Judge Blocks HHS From Sharing Medicaid Data With Immigration Authorities

The Department of Health and Human Services (HHS) must stop sharing certain Medicaid data with immigration authorities, a federal judge has ruled.

U.S. District Judge Vince Chhabria, an Obama appointeed, issued a preliminary injunction on Aug. 12, finding that the Centers for Medicare and Medicaid Services (CMS), a division of HHS, failed to conduct a “reasoned decision-making process” before deciding to provide the information to the Department of Homeland Security (DHS), The Hill reported.

“To be sure, the Administration has made clear, through a series of Executive Orders and elsewhere, that immigration enforcement will become a higher priority in general,” Chhabria wrote. “But using CMS data about Medicaid patients for immigration enforcement involves unique policy tradeoffs.

“As shown by the evidence presented by the states, using CMS data for immigration enforcement threatens to significantly disrupt the operation of Medicaid—a program that Congress has deemed critical for the provision of health coverage to the nation’s most vulnerable residents,” the judge added.

The injunction bars HHS from sharing Medicaid data from 20 states, including California and Hawaii, with DHS. It also prevents DHS from using Medicaid data it has already obtained from those states for immigration enforcement purposes.

The ruling is temporary and does not permanently block the agencies from pursuing such cooperation, however.

Chhabria emphasized that the agencies failed to properly weigh the consequences of reversing a long-standing policy of protecting Medicaid patient information. “The evidence presented in this case indicates that HHS and DHS did not consider these tradeoffs before deviating from the agencies’ longstanding policy,” he wrote.

A federal judge ordered the nation’s health department to stop giving deportation officials access to the personal information — including home addresses — of all 79 million Medicaid enrollees. https://t.co/1UA8YzlQe3

— Yahoo News (@YahooNews) August 14, 2025

The case stems from actions taken earlier this year.

After President Donald Trump took office in January, CMS officials requested that states provide data on people with what they described as “unsatisfactory immigration status.” By June, CMS had begun sharing some of that information with DHS, including statistical Medicaid data. The arrangement later evolved into a formal agreement giving immigration authorities direct access to the CMS statistical database.

The database did not include protected health information such as patient diagnoses. Government lawyers argued the decisions “reflect reasonable judgments about the need to assist immigration authorities in carrying out their work and are tailored to those needs.”

An HHS spokesperson defended the effort, saying the agency had acted “entirely within its legal authority—and in full compliance with all applicable laws—to ensure that Medicaid benefits are reserved for individuals who are lawfully entitled to receive them.”

The spokesperson added that data revealed states such as California were using taxpayer-funded health benefits to cover individuals who are in the country illegally, which HHS said “directly defies the intent of federal Medicaid law.” Officials said the new data-sharing arrangement was aimed at preventing misuse of the program.

State attorneys general challenged the move in a lawsuit filed in July, arguing that the abrupt reversal of prior policy required court intervention. They contended that the policy change would chill participation in Medicaid and undermine health services for low-income residents.

Chhabria’s ruling acknowledged that DHS has a legitimate interest in pursuing immigration enforcement, and that there is nothing “categorically unlawful” about the agency obtaining data from HHS. But he said the abrupt change could not be justified as reasonable decision-making.

“The interest asserted by the agencies in ramping up immigration enforcement is certainly legitimate and entitled to deference,” he wrote. “But the harm from delaying access to this single enforcement tool until the agencies undertake a reasoned decision-making process is outweighed by the harm and disruption that this bolt-from-the-blue reversal has visited upon the states, providers, and patients.”

The case will now move forward as the Trump administration weighs whether to appeal or refine the policy to comply with the court’s ruling.