Dr. Acklema Mohammad checks a affected person at El Nuevo San Juan Well being Middle within the Bronx in New York Metropolis in 2024. Group well being clinics, like this one, are sometimes positioned in immigrant communities and depend on Medicaid.
Eduardo Munoz Alvarez/AP
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Eduardo Munoz Alvarez/AP
For many years, folks making use of for Medicaid had been instructed their private info — 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 worry by way of households and communities.
“My daughter’s life is determined by Medicaid,” says P., who requested that NPR determine 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 may additionally put her household susceptible to being detained or deported by immigration authorities.
For many years Medicaid promised eligible immigrants they would not share info 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 comfy that they will entry their care with out worry 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 yr, a “180-degree reversal of longstanding coverage.”
“Anxiousness day-after-day”
P.’s 11-year-old daughter has Rett Syndrome, a uncommon neurological situation that makes it onerous 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 (bodily remedy), (occupational remedy), 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 folks 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 youngsters who qualify for Medicaid protection due to disabilities.
“It brings us an quantity of hysteria day-after-day,” P. says. She’s had buddies detained by immigration authorities and he or she worries about her household’s security. That is the case despite the fact that everybody in P.’s household has authorized standing, together with two of their youngsters who’re residents.
Uncommon requests
Twenty-two states have sued to cease federal well being companies from sharing Medicaid information with the Division of Homeland Safety, together with Arizona, Michigan and New Jersey. In the mean time, following the December ruling in federal court docket in San Francisco, Medicaid can share names, addresses and different figuring out info for people who find themselves within the nation unlawfully with immigration officers. Within the remaining 28 states together with Texas, Kentucky and Utah, there aren’t any limits on what Medicaid information may be shared with Immigration and Customs Enforcement and different entities.
Another latest 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 instructed NPR they acquired 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 examine solely immigration standing.
The director, who spoke on situation of anonymity as a result of they weren’t approved to debate federal communications, stated that is not how these opinions usually work. Normally, states are requested to assessment 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 checklist remained eligible to proceed with Medicaid.
Final August, the federal company that oversees Medicaid, the Facilities for Medicare & Medicaid Providers (CMS), began a new initiative to assessment immigration standing of Medicaid enrollees. The company stated in a press launch it could 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 2025ICE says that it’s rescinding a 2013 coverage that stated CMS and HHS information 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 worry
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 fearful in regards to the coverage change that she dropped her protection — solely to return after struggling with out it.
“She discovered it extremely onerous to go with out well being protection,” Lopez says. “Now she’s right here taking a danger as a result of she wants her medicine.”
Venice Household Clinic is certified to obtain particular federal funding to take care of weak communities, and 80% of its 45,000 sufferers depend on Medicaid. If folks drop protection however nonetheless want care, the clinic may 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 Regulation Advocates in Massachusetts, stated that for folks already enrolled in Medicaid or different packages, the federal authorities possible has their info already.
“So remaining on protection could also be no extra danger,” he stated. “However there are situations the place it will not be 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 worry in immigrant communities, together with amongst folks with authorized standing.
Stephen Maturen/Getty Pictures
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Stephen Maturen/Getty Pictures
Some immigrants could also be weighing whether or not to enroll or proceed protection. For P., although, strolling away from Medicaid is not potential.
“We have no different possibility,” she says about dropping protection for her severely disabled daughter. “We must danger that.”
With out the protection, she says, it is her daughter’s life that will be in danger.
