Your Medicaid Enrollment Just Became a Deportation Database

The Tool That Turns Healthcare Into Targeting

Immigration and Customs Enforcement is now using a Palantir application called ELITE—Enhanced Leads Identification & Targeting for Enforcement—to map deportation targets across America. The tool pulls addresses directly from Department of Health and Human Services data, including Medicaid enrollment records.

According to reporting from 404 Media, ELITE "populates a map with potential deportation targets, brings up a dossier on each person, and provides a confidence score on the person's current address." Senator Ron Wyden compared the app's ease of use to finding a coffee shop on your phone.

On January 5, 2026, a federal judge ruled that HHS can share this data with ICE, rejecting a legal challenge brought by 20 state attorneys general. The ruling authorizes sharing of citizenship status, addresses, phone numbers, dates of birth, and Medicaid ID numbers. Health information remains protected—for now.

How Confidence Scores Replace Probable Cause

ELITE assigns each target a numerical confidence score from zero to 100, indicating how likely it is that someone lives at a given address. ICE agents use these scores to determine whether a location is "worth attempting to serve an administrative arrest warrant."

Court testimony from an ICE agent in Oregon revealed that the tool helps identify "target rich" locations—neighborhoods where many potential targets are clustered. Since June, 21 "major" ICE operations have resulted in 6,852 apprehensions, according to leaked government documents.

This represents a fundamental shift in enforcement methodology. Rather than investigating specific individuals based on probable cause, ELITE enables neighborhood scale deployment based on algorithmic probability. The system favors operational efficiency over constitutional safeguards.

The Death of Data Silos

The Electronic Frontier Foundation's executive director Cindy Cohn calls this approach "a throwback to the rightly mocked Total Information Awareness plans of the early 2000s that were, at least publicly, stopped after massive outcry."

The original Total Information Awareness program, proposed after 9/11, sought to consolidate government databases into a single searchable system. Public outrage killed it. Two decades later, the same concept has returned under different branding.

"While couched in the benign language of eliminating government data silos," Cohn wrote, "this plan runs roughshod over your privacy and security."

Palantir's business model depends on breaking down barriers between databases that were intentionally separated. There are good reasons why IRS data was never linked with immigration records and social media data. Palantir's software eliminates those firewalls, creating opportunities for surveillance that would have been technically impossible a decade ago.

The company has received more than $900 million in federal contracts since the current administration took office. ICE alone awarded Palantir $30 million for ImmigrationOS, a broader surveillance platform that ELITE feeds into.

The Chilling Effect on Healthcare

Public health officials have long warned that linking healthcare data to immigration enforcement would deter people from seeking medical care. When signing up for health insurance means potentially appearing on a deportation map, many will choose to stay uninsured.

The implications extend beyond immigration. If healthcare enrollment data can be repurposed for enforcement, what about other government databases? Tax records, driver's licenses, school enrollment, utility bills—each represents another potential data source for surveillance tools like ELITE.

The precedent matters more than the immediate application. Once the legal and technical infrastructure exists to consolidate government data for one enforcement purpose, expanding it to others becomes trivially easy.

What You Can Do

The EFF has pursued multiple legal challenges against these programs, including amicus briefs challenging ICE's access to Medicaid data and lawsuits against mass surveillance programs. But litigation alone cannot stop the expansion of government surveillance infrastructure.

For those concerned about data privacy:

• Understand your data footprint. Every interaction with government services creates records that could potentially be linked to other databases.
• Support organizations fighting surveillance. Groups like EFF, ACLU, and the American Immigration Council are challenging these programs in court and advocating for legislative limits.
• Contact your representatives. Congressional action remains the most effective way to restrict data consolidation programs and restore meaningful privacy protections.

The transformation of healthcare enrollment into a deportation database represents a fundamental shift in the relationship between citizens and their government. When data collected to help you access medical care can be weaponized against you, the very concept of public services becomes compromised.

The question is not whether this technology will be used. It already is. The question is whether it will be constrained—or whether the elimination of data silos will continue until no corner of American life remains outside the surveillance state's reach.