The Trump administration reversed a 2013 policy that had prohibited the use of Medicaid and Health and Human Services data for immigration enforcement. In October 2025, ICE rescinded the prior policy, and the Centers for Medicare and Medicaid Services launched a nationwide initiative to review immigration status of enrollees. The change affects a program that covers over 70 million low-income and disabled Americans.

A federal court in San Francisco issued a ruling limiting data sharing, but the order applies only in some states. In 28 states — including Texas, Kentucky, and Utah — federal authorities can share Medicaid enrollment data with ICE without a court-imposed restriction. Twenty-two states have filed lawsuits to block the practice. The legal landscape remains unsettled.

NPR reported on March 13 that community health clinics are facing patient volume drops and hiring freezes as eligible enrollees — including U.S. citizen children whose parents are undocumented — drop Medicaid coverage out of fear that enrollment will expose their families to immigration enforcement. A former Obama-era CMS official told NPR the reversal is a "180-degree reversal" of protections that were explicitly guaranteed on healthcare.gov.

An anonymous state Medicaid director told NPR of receiving "unusual federal requests" to identify enrollees by specific ethnic identifiers — a detail that state officials found alarming. The administration's stated rationale is ensuring that taxpayer-funded benefits reach only eligible recipients and that welfare programs are not accessed by those in the country illegally. Fox News has not prominently featured the data-sharing policy on its health or politics pages, though its broader editorial framing consistently supports immigration enforcement and program eligibility verification.