The Department of Health and Human Services (HHS) must stop sharing some Medicaid data with immigration officials, a federal judge has ruled.
U.S. District Judge Vince Chhabria said on Aug. 12 that the Centers for Medicare and Medicaid Services (CMS), a component of HHS, failed to “carry out a reasoned decisionmaking process” before deciding to share the data with the Department of Homeland Security (DHS).
“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,” he 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 evidence presented in this case indicates that HHS and DHS did not consider these tradeoffs before deviating from the agencies’ longstanding policy of protecting Medicaid patient information from use for immigration enforcement,” he added.
Chhabria entered a preliminary injunction that prevents HHS from sharing Medicaid data from 20 states, including California and Hawaii, with DHS. The injunction, which is not permanent, also bars DHS from using Medicaid data it already obtained from the states for immigration enforcement.
An HHS spokesperson revealed that the agency does not comment on litigation before stating that, regarding the data sharing, “HHS 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.”
After President Donald Trump took office in January, CMS officials asked states for data on people described as having unsatisfactory immigration status. In June, CMS shared the data with DHS. CMS later shared data from its Medicaid statistical database with immigration authorities. Officials were encouraged by the information, prompting them to enter into a formal agreement to provide immigration authorities with direct access to the database.
That data sharing keeps from authorities a subset of the data that includes protected health information, such as diagnoses. The actions “reflect reasonable judgments about the need to assist immigration authorities in carrying out their work and are tailored to those needs,” government lawyers said in a brief.
The HHS spokesperson said that the data showed that states such as California are using taxpayer-funded health benefits to cover illegal immigrants, “directly defying the intent of federal Medicaid law,” and that the new effort is aimed at stopping the misuse of the funds.
State attorneys general said in their lawsuit, filed in July, that the change in posture from prior administrations concerning the sharing of the data should spur an injunction.
Chhabria said in his ruling that “there does not appear to be anything categorically unlawful about DHS obtaining data from agencies like HHS for immigration enforcement purposes.”
Officials have not shown that the change was not arbitrary, he added later.
“The interest asserted by the agencies in ramping up immigration enforcement is certainly legitimate and entitled to deference, but the harm from delaying access to this single enforcement tool until the agencies undertake a reasoned decisionmaking process is outweighed by the harm and disruption that this bolt-from-the-blue reversal has visited upon the states, providers, and patients,” he wrote.
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