ICE is getting unprecedented access to Medicaid data

Original Article ↗ Hacker News Discussion ↗

Executive Power, Courts, and Eroding Checks

  • Many see ICE’s access as part of a broader executive “power grab,” enabled by decades of expanding presidential authority (Cold War, post‑9/11, Nixon/Reagan precedents).
  • Several comments argue Congress has largely ceded power; budget increases and new authorities turn ICE into a de‑facto domestic security force.
  • Sharp disagreement over the Supreme Court: some say it is a partisan tool enabling executive lawlessness (e.g., immunity, blocking Biden’s loan relief); others reply that the core problem is bad statutes, not the Court, whose job is to apply existing law.

Non‑Citizens, Constitutional Rights, and Due Process

  • Multiple commenters insist most constitutional protections apply to “persons,” not just citizens; others point to laws like the Privacy Act and Patriot Act that explicitly limit protections.
  • There is detailed discussion of “expedited removal”: originally narrow, then progressively expanded, cited as a textbook slippery slope once due process is denied to any category.
  • Some warn that once the state can deport people without meaningful process, it can misclassify even citizens; others counter that courts and evidentiary standards still exist.

Why ICE Wants Medicaid Data & HIPAA Questions

  • Confusion arises because Medicaid is generally for citizens/permanent residents. Participants note:
    • “Qualified non‑citizens,” emergency Medicaid, and state‑funded expansions (e.g., for undocumented children, pregnant people, full coverage in some states).
    • Use cases: identifying undocumented enrollees, relatives of citizen children on Medicaid, or cross‑state inconsistencies and fraud.
  • HIPAA’s law‑enforcement carve‑outs are cited as the legal hook; critics say this shows how weak those protections are when “administrative requests” suffice.

Databases, Surveillance, and Historical Echoes

  • Strong concern that any centralized list (health, immigration, etc.) will be repurposed—today for immigrants, tomorrow for the poor, dissenters, or minorities.
  • Comparisons are made to WWII internment and Gestapo/Stasi‑style list‑building and “disappearances,” with some warning this is a first run at secret police.
  • Others argue LE access to data is long‑standing (e.g., used against CSAM) and not unique to this administration, though abuse risk is widely acknowledged.

Partisan Blame and “Both Sides”

  • Some frame this as uniquely driven by current GOP leadership and an explicitly nativist agenda; others emphasize bipartisan responsibility for building the tools.
  • There is recurring tension between “both parties are the same” cynicism and pushback that current deportation plans and rhetoric mark a qualitative escalation.