ICE, DOGE seek sensitive Medicare data as immigration crackdown intensifies

Trump immigration officials and the U.S. DOGE Service are seeking to use a sensitive Medicare database as part of their crackdown on undocumented immigrants, according to a person familiar with the matter and records obtained by The Washington Post.

The database, which is managed by the Centers for Medicare and Medicaid Services and includes reams of health and personal information, contains addresses sought by Immigration and Customs Enforcement officials, according to the person and documents reviewed by The Post. Current and former health officials said they were deeply concerned by what appears to be an unprecedented use of the Medicare database as part of immigration enforcement efforts, and they were unsure whether it was legal.

The requests to CMS, made over the past month, came from ICE officials and involved DOGE, a team that is led by billionaire Elon Musk and has sought access to sensitive data systems across the federal government, according to the records and the person, who spoke on the condition of anonymity to describe internal deliberations.

ICE is trying to track down a list of immigrants the Trump administration has deemed illegally present in the country, the person and the records show. To aid in that effort, ICE — in coordination with DOGE — is asking CMS to check the immigrants’ Social Security numbers against a Medicare claims database to determine the individuals’ addresses, according to the person and the records.

CMS was still weighing the request as of early April, according to the person and the records. It is not clear whether the agency has since provided ICE with the requested addresses. It is also unclear how many immigrants ICE is seeking addresses for and how much data would be available given that Medicare — the federal health insurance program for people 65 and older, certain people with disabilities and several other vulnerable groups — does not cover undocumented immigrants.

A White House spokesman said the conversations reflect President Donald Trump’s pledge “to protect Medicare for eligible beneficiaries.”

“To keep that promise after Joe Biden flooded our country with tens of millions of illegal migrants, DOGE and CMS are exploring an initiative to ensure that illegal aliens are not receiving Medicare benefits that are meant for law-abiding Americans,” spokesman Kush Desai said in a statement.

CMS declined to comment.

The Trump administration has moved aggressively to gather personal data stored across federal agencies — normally closely held and protected from any outside dissemination — and use it to locate undocumented immigrants where they work, study and live. Such efforts are ongoing at the Department of Housing and Urban Development, where DOGE is targeting mixed-status households in which some members have legal status and some do not, The Post reported this week.

At the Social Security Administration, the Trump administration recently overrode the objections of career staff to list 6,000 living immigrants as dead, in an effort to make them self-deport.

Trump on Tuesday also signed an executive order intended to crack down on undocumented immigrants’ ability to obtain benefits through the Social Security Act, which includes Medicare and other programs. Trump has repeatedly claimed that undocumented immigrants are threatening the solvency of Medicare and Social Security.

“The surge in illegal immigration caused by the previous Administration is siphoning dollars and essential services from American citizens while state and local budgets grow increasingly strained,” the White House wrote in an accompanying fact sheet.

The CMS database that ICE wants to use is known as the Integrated Data Repository, the central archive for claims information through Medicare. It helps the agency craft future policies, ensure payment accuracy and generally monitor the program. It is also shared with law enforcement agencies to track waste, fraud and abuse in the health care system. That database can be used to track down hospitals that are inappropriately billing the Medicare program, but using the database to find addresses of people would be unprecedented, according to a former CMS official, who spoke on the condition of anonymity to talk candidly.

Three DOGE engineers were previously granted read-only access to the database, according to a Trump administration court filing on March 29 related to a lawsuit challenging DOGE’s authority to access federal data. Two of those engineers subsequently had their access disabled, the administration told the court.

It is unclear whether requests have been made for other health programs, such as Medicaid, the safety-net program covering low-income Americans.

More than 68 million Americans are enrolled in Medicare. The health insurance program does not cover undocumented immigrants, so the use of this dataset could have limited value, the official said.

New immigrants who are in the country legally are not eligible for Medicare and can only qualify after they meet certain residency or work history requirements.

“It definitely seems like [the Trump administration] is just mining for this information from whatever government databases they have available to them,” said Juliette Cubanski, a Medicare policy expert at KFF, a nonprofit health care research organization. “It may reflect a lack of understanding of who qualifies for Medicare.”

Trump has repeatedly claimed that undocumented immigrants are using Medicare and Social Security, despite laws that generally bar them from accessing the programs. “They’re filling up and loading up Social Security, Medicare, with illegal immigrants that have come into our country,” Trump said in a Fox News town hall in September, criticizing the Biden administration’s policies.

There are strict rules around who is eligible for the Medicare program, said Jack Hoadley, a research professor emeritus at Georgetown University’s McCourt School of Public Policy. In his spare time, Hoadley helps counsel older adults and those with disabilities on how to sign up for the federal program, and people who are undocumented are not eligible.

“I’d be surprised if they find very many people, at least on the Medicare side, who would fall into these categories,” he said, referring to people who are undocumented.

Tanya Broder, senior counsel for health and economic justice policy at the National Immigration Law Center, a nonprofit that advocates for low-income immigrants, said that she worried the Trump administration’s push to access data from a variety of programs, such as Medicare or Social Security, could turn those programs into “immigration enforcement machines that deter eligible people from getting the services they need.”

She pointed to the first Trump administration’s effort to crack down on granting green cards to legal immigrants if they used public benefits such as Medicaid.

“We saw that when anyone is afraid to use health care — afraid that their privacy or the privacy of their family members could be compromised — then not only will their health be compromised, but the health of entire communities will be at risk,” Broder said. “For people who are receiving Medicare — those are people who are seniors, have disabilities or are vulnerable and need their health care to basically stay alive.”