the White House. However, Department of Health lawyers responded that there were no legal objections to proceeding.
Senator Adam Schiff (California) publicly condemned the decision: “The massive transfer of personal data of millions of Medicaid recipients should alarm everyone. This massive violation of our privacy laws must stop immediately.”
DHS has stated that access to this data is an effort to reduce costs and prevent fraud. However, civil rights advocates see this measure as a serious precedent that could discourage immigrant families—even citizens—from seeking medical care and accelerate the deportation process by arresting immigrants. immigrants who are not criminals to fulfill campaign promises based on inaccurate figures.
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