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- Federal immigration officials could gain access to sensitive Medicaid data — but not yet. A judge has temporarily limited what information the Department of Homeland Security can access in states, like Wisconsin, that are suing to block a data-sharing agreement.
- Advocates warn the data-sharing risks chilling health care access — potentially even discouraging some from enrolling in programs for which they’re eligible.
- Undocumented immigrants are categorically ineligible for full Medicaid, but two narrower options exist. In Wisconsin, emergency care and prenatal coverage are available regardless of immigration status, covering about 3,200 people as of late 2025.
- State Republicans unsuccessfully sought to ban any public funding for health care for people without legal immigration status, citing rising Medicaid costs. Gov. Tony Evers vetoed the proposal, arguing it would create confusion and solve problems that don’t exist.
Can federal immigration officials access personal data on every Wisconsinite enrolled in Medicaid?
Not for now, but the question is winding its way through federal courts.
The U.S. Department of Health and Human Services last summer signed an agreement with the Department of Homeland Security to give immigration enforcement officers broad access to Medicaid data, which includes names, addresses, claim information and banking details. Trump administration officials claim the agreement is needed “to ensure that Medicaid benefits are reserved for individuals who are lawfully entitled to receive them.”
Wisconsin joined 21 other states in a lawsuit challenging the agreement last year.
“Millions of individuals’ health information was transferred without their consent,” the lawsuit argues. “In doing so, the Trump administration silently destroyed longstanding guardrails that protected the public’s sensitive health data.”
In December, a federal judge in California ordered that, in states involved in the lawsuit, DHS can only access the names and contact information of undocumented immigrants in states involved in the lawsuit.
But patient advocates say it’s unclear how the agency could separate the records of undocumented immigrants from those of immigrants with legal status.
“The sharing of data is dangerous for all of us at the end of the day,” said Esther Reyes, movement-building director with the national advocacy group Protecting Immigrant Families.
How does immigration status affect eligibility for Medicaid and other health programs?
Federal law bars undocumented immigrants and many other recent immigrants from receiving full-benefits Medicaid coverage. Most legal permanent residents and new arrivals with legal status become eligible for full Medicaid coverage only after five years in the U.S. A list of exceptions to that rule shrank last year when President Trump signed his trademark “big beautiful bill” into law.
But the White House claims many undocumented immigrants still access Medicaid benefits, largely citing state-funded health care programs — including a now-shuttered program in Illinois — that provided coverage for undocumented adults. While those programs must operate without federal dollars to avoid running afoul of federal law, the Trump administration argues a tax “loophole”, which it moved to close last week, made them possible.
Medicaid rules make one exception for immigrants ineligible for full coverage: Under federal law, hospitals must provide emergency care for any uninsured patient. Emergency Medicaid coverage can reimburse hospitals for those costs, meaning people of any legal status can receive temporary coverage in dire circumstances — though receiving that emergency coverage is not guaranteed.
“Emergency Medicaid is exclusively available when you go to the emergency room if you don’t qualify for Medicaid because of your immigration status, and it covers services that states by law are required to cover — life or death situations,” Reyes said.
Absent that reimbursement, hospitals may distribute the costs of emergency care for people without insurance across other patients.
Some states also rely on the federal Children’s Health Insurance Program, which is separate from Medicaid, to cover prenatal care for pregnant patients regardless of immigration status.
How do those programs work in Wisconsin, and how much do they cost?
In Wisconsin, those two options are called Medicaid Emergency Services and BadgerCare Plus Prenatal, respectively. The prenatal program is open both to immigrants ineligible for other coverage and to pregnant inmates in Wisconsin’s prisons and jails.
Immigrant patients can receive emergency services coverage until their “condition is no longer considered an emergency,” according to state guidelines. Patients enrolled in the prenatal plan remain covered through their pregnancy, though many then become eligible for two months of emergency care coverage.
Roughly 3,200 people were enrolled in the two programs combined in October 2025, according to Wisconsin’s Department of Health Services’ data. That marked the programs’ lowest monthly enrollment since the start of the COVID-19 pandemic.
The state paused reviews of Medicaid recipients’ eligibility during the pandemic, allowing some enrollees in the emergency services and prenatal programs to remain insured beyond the standard cutoff, but enrollment plummeted after Wisconsin DHS resumed reviews in June 2023 in a process often called the “unwinding.”
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Medicaid unwinding: 360,000 in Wisconsin lose coverage as eligibility checks resume
The federal government requires states each year to verify Medicaid recipients’ eligibility, but it paused the mandate early in the pandemic to help people maintain coverage. Verification resumed in June 2023 in Wisconsin, a process called unwinding.
Not all patients enrolled in the programs are undocumented, and Wisconsin DHS records do not break down enrollment by legal status.
Spending on the two programs dipped from about $60 million in fiscal year 2024 to about $57 million in 2025 — less than 0.4% of the state’s overall medical assistance spending that year.
Why did Wisconsin Republicans try to block state-funded health care for undocumented immigrants last year?
The Republican-controlled Legislature voted last year to bar Wisconsin agencies and local governments from funding any form of health services for undocumented immigrants.
Rep. Alex Dallman, R-Markesan, one of the bill’s co-sponsors, pointed to Illinois’ expansion of health coverage to some undocumented adults as reason for Wisconsin to preemptively block any similar expansion; the Illinois program’s costs consistently exceeded projections, prompting the state to end the program last year.
“We’re in such a deficit on Medicaid already that it’s hard to keep up as it is,” he told Wisconsin Watch. Wisconsin is on track to overspend its Medicaid budget by $213 million by the end of the current budget cycle, state DHS Secretary-designee Kirsten Johnson wrote in a letter to state lawmakers at the end of December.
Dallman noted that the bill made an exception for health care spending required under federal law. “If they go to the emergency room, they are still going to get emergency care,” he said. As he understood it, Dallman said, that language in the bill would have shielded emergency Medicaid.
But opponents say it isn’t clear that Wisconsin’s emergency services program would have been left untouched. Some also argue that the proposal could also require immigration status checks to access any form of subsidized health care, spanning far beyond hospitals alone.
“If a child is at school and they’re sick… does the school nurse need to figure out how to verify their status before they provide health care?” asked William Parke-Sutherland, government affairs director of Kids Forward, which advocates for low-income and minority families.
“It would have affected health care services for people if they are in need of emergency services like EMTs,” he added. “We have a primarily county-based crisis mental health system — I think that this would have applied to those as well.”
Gov. Tony Evers vetoed the bill in December, arguing that it sought to solve problems that “do not exist.”
Could sharing Medicaid data deter patients from seeking health care?
Health outreach workers warn that giving federal immigration officials access to even some Medicaid patient data could discourage people from enrolling in programs for which they are eligible — including U.S. citizens.
The database shared with immigration authorities, called the Transformed Medicaid Statistical Information System, doesn’t clearly distinguish between undocumented immigrants and immigrants with legal status who are ineligible for full-coverage Medicaid for various reasons.
In December, U.S. District Court Judge Vince Chhabria of northern California ruled that immigration authorities may access data only on undocumented immigrants — and only if it can be separated from data on citizens and eligible immigrants.
It’s still unclear whether officials can do that.
Regardless, the data-sharing agreement alone is enough to make many immigrants — and some citizens with immigrant family members — “think twice about whether they actually access programs like Medicaid,” Reyes said.
But health care navigators say skipping coverage can be far riskier than the potential for their address to land in the hands of immigration enforcement officers.
“You’re protecting the life of your child — and yours” by enrolling in the prenatal program, said Francisco Guerrero, a health coverage navigator with the Wisconsin Institute for Public Policy and Service.
For now, advocates are urging people to be cautious when deciding whether to drop their coverage. If people are already enrolled in the emergency or prenatal programs and haven’t changed their address, leaving the program won’t wipe their information from the database, Reyes said. U.S. citizens don’t have to disclose the immigration status of anyone in their household, she added, and immigrant parents enrolling U.S.-born children do not need to share their own legal status.
“We want people to make informed decisions and understand the risks,” Reyes said. “We understand, though, that it’s really critical to get the care that you need for yourself and for your children.”
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