Medicaid can share data with ICE. Here's how that 180-degree change spreads fear
Health
Medicaid can share data with ICE. Here's how that 180-degree change spreads fear
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Alex Olgin
Medicaid can share data with ICE. Here’s how that 180-degree change spreads fear
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Dr. Acklema Mohammad checks a patient at El Nuevo San Juan Health Center in the Bronx in New York City in 2024. Community health clinics, like this one, are often located in immigrant communities and rely on Medicaid. Eduardo Munoz Alvarez/AP hide caption
For decades, people applying for Medicaid were told their personal information — including their names, addresses and immigration status — would not be used for immigration enforcement.
But a December court ruling changed that. And that change has sent ripples of fear through families and communities.
"My daughter's life depends on Medicaid," says P., who asked that NPR identify her by her first initial only.
P. and her family have legal immigration status, but she fears that the health insurance keeping her medically fragile daughter alive could also put her family at risk of being detained or deported by immigration authorities.
For decades Medicaid promised eligible immigrants they wouldn't share information with immigration authorities. It was even explicitly written on government websites. Those commitments are no longer on the Medicaid website.
The promise was meant to assure eligible immigrants "to feel comfortable that they can access their care without fear of putting their immigration status into jeopardy," says Cindy Mann, who oversaw Medicaid during the Obama administration and now works at the legal and consulting firm Manatt Health.
Mann calls the change, which the Trump administration began quietly last year, a "180-degree reversal of longstanding policy."
"Anxiety every day"
P.'s 11-year-old daughter has Rett Syndrome, a rare neurological condition that makes it hard for her to eat, breathe, walk and talk.
"She receives in-home support," P. says, along with frequent visits to cardiologists, pulmonologists and other specialists. "She also receives [physical therapy], [occupational therapy], speech, aquatic therapy on a weekly basis."
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All this care would cost tens of thousands of dollars without Medicaid — the joint state and federal health insurance program for more than 70 million people with low-incomes or disabilities.
P. says she and her husband are allowed to work in the U.S. legally and have private health insurance through their jobs. They have two children who qualify for Medicaid coverage because of disabilities.
"It brings us an amount of anxiety every day," P. says. She's had friends detained by immigration authorities and she worries about her family's safety. This is the case even though everyone in P.'s family has legal status, including two of their children who are citizens.
Unusual requests
Twenty-two states have sued to stop federal health agencies from sharing Medicaid data with the Department of Homeland Security, including Arizona, Michigan and New Jersey. At the moment, following the December ruling in federal court in San Francisco, Medicaid can share names, addresses and other identifying information for people who are in the country unlawfully with immigration officials. In the remaining 28 states including Texas, Kentucky and Utah, there are no limits on what Medicaid data can be shared with Immigration and Customs Enforcement and other entities.
Some other recent federal actions are raising new alarms.
An employee in Rayito de Sol Spanish Immersion preschool in Chicago was taken into federal custody on Nov. 5, 2025. Immigration enforcement at schools and hospitals was against policy under previous presidents. Here, two parents console each other. Erin Hooley/AP hide caption
One former state Medicaid director told NPR they received what they described as a highly unusual request from the federal government in summer 2025 — a list of mostly Latino-looking last names, with instructions to check only immigration status.
The director, who spoke on condition of anonymity because they were not authorized to discuss federal communications, said that's not how these reviews typically work. Usually, states are asked to review all criteria — income, disability and immigration status — to determine eligibility for the program, not single out one factor.
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The director says they were floored. After reviewing the cases, they found everyone on the list remained eligible to continue with Medicaid.
Last August, the federal agency that oversees Medicaid, the Centers for Medicare & Medicaid Services (CMS), started a new initiative to review immigration status of Medicaid enrollees. The agency said in a press release it would start sending monthly enrollment reports with names of people it needed states to verify.
Choosing between care and fear
At Venice Family Clinic in Los Angeles, staff say patients are increasingly asking whether it's safe to remain on Medicaid.
Pattie Lopez manages the clinic's health insurance department. She says one patient became so worried about the policy change that she dropped her coverage — only to return after struggling without it.
"She found it incredibly hard to go without health coverage," Lopez says. "Now she's here taking a risk because she needs her medication."
Venice Family Clinic is qualified to receive special federal funding to take care of vulnerable communities, and 80% of its 45,000 patients rely on Medicaid. If people drop coverage but still need care, the clinic could face financial strain. It has already frozen hiring and is looking for other ways to cut costs.
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Andrew Cohen, an attorney with Health Law Advocates in Massachusetts, said that for people already enrolled in Medicaid or other programs, the federal government likely has their information already.
"So remaining on coverage may be no additional risk," he said. "But there are instances where it may not be safe for everybody."
Some immigrants may be weighing whether to sign up or continue coverage. For P., though, walking away from Medicaid isn't possible.
"We don't have any other option," she says about dropping coverage for her severely disabled daughter. "We will have to risk that."
Without the coverage, she says, it's her daughter's life that would be at risk.
OpenAI’s adult mode will reportedly be smutty, not pornographic
The feature was delayed, reportedly due to internal concerns surrounding moderation and safeguarding children.
The feature was delayed, reportedly due to internal concerns surrounding moderation and safeguarding children.
OpenAI’s delayed “adult mode” for ChatGPT is expected to support saucy text conversations at launch, but not the chatbot’s ability to generate images, voice, or video. Speaking to The Wall Street Journal, an unnamed OpenAI spokesperson described content that will be provided by the upcoming feature as smut rather than pornography, allowing ChatGPT users to generate textual chats with adult themes.
The feature was initially announced in October, with OpenAI CEO Sam Altman claiming that the company had managed to mitigate enough of the “serious mental health issues“ with its AI model to relax safety restrictions and introduce “erotica for verified adults.” ChatGPT’s adult mode was expected to launch sometime this quarter, but OpenAI said earlier this month that it was delaying the rollout to focus on higher-priority tasks. A new release timeline has yet to be announced.
The delay was also due to internal concerns and technical challenges around safeguards for the feature, according to The Wall Street Journal’s reporting. A council of advisors selected by OpenAI warned the company in January that ChatGPT’s adult mode may be accessible to children and foster unhealthy emotional dependence on the chatbot, with one unnamed council member saying OpenAI risked creating a “sexy suicide coach.”
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Content moderation issues have also contributed to the delays. Sources familiar with the matter told The Journal that OpenAI is struggling to lift ChatGPT’s restrictions on NSFW content while keeping more harmful scenarios off limits, such as those depicting nonconsensual behavior or child sexual abuse.
The age-prediction system that OpenAI developed to keep children away from erotica was also, at one point, misclassifying minors as adults about 12 percent of the time. Given ChatGPT attracts around 100 million users under 18 each week, that error rate could allow millions of minors into sexualized conversations with the chatbot. OpenAI’s age prediction algorithms show similar performance to the rest of the industry, an unnamed spokesperson told The Journal, but “will never be completely foolproof.”
Sticking to text-based conversations may make it easier for the ChatGPT-maker to navigate around rules like the UK’s Online Safety Act, which requires online platforms to enforce age verification for pornographic images, but not written erotica. It also contrasts with more visual NSFW experiences from rival AI providers, such as Grok’s “spicy” companions, with xAI’s Elon Musk announcing last week that Grok’s image and video generator is allowed to spit out anything that’s “allowed in an R-rated movie.”
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2026 Oscars Analysis: How ‘One Battle’ Beat ‘Sinners,’ Jordan Overcame Chalamet and Penn Won Without Doing Anything
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An awards season that often felt like an endurance test — talk about one battle after another — came to an end on Sunday evening with the 98th Academy Awards. The results at the Dolby Theatre in Hollywood confirmed that even though the Academy has changed significantly over the decade since it was rocked by #OscarsSoWhite — its membership today includes way more non-males, non-whites, non-Americans and non-AARP-members than ever before — the statistics that have long offered clues about Oscars outcomes remain dependable.
Indeed, despite all the talk of a late Sinners surge, One Battle After Another still won the top prize, best picture, just as it did at every other notable awards ceremony this season — from the Gothams to the Golden Globes to the guilds, not to mention all the major critics groups, plus the BAFTA Awards — save for the Actor Awards (formerly the SAG Awards) two weeks ago.
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It was easy to get swept up in the excitement of Sinners’ best cast win at the Actor Awards — the reaction in the room was exuberant — but that prize has a terrible track record of predicting the best picture Oscar (now just 15 of 32 times). The fact that the best cast Actor Award did presage several of the biggest best picture Oscar surprises of yesteryear (including Shakespeare in Love, Crash and Parasite), and that this year’s Actor Awards took place in the middle of the final round of Oscars voting, unfortunately gave Sinners supporters false hope.
Why did Paul Thomas Anderson‘s film prevail over Ryan Coogler‘s when both were Warner Bros. releases that skipped the festival circuit, went directly to movie theaters and proved to be darlings of critics and audiences alike, and when Sinners grossed more money and landed more Oscar nominations (16 — two more than the previous all-time record — versus 13)? Let’s unpack that…
For one thing, being the most Oscar-nominated film of the year has limited significance. In the past decade, it didn’t help Emilia Pérez against Anora, The Power of the Dog against CODA, Mank against Nomadland, Joker against Parasite, The Favourite and Roma against Green Book, La La Land against Moonlight or The Revenant against Spotlight. And this year, you couldn’t fault One Battle for not having an original song or much in the way of makeup/hairstyling or visual effects, the three categories in which Sinners landed noms but One Battle did not. Both films got nominated for everything they could have realistically hoped for (minus One Battle’s newcomer Chase Infiniti in the crowded best actress race).
Additionally, One Battle had genre on its side. In the post-#OscarsSoWhite era, the Academy has embraced a wider assortment of films than ever before, rendering moot the notion of an “Oscar movie” by awarding best picture to The Shape of Water, Parasite and Everything Everywhere All at Once. But a zombies-centric film — up against a dramedy/thriller — was perhaps a bridge too far for even a hipper Academy.
Most significantly, I think, One Battle was a major work — if not the best work — of a filmmaker widely regarded as overdue for recognition, not unlike The Departed (Martin Scorsese) or Oppenheimer (Christopher Nolan). Indeed, prior to One Battle, Anderson was already well-established as one of the greatest filmmakers of his generation — see Boogie Nights, Magnolia, Punch-Drunk Love, There Will Be Blood, The Master and Phantom Thread, in particular — and yet had gone 0-for-11 at the Oscars. One Battle provided voters with a sufficient excuse to right that wrong.
On Sunday, it became clear pretty early in the show that Sinners’ best picture prospects were in trouble. If the film had the juice to topple One Battle, then that probably would have manifested itself in the race for best supporting actress, but Sinners’ Wunmi Mosaku came up short; shortly thereafter, it lost the inaugural Oscar for best casting — which every pundit of note had predicted it to win — to One Battle, no less; and by the time Sinners’ Delroy Lindo lost best supporting actor to one of the two One Battle nominees in that category, the cake was baked.
Fortunately, both films’ auteurs got moments in the sun — Anderson won best adapted screenplay and Sinners‘ Ryan Coogler won best original screenplay back-to-back before Anderson claimed best director and best picture later in the night. Plus, both films took home acting awards (best actor for Sinners and best supporting actor for One Battle) and craft awards (casting and film editing for One Battle, cinematography and original score for Sinners). The final score: One Battle 6, Sinners 4.
Speaking of the acting awards, though, it must be noted that the Actor Awards were, in fact, the only awards group to presage all four of this year’s individual acting Oscar winners: Hamnet’s Jessie Buckley for best actress, Sinners’ Michael B. Jordan for best actor, Weapons’ Amy Madigan for best supporting actress and One Battle’s Sean Penn for best supporting actor.
It’s interesting that a group comprised only of actors (SAG-AFTRA, all 160,000 members of whom vote for the Actor Awards winners) and a group in which actors account for less than 12% of all voters (the Academy) both responded not only to the same performances, but to performances that might be described as Acting with a capital A: Buckley playing a grieving mother who wails upon losing a child and seems possessed by a theatrical production; Jordan playing twins with very different personalities; Madigan chewing scenery in clown makeup; and Penn sporting an erection and a glass eye.
They all took very different paths to their wins.
Penn did not campaign or show up for any award shows except the Golden Globes, but gave such a memorable performance — and, despite being a difficult guy, is so highly regarded as an actor — that he still won BAFTA and Actor Awards en route to Academy members catapulting him into its rarified club of three-time male acting Oscar winners (the only other members of which are Walter Brennan, Jack Nicholson and Daniel Day-Lewis).
Penn was up against formidable talents, including two septuagenarian first-time nominees, Sentimental Value’s Stellan Skarsgård and Sinners’ Lindo. But a path to victory was always going to be tough for a performance not in English (Skarsgård would have been the first such winner in the supporting actor category) and/or a performer who wasn’t even nominated for any other major award (Lindo hoped to follow in the 25-year-old footsteps of Marcia Gay Harden, the only person who has ever overcome that stat).
Madigan, meanwhile, won early in the year at the Critics Choice Awards, in something of a surprise — many were still predicting Wicked: For Good’s Ariana Grande at the time — and only continued to build goodwill between then and the Actor Awards, when she won again.
To be sure, the other precursors were all over the place, with Sinners’ Mosaku winning BAFTA, One Battle’s Teyana Taylor winning the Golden Globe and Sentimental Value’s Inga Ibsdotter Lilleaas winning some big critics prizes. And it was a bit disconcerting that Madigan was her category’s only nominee whose film wasn’t also up for best picture.
But what proved to be more important is that she has been in the business forever (her prior Oscar nom came 40 years ago, before any of her fellow supporting actress nominees were even born), knows and is known by everyone (whereas most people had not even heard of three of her four fellow nominees a year ago) and is one-half of a great Hollywood couple (not unlike another veteran who won the same Oscar for another horror film 57 years ago, Rosemary’s Baby’s Ruth Gordon).
As for Jordan, he initially seemed to be trailing Marty Supreme’s Timothée Chalamet, given that won at the Critics Choice and Golden Globe awards — but those two prizes were determined solely by journalists, of which there are virtually none in the Academy. The Academy clearly preferred Sinners to Marty Supreme — Marty Supreme ended up going 0-for-9 at the Oscars, a worse shutout than all but five films ever, The Turning Point (0-for-11), The Color Purple (0-for-11) Gangs of New York (0-for-10), the 2010 True Grit (0-for-10) and American Hustle (0-for-10). And many individual members said they were repelled by the character Chalamet played in the film.
Additionally, it seems that the best actor race was jolted, in the homestretch, by a variety of factors, from Chalamet’s unconventional approach to campaigning, which rubbed many the wrong way, to the terribly unfortunate incident that occurred while Jordan and Lindo were presenting at the BAFTA Awards, which evoked from many sympathy and admiration. Plus, seeing Jordan win the best actor Actor Award in the middle of the Oscar voting window presented to Academy members a clear and appealing alternative to Chalamet.
Buckley, meanwhile, was a no-doubter from the moment her film premiered at the Telluride Film Festival. Even people who disliked Hamnet liked her performance and her, and why not? In addition to being a tremendously gifted actress, she is also one of the most genuine and lovely people I encountered all season long. And my guess is that the Irishwoman, at just 36, will soon be back in the hunt for a sibling for her new statuette.
Elsewhere, best documentary feature went to the team behind Kino Lorber’s powerful Mr. Nobody Against Putin (my tablemates at the Oscar Nominees Luncheon) over another equally affecting exposé, Netflix’s The Perfect Neighbor. But Netflix dominated the remaining categories, picking up best costume design, makeup/hairstyling and production design for Frankenstein; for KPop Demon Hunters, the most watched original film in its history, best animated feature and original song (“Golden”); best documentary short for All the Empty Rooms; and for The Singers, which the company was smart enough to acquire — probably for a pittance — late in the season, best live action short (in a tie with Two People Exchanging Saliva). The streamer’s total tally of seven matches a company-best (first achieved five years ago).
Some final takeaways?
I thought that this year’s telecast, like last year’s, was very solid, highlighted by returning-host Conan O’Brien’s amiable emceeing; a skillfully executed In Memoriam segment (although the omission of Brigitte Bardot was inexcusable); the Sinners and KPop Demon Hunters performances; and the suspenseful presentations and gracious acceptances of the big awards. Also, kudos to Kumail Nanjiani for his deft handling of the potentially treacherous terrain of a tie (only the seventh in Oscars history, 13 years after the sixth, which I remember witnessing in 2013).
My only quibbles with the show: the Marvel “reunion” was overhyped (just Robert Downey Jr. and Chris Evans?); the playing-off of winners was handled poorly for the second year in a row; and a bunch of presenter decisions seemed off to me. Bill Pullman and Lewis Pullman are fine talents, but don’t rise to the level of accomplishment or familiarity that would merit being Oscars presenters; Robert Pattinson and Zendaya were odd choices to present best director, as opposed to, say, recent winner and current Directors Guild president Christopher Nolan; and as much as I love Ewan McGregor and Nicole Kidman, I’m not sure that the 25th anniversary of Moulin Rouge!, a film to which the Academy awarded only two Oscars (art direction and costume design), merited having them co-present best picture. (I wonder if they tried Tom Cruise, one of this season’s honorary Oscar recipients?)
I’ll close with a few personal notes. (1) I was very pleased that the final Feinberg Forecast of the season correctly projected 21 of 24 categories, including all of The Big Eight and all three shorts. (2) I was heartened to see so many past guests of my podcast Awards Chatter take home Oscars, among them Jordan, Buckley, Penn, Madigan, Sentimental Value’s Joachim Trier, All the Empty Rooms’ Joshua Seftel and KPop Demon Hunters’ EJAE. I thank them for their time, and encourage you to subscribe — for free — if you haven’t already done so. (3) And lastly, I want to thank my THR colleagues, readers/listeners and friends/family for their support over the course of this whole season — it was a grueling but mostly enjoyable ride that ended with my 15th trip to the Oscars, a privilege that I do not take for granted. And now… sleep!
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