A federal judge in California has ruled that U.S. immigration authorities can access limited personal information from the nation’s biggest public health insurance program. On December 29, 2025, U.S. District Judge Vince Chhabria said Immigration and Customs Enforcement (ICE) may obtain basic identifying details from Medicaid records, though full medical data will remain off-limits for now. The decision partially lifts a broader block that had stopped all data sharing between Medicaid and ICE.
Judge Chhabria’s ruling allows federal agencies to collect names, addresses, phone numbers, birth dates, Medicaid identification numbers, and recorded citizenship or immigration status for people believed to be in the country unlawfully. However, medical histories, treatments, and diagnoses must stay private until stronger protections are in place.
The ruling narrows an earlier injunction that had completely prevented any transfers of Medicaid information. That earlier ban will expire on January 6, 2026, after which ICE can begin receiving limited data unless a higher court intervenes. The judge said he was concerned by the lack of clear government guidelines on how the information would be used or safeguarded but found that limited sharing could proceed in the meantime.
Medicaid’s Role and What’s at Stake
Medicaid is a joint federal and state program that provides health coverage for roughly 77 to 79 million low-income Americans, including children, seniors, and people with disabilities. It insures nearly one in four people in the United States. Federal law generally restricts full Medicaid benefits to U.S. citizens and certain legal residents, while undocumented immigrants can receive only emergency medical services.
For years, Medicaid and immigration enforcement were strictly separate. Since about 2013, the Centers for Medicare & Medicaid Services (CMS) had assured states and families that Medicaid data would never be used for deportation purposes. That policy aimed to build trust and prevent families from avoiding healthcare out of fear.
But in mid-2025, the Trump administration directed CMS to begin sharing data with ICE. Records from states such as California, Illinois, and Washington, D.C., were among the first to be transferred. This marked a significant shift in policy and led to immediate backlash from state governments and advocates who said the change violated long-standing privacy practices.
States Fight Back in Court
In response, 20 states led by California Attorney General Rob Bonta sued the Department of Health and Human Services (HHS) and the Department of Homeland Security (DHS), which oversees ICE. The states argued that using Medicaid enrollment data for immigration enforcement would discourage eligible people from enrolling, harm public health, and break the government’s promise of confidentiality.
Federal courts initially sided with the states, ordering a temporary halt to all data sharing nationwide through early January 2026. Judge Chhabria’s December ruling, however, narrowed those orders, allowing certain basic identifiers to be shared while lawsuits continue. Other cases, including one in Oregon, have separate blocks still in place pending further review.
In his written opinion, Judge Chhabria criticized federal officials for failing to justify why they needed such extensive data or how they planned to protect it. He described the government’s policy as inconsistent and poorly reasoned, noting that access to health records remained unjustified under current arguments. His decision represents a cautious middle ground between privacy advocates and federal enforcement efforts.
Concerns Grow Over Privacy and Public Trust
California, home to the country’s largest Medicaid program (known locally as Medi-Cal), has become the focal point of the debate. State officials said federal authorities began requesting data as early as June 2025, sometimes giving them less than an hour to comply. Community advocacy groups report that many families are now hesitant to seek care, fearing their personal information could be linked to immigration investigations.
For mixed-status households, where U.S.-born children receive Medicaid but their parents lack legal status, the risk feels especially personal. Even limited data like addresses or phone numbers could reveal family connections and expose undocumented relatives to enforcement action.
Federal officials say the goal is to ensure Medicaid funds go only to those eligible, describing the effort as a “program integrity” measure. Critics counter that the financial stakes are tiny, since emergency care for undocumented immigrants accounts for less than 1 percent of Medicaid spending. They argue the damage to public trust and health access could far outweigh any potential savings.
Documents released through public records requests show that early drafts of the CMS–ICE agreement proposed broader access, including some financial details like bank routing numbers. Judge Chhabria’s order eliminated those categories, but privacy advocates remain worried that the policy could expand again in the future.
The decision also highlights growing tension between state governments and the federal administration. Plaintiff states accuse HHS and DHS of sidestepping normal rulemaking procedures and breaking promises made to millions of families. The policy reflects the priorities of Health Secretary Robert F. Kennedy Jr., CMS Administrator Dr. Mehmet Oz, and Acting ICE Director Todd Lyons, each of whom plays a role in carrying out the data exchange.
President Trump has defended the approach, saying it helps enforce immigration laws while protecting resources for eligible citizens. Opponents, however, warn that blurring the line between healthcare and immigration enforcement could deter vulnerable families from seeking coverage altogether.
Unless higher courts extend current injunctions, ICE will regain access to some Medicaid identifiers after January 6, 2026. What happens next depends on ongoing lawsuits and possible new regulations. The coming months will show whether this policy becomes a short-lived experiment or a lasting change in how the U.S. government handles health information and immigration enforcement.
Sources
U.S. District Court, Northern District of California – Judge Vince Chhabria’s Ruling on State of California et al. v. HHS et al. – December 29, 2025
Centers for Medicare & Medicaid Services – September 2025 Medicaid & CHIP Enrollment Data Highlights – December 22, 2025
U.S. Department of Health and Human Services – Data Exchange Memorandum of Agreement (CMS-DHS) – July 2025
U.S. Department of Health and Human Services – Robert F. Kennedy, Jr. Sworn in as 26th Secretary – February 12, 2025
JAMA (Journal of the American Medical Association) – Medicaid Spending for Undocumented Immigrants – October 8, 2025
California Attorney General’s Office – Attorney General Bonta: Trump Administration’s Unprecedented Move to Allow ICE Access to Californians’ Medicaid Information – June 2025