A federal judge has temporarily blocked the U.S. Department of Homeland Security from using the Medicaid data of patients in Washington and 19 other states for immigration enforcement purposes.
U.S. District Judge Vince Chhabria issued a preliminary injunction this week in the multistate lawsuit, filed in Northern California federal court, citing federal agencies' apparent failure to follow proper decision-making processes when changing policies around sharing personal health information. Chhabria's ruling also means the U.S. Department of Health and Human Services, which oversees the Center for Medicaid & Medicare Services, is barred from sharing Medicaid data with DHS for deportation purposes going forward.
Using CMS data for immigration enforcement threatens to significantly disrupt the operation of Medicaid — a program that Congress has deemed critical for the provision of health coverage to the nation’s most vulnerable residents," Chhabria wrote in the Tuesday ruling.
The preliminary injunction will remain in place until after HHS and DHS complete the "reasoned decision-making process" that complies with federal law, or until litigation concludes, wrote Chhabria, who was appointed by former President Barack Obama in 2014.
“Protecting people’s private health information is vitally important,” Washington Attorney General Nick Brown wrote in a statement following the ruling. “And everyone should be able to seek medical care without fear of what the federal government may do with that information.”
Washington joined the lawsuit against President Donald Trump's administration in early July, after reports that Medicaid data from several states was shared with federal deportation officials. The data included addresses, names, Social Security numbers, claims data and immigration status, according to The Associated Press.
The data-sharing incident was met with outrage among immigrant advocates, civil rights groups and state officials in Washington, who expressed deep concern about medical data being weaponized against patients. In the Seattle area, some community health clinics vowed to make changes to their medical facilities to bolster security and up patient privacy in case federal immigration officers showed up.
In Washington, more than 1.9 million people are members of Apple Health, the state's Medicaid program, including about 49,000 residents whose immigration status makes them ineligible for some federally funded programs, according to the attorney general's office.
The state's Apple Health Expansion program also enrolled roughly 12,000 low-income immigrants without legal status last year, covering primary care, emergency visits, dental services and more. All services provided through that program are paid for with state taxpayer dollars, except emergency care, which is federally reimbursed.
Patients registered for Apple Health Expansion with the promise their data would remain confidential, according to the state Health Care Authority, which administers Washington's Medicaid program.
States already were sharing most of this personal medical information with CMS, as a longtime requirement to receive federal funding, but health leaders didn’t realize it would be passed along to other non-health agencies.
Furthermore, Chhabria wrote in his preliminary injunction this week, Immigration and Customs Enforcement has had a policy for over a decade against using Medicaid data for deportation purposes. This policy has been publicized to states, medical providers and Medicaid patients, Chhabria wrote.
Given these policies, "it was incumbent upon the agencies to carry out a reasoned decisionmaking process before changing them," he said in the ruling. "The record in this case strongly suggests that no such process occurred."
Chhabria denied another plaintiff request to require additional rule making when changing policies around sharing data between agencies.
"The lawsuit highlighted that the administration’s illegal actions are creating fear and confusion, leading eligible noncitizens and their family members to disenroll, or refuse to enroll, in emergency Medicaid," the attorney general's office said in this week's statement. "This leaves states and their safety net hospitals to foot the bill for federally mandated emergency health care services.
The lawsuit is also joined by attorneys general from Arizona, California, Colorado, Connecticut, Delaware, Hawaii, Illinois, Massachusetts, Maine, Maryland, Michigan, Minnesota, Nevada, New Jersey, New Mexico, New York, Oregon, Rhode Island and Vermont.
Information from The Seattle Times archives was included in this story.
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