SAN FRANCISCO—A federal judge ruled Monday that states must share basic personal information, including citizenship status, about undocumented immigrants enrolled in Medicaid with Immigration and Customs Enforcement (ICE) for deportation efforts, but barred the exchange of sensitive health records. The decision, issued by U.S. District Judge Vince Chhabria, partially upholds a President Donald J Trump’s policy aimed at bolstering immigration enforcement while maintaining some privacy protections.
“DHS and HHS have since released documents explaining their new proposed data-sharing policies,” Judge Chhabria wrote in his 28-page opinion affirming the federal government’s authority for the basic data exchange with states. “The States challenge those new policies in a renewed motion for a preliminary injunction. The motion is denied as to the data that is the primary focus of the new policies—basic biographical, location, and contact information—because the sharing of such information is clearly authorized by law and the [federal] agencies have adequately explained their decisions.”
He further noted that federal statutes permit interagency cooperation for law enforcement, including immigration matters, and dismissed most arguments from the states that the policy violated privacy laws like HIPAA or the Affordable Care Act.
Chhabria’s order reverses parts of an earlier block on the practice, which had been challenged by 20 states—including Washington state—fearing it would deter immigrants, as part of a “vulnerable population,” from seeking medical care. He did, however, keep an injunction in place against sharing medical histories or other detailed health information.
The ruling allows the Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) to provide ICE with limited data, including citizenship status, addresses, phone numbers, dates of birth, immigration details and Medicaid IDs. This data sharing applies only to individuals unlawfully present in the United States and takes effect January 6, 2026, after a temporary injunction expires.
The case originated in July 2025 when Washington State Attorney General Nick Brown joined a coalition of attorneys general in suing the Trump administration over the alleged illegal transfer of Medicaid data to the Department of Homeland Security, which oversees ICE. The lawsuit, filed in the U.S. District Court for the Northern District of California, accused federal officials of violating health privacy protections by handing over en masse files containing personal details of millions.
“Washington residents expect that the confidential information they give to the government to access medical treatment will only be used for healthcare purposes,” Brown said in a statement at the time of filing. “Their data should not go towards creating a giant database of Americans’ personal information or used so that ICE can deport undocumented immigrants because they had to go to the doctor.”
The complaint argued that the data sharing threatened public health by instilling fear among immigrant communities, potentially leading families to avoid enrolling in emergency Medicaid programs. States contended this could result in higher costs for uncompensated care and worsen health outcomes, including delayed treatments that might lead to severe consequences. The attorneys general also claimed the transfers breached the Administrative Procedure Act, the Social Security Act and other statutes, reversing prior federal acknowledgments that Medicaid information should not fuel immigration enforcement.
Washington’s Medicaid program is operated as a part of the broader Apple Health suite of health benefits programs. Apple Health includes Apple Health Expansion which provides full-scope medical services to Washington residents regardless of their immigration status. There are more than 1.9 million Apple Health clients in Washington, including about 49,000 whose immigration status makes them ineligible for some federally funded programs.
Apple Health covers a range of healthcare services, including inpatient and outpatient hospital care, primary and preventative care, long-term services and supports, and behavioral health. Washington residents signed up for Apple Health understanding that their information would be confidential and not shared for reasons unrelated to the provision of healthcare.
Author: Mario Lotmore
