The lawsuit, led by Democratic attorneys general, alleges that the Department of Health and Human Services (HHS) unlawfully provided personal data—including immigration status details — to the Department of Homeland Security (DHS), undermining federal privacy protections. The data covers residents in four states: California, Illinois, Washington and Washington, D.C., which expanded Medicaid access to noncitizens. The plaintiffs argue the move violates privacy laws and enables mass deportations, while the Trump administration insists it is combating fraud and protecting taxpayer resources in a politically charged fight with deep implications for immigration policy and federal-state relations.

Privacy violations fuel fears of mass deportations
The lawsuit, filed by California AG Rob Bonta and counterparts in states like New York and Massachusetts, argues HHS acted "silently" to dismantle legal safeguards. Court documents cite § 553 of the Administrative Procedure Act (APA), which requires agencies to provide public notice before major policy changes. "The federal government's transfer of health data without consent violates congressional mandates and upends the trust essential to public health systems," the plaintiffs stated.

The disputed data stems from an HHS directive enabling DHS to use Medicaid enrollment information to identify noncitizens, including unauthorized migrants. An Associated Press report cited an internal memo revealing that nearly half of Medicaid recipients in the targeted states are noncitizens, many of whom rely on state programs to access healthcare. While federal law restricts Medicaid reimbursements for unauthorized residents except in emergencies, several states—often with Democratic leadership — have expanded eligibility using state funds.

Critics warn the data could be weaponized, allowing Immigration and Customs Enforcement (ICE) to track vulnerable populations. "This is the Trump administration's latest scheme to weaponize social services against immigrant communities," said Washington State AG Bob Ferguson.

"Restoring accountability" to healthcare programs
HHS rebutted the claims, asserting its actions were lawful and necessary to combat waste. Spokesperson Andrew Nixon stated that over 5 billion annually is misdirected to ineligible noncitizens, citing federal budget disputes with states like California, which were forced to repay $53 million in 2024 for improper reimbursements.

"Andy Nixon emphasized that the data-sharing protocol, spearheaded by HHS Secretary Robert F. Kennedy Jr., was narrow in scope, focusing on systemic compliance issues. The effort, he added, aligns with President Trump's drive to prioritize healthcare for U.S. citizens. "We must ensure that hardworking taxpayers' dollars go to those legally entitled to them," Nixon said.

Meanwhile, House Republicans advance reforms this week, seeking to bar federal funding for illegal immigrants under Medicaid. The House Energy and Commerce Committee's budget reconciliation proposal would exclude roughly 1.4 million unauthorized residents by 2034, though Democrats decried the move as "shadowing" to gut access for U.S. citizens.