California Attorney General Rob Bonta, a Democrat, has taken the lead in a 20-state lawsuit against the Trump administration, accusing federal officials of violating privacy laws by transferring Medicaid data to the Department of Homeland Security (DHS). The lawsuit, filed Tuesday in the Northern District of California, represents one of 28 legal challenges California has brought against the president in 23 weeks, highlighting the state’s ongoing adversarial relationship with the administration. The states argue that the Trump administration’s actions, which involved sharing sensitive health information with DHS, are part of an ‘anti-immigrant crusade’ and have compromised the confidentiality of personal data for millions of individuals. The complaint states that the U.S. Department of Health and Human Services (HHS) violated federal law by sharing health records obtained from states including California, Illinois, and Washington, without the consent of those individuals. The data, which reportedly included names, addresses, social security numbers, and claims data, was allegedly transferred to DHS for use in immigration enforcement activities. The lawsuit alleges that these actions have created a climate of fear, leading to potential disenrollment from Medicaid programs and jeopardizing public health by reducing access to emergency medical care for vulnerable populations.
According to the complaint, the states claim that the Trump administration’s decision to share Medicaid data with DHS is not aimed at combating fraud or waste but rather to suppress the enrollment of noncitizens in federally funded Medicaid programs. The complaint asserts that Congress has explicitly extended coverage and federal funds for emergency Medicaid to all individuals residing in the United States, regardless of their immigration status. The states maintain that they have consistently verified eligibility for Medicaid through established federal systems and cooperate with federal oversight to ensure that federal funds are used only for legally authorized services. The complaint further alleges that the transfer of data violates key federal privacy laws, including the Health Insurance Portability and Accountability Act (HIPAA) and the Administrative Procedure Act (APA). HHS has defended the data transfer as necessary to prevent the misuse of Medicaid funds, claiming that it is focused on identifying waste, fraud, and systemic abuse. However, the states argue that the Trump administration’s actions have created a culture of fear and undermined the trust of millions of people who rely on Medicaid for their healthcare needs.
In a statement, HHS spokesman Andrew Nixon emphasized that the administration acted within its legal authority to ensure that Medicaid benefits are reserved for individuals who are lawfully entitled to receive them. He acknowledged that the data transfer was part of a lawful interagency effort to protect taxpayer dollars and restore credibility to one of the nation’s most vital programs. However, the states and their attorneys general, including those from Arizona, Colorado, Connecticut, Delaware, Hawaii, Illinois, Massachusetts, Maine, Maryland, Michigan, Minnesota, Nevada, New Jersey, New Mexico, New York, Oregon, Rhode Island, Vermont, and Washington, argue that the Trump administration’s actions have put millions of people at risk by exposing their personal health information and threatening their access to essential medical services. The legal action is seen as a crucial step in protecting state Medicaid programs from being used in ways that are unrelated to the administration of those programs, as the states demand that any shared data not be used for immigration enforcement purposes. The lawsuit also warns that the fear and confusion caused by the data disclosures could lead to a significant decrease in the enrollment of noncitizens and their families in emergency Medicaid programs, ultimately leaving states and safety-net hospitals to bear the financial burden of federally mandated healthcare services. The complaint further highlights the potential negative public health consequences of reduced healthcare utilization, including increased morbidity and mortality rates among vulnerable populations. As the legal battle progresses, the outcome of this case could have far-reaching implications for the protection of sensitive health data and the ethical use of federal programs to serve the public good.