ICE Is Getting Unprecedented Access to Medicaid Data

Immigration and Customs Enforcement officials are getting access to the personal data of nearly 80 million people on Medicaid in order to acquire “information concerning the identification and location of aliens in the United States,” according to an information exchange agreement viewed by WIRED.

The agreement, which is titled “Information Exchange Agreement Between the Centers for Medicare and Medicaid Services and the Department of Homeland Security (DHS) for Disclosure of Identity and Location Information of Aliens,” was signed by CMS officials on Tuesday and first reported by AP News.

Per the agreement, ICE officials will get login credentials for a Centers for Medicare and Medicaid Services (CMS) database containing sensitive medical information, including detailed records about diagnoses and procedures. 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.

The move comes as President Donald Trump’s administration has continued to expand its crackdown on immigration. The administration aims to deport 3,000 people per day—four times as many as were deported in the fiscal year of 2024, according to ICE. Its plans to do so seemingly involves vacuuming up data from across the government. WIRED previously reported that the so-called Department of Government Efficiency (DOGE) and DHS were working on a master database, pulling in data from across DHS and other agencies, in order to surveil and deport immigrants.

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.

“This was never even considered during my five years at DHS working on immigration enforcement,” says John Sandweg, the acting director of ICE during President Barack Obama’s administration. “You want to be careful of a possible chilling effect where people who might apply for benefits and be eligible for benefits—or who seek emergency medical care—won’t do so because they’re worried the information they provide at the hospital could make them a target for immigration action.”

This isn’t the concern of the administration now, spokespeople tell WIRED. “Under the leadership of Dr. [Mehmet] Oz, CMS is aggressively cracking down on states that may be misusing federal Medicaid funds to subsidize care for illegal immigrants,” Andrew Nixon, the director of communications at the Department of Health and Human Services (HHS), tells WIRED. “This oversight effort—supported by lawful interagency data sharing with DHS—is focused on identifying waste, fraud, and systemic abuse. We are not only protecting taxpayer dollars—we are restoring credibility to one of America’s most vital programs. The American people deserve accountability. HHS is delivering it.”