Why It Matters
A coalition of 22 states and the District of Columbia has filed a new legal challenge alleging that the Trump administration violated a federal court order restricting the types of Medicaid data that could be shared with U.S. Immigration and Customs Enforcement. The case has direct implications for millions of low-income Americans enrolled in Medicaid, including lawful permanent residents, refugees, and citizens whose health information may have been improperly transmitted to federal immigration authorities. New Jersey is among the states involved in the ongoing litigation, which centers on the intersection of federal health data policy and immigration enforcement operations.
What Happened
In a new court filing submitted on March 31, 2026, the coalition of states told a federal court that the U.S. Department of Health and Human Services appears to have shared a data set with ICE that exceeded the boundaries established by a prior court ruling. The states allege that HHS admitted to transferring a “large and complex” set of Medicaid recipient data to ICE, despite a December court order that limited the scope of permissible sharing.
That December ruling had represented a partial victory for the Trump administration in the ongoing lawsuit, originally filed by the states to block any data sharing between ICE and Medicaid entirely. The court permitted ICE to access limited identifying information — such as addresses, phone numbers, birth dates, and citizenship or immigration status — to assist in locating individuals residing in the country without legal authorization.
However, the court also placed explicit restrictions on the data transfer, barring ICE from receiving information on lawful permanent residents, citizens, or other individuals with legal immigration status. The states now contend that those restrictions were not followed, and that the federal government has not clarified how it distinguishes between individuals with and without lawful status when compiling the data it shares with immigration enforcement.
By the Numbers
- 22 states plus the District of Columbia are party to the lawsuit against the federal government over Medicaid data sharing with ICE.
- The December 2025 court order permitted ICE access to 4 categories of basic identifying data: addresses, phone numbers, birth dates, and citizenship or immigration status.
- Medicaid covers approximately 72 million Americans nationwide, including low-income adults, children, pregnant women, elderly individuals, and people with disabilities.
- The coalition’s new filing was submitted on March 31, 2026, following HHS’s acknowledgment of the data transfer.
- The states are seeking 3 specific remedies from the court: a formal prohibition on sharing protected health data of lawfully present individuals, a clarification of who qualifies as “lawfully residing,” and an audit of what data has already been shared with ICE and how it has been used.
Zoom Out
The dispute is part of a broader national debate over the use of federal agency databases to support immigration enforcement. Since early 2025, the Trump administration has moved aggressively to expand data-sharing agreements between immigration authorities and a range of federal agencies, including the Social Security Administration and the Department of Health and Human Services.
Health policy advocates and immigration attorneys have warned that even lawful data sharing between health agencies and ICE creates a chilling effect on enrollment in public benefit programs. Early research following the December court ruling suggested that Medicaid enrollment inquiries dropped among immigrant communities in several states, including those where individuals would otherwise qualify under existing eligibility rules.
Other states have pursued parallel legal strategies. California, Washington, and Massachusetts have each taken independent steps — through state legislation or executive orders — to limit state-level cooperation with federal immigration data requests involving health records.
What’s Next
The coalition of states is now asking the presiding federal court to issue a formal order barring the sharing of any health data for individuals lawfully residing in the United States, pending further review. They are also requesting court authorization to examine the data already transferred to ICE and to assess how that data has been used in deportation proceedings.
The federal government will likely be required to respond to the new filing within a court-specified timeframe. If the court finds that the December order was violated, it could impose sanctions, issue an injunction, or require the return or deletion of improperly shared data. Legal analysts expect the case to continue through the federal courts and may eventually reach the Supreme Court given its implications for the intersection of federal health policy and immigration enforcement authority.