Dr. Acklema Mohammad checks a affected person at El Nuevo San Juan Well being Heart within the Bronx in New York Metropolis in 2024. Group well being clinics, like this one, are sometimes situated in immigrant communities and depend on Medicaid.
Eduardo Munoz Alvarez/AP
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Eduardo Munoz Alvarez/AP
For many years, individuals making use of for Medicaid had been advised their private data — together with their names, addresses and immigration standing — wouldn’t be used for immigration enforcement.
However a December court docket ruling modified that. And that change has despatched ripples of concern by way of households and communities.
“My daughter’s life is dependent upon Medicaid,” says P., who requested that NPR establish her by her first preliminary solely.
P. and her household have authorized immigration standing, however she fears that the medical insurance maintaining her medically fragile daughter alive might additionally put her household susceptible to being detained or deported by immigration authorities.
For many years Medicaid promised eligible immigrants they would not share data with immigration authorities. It was even explicitly written on authorities web sites. These commitments are not on the Medicaid web site.
The promise was meant to guarantee eligible immigrants “to really feel snug that they will entry their care with out concern of placing their immigration standing into jeopardy,” says Cindy Mann, who oversaw Medicaid in the course of the Obama administration and now works on the authorized and consulting agency Manatt Well being.
Mann calls the change, which the Trump administration started quietly final 12 months, a “180-degree reversal of longstanding coverage.”
“Anxiousness daily”
P.’s 11-year-old daughter has Rett Syndrome, a uncommon neurological situation that makes it laborious for her to eat, breathe, stroll and speak.
“She receives in-home help,” P. says, together with frequent visits to cardiologists, pulmonologists and different specialists. “She additionally receives [physical therapy], [occupational therapy], speech, aquatic remedy on a weekly foundation.”
All this care would value tens of hundreds of {dollars} with out Medicaid — the joint state and federal medical insurance program for greater than 70 million individuals with low-incomes or disabilities.
P. says she and her husband are allowed to work within the U.S. legally and have personal medical insurance by way of their jobs. They’ve two kids who qualify for Medicaid protection due to disabilities.
“It brings us an quantity of hysteria daily,” P. says. She’s had buddies detained by immigration authorities and she or he worries about her household’s security. That is the case regardless that everybody in P.’s household has authorized standing, together with two of their kids who’re residents.
Uncommon requests
Twenty-two states have sued to cease federal well being companies from sharing Medicaid knowledge with the Division of Homeland Safety, together with Arizona, Michigan and New Jersey. In the meanwhile, following the December ruling in federal court docket in San Francisco, Medicaid can share names, addresses and different figuring out data for people who find themselves within the nation unlawfully with immigration officers. Within the remaining 28 states together with Texas, Kentucky and Utah, there are not any limits on what Medicaid knowledge will be shared with Immigration and Customs Enforcement and different entities.
Another current federal actions are elevating new alarms.
An worker in Rayito de Sol Spanish Immersion preschool in Chicago was taken into federal custody on Nov. 5, 2025. Immigration enforcement at faculties and hospitals was towards coverage beneath earlier presidents. Right here, two mother and father console one another.
Erin Hooley/AP
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Erin Hooley/AP
One former state Medicaid director advised NPR they obtained what they described as a extremely uncommon request from the federal authorities in summer season 2025 — a listing of largely Latino-looking final names, with directions to test solely immigration standing.
The director, who spoke on situation of anonymity as a result of they weren’t licensed to debate federal communications, mentioned that is not how these critiques usually work. Normally, states are requested to overview all standards — earnings, incapacity and immigration standing — to find out eligibility for this system, not single out one issue.
The director says they had been floored. After reviewing the instances, they discovered everybody on the record remained eligible to proceed with Medicaid.
Final August, the federal company that oversees Medicaid, the Facilities for Medicare & Medicaid Companies (CMS), began a new initiative to overview immigration standing of Medicaid enrollees. The company mentioned in a press launch it might begin sending month-to-month enrollment studies with names of individuals it wanted states to confirm.
The Division of Homeland Safety didn’t reply to NPR’s questions on whether or not the info has been used for immigration enforcement. In the Federal Register and in a memo issued in October 2025, ICE says that it’s rescinding a 2013 coverage that mentioned CMS and HHS knowledge wouldn’t be used for immigration enforcement. The Related Press first reported on the Trump administration’s change in July 2025.
Selecting between care and concern
At Venice Household Clinic in Los Angeles, employees say sufferers are more and more asking whether or not it is protected to stay on Medicaid.
Pattie Lopez manages the clinic’s medical insurance division. She says one affected person turned so nervous concerning the coverage change that she dropped her protection — solely to return after struggling with out it.
“She discovered it extremely laborious to go with out well being protection,” Lopez says. “Now she’s right here taking a threat as a result of she wants her remedy.”
Venice Household Clinic is certified to obtain particular federal funding to take care of susceptible communities, and 80% of its 45,000 sufferers depend on Medicaid. If individuals drop protection however nonetheless want care, the clinic might face monetary pressure. It has already frozen hiring and is in search of different methods to chop prices.
Andrew Cohen, an lawyer with Well being Legislation Advocates in Massachusetts, mentioned that for individuals already enrolled in Medicaid or different applications, the federal authorities doubtless has their data already.
“So remaining on protection could also be no extra threat,” he mentioned. “However there are situations the place it is probably not protected for everyone.”
ICE brokers detain an individual on January 13, 2026 in Minneapolis. Arrests, detainments and deportations in Minnesota, Illinois and different states have engendered concern in immigrant communities, together with amongst individuals with authorized standing.
Stephen Maturen/Getty Photographs
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Stephen Maturen/Getty Photographs
Some immigrants could also be weighing whether or not to enroll or proceed protection. For P., although, strolling away from Medicaid is not attainable.
“We haven’t any different possibility,” she says about dropping protection for her severely disabled daughter. “We should threat that.”
With out the protection, she says, it is her daughter’s life that may be in danger.
