Ethics and federal law hold that your medical records should be private, but President Trump’s ongoing campaign for mass deportation has started to tear down that wall. There are unnerving consequences, not just for undocumented immigrants, but for every American with health insurance.

On July 9, 404 Media reported that the federal Immigration and Customs Enforcement (ICE) is utilizing a vast insurance and medical billing database called ISO ClaimSearch to hunt for people to deport. “Traditionally ISO ClaimSearch is used by insurers to identify people committing fraud or police to recover stolen vehicles,” wrote 404 Media cofounder Joseph Cox. “Now, that database is being repurposed as a deportation tool.”

Under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), law enforcement usually needs a warrant, court order or subpoena to access a patient’s medical records. However, ICE has taken advantage of a legal loophole by obtaining insurance claims data from third-party clearinghouses and data brokers. By accessing these alternative channels, federal agents can avoid legal protections designed to safeguard patient privacy.

There’s little reason, though, to think this tactic will be particularly useful in directly targeting individuals without legal status. Half of all likely undocumented immigrant adults don’t even have health insurance, according to estimates by the Kaiser Foundation. In contrast, 8% of U.S.-born adult citizens are uninsured.

Meanwhile, those undocumented immigrants who do have health insurance are likely making cash payments; or they’re relying on emergency services or federally qualified health centers. Those approaches typically don’t generate traditional insurance claims.

But even if these insurance databases aren’t particularly helpful for finding people directly, ICE could be using the data in other ways.

Consider a married couple where one person has legal status and uses their insurance to cover a spouse who lacks legal status. ICE could use ISO ClaimSearch data to uncover such mixed-status households and deport that undocumented husband or wife.

Moreover, ICE’s very use of ISO ClaimSearch to go after a large segment of the immigrant community is already having a chilling effect, causing those not in legal status to avoid seeking needed medical care.

One of us (Singer) is a general surgeon in Phoenix, Arizona — home to the fourth-largest Hispanic population in the country. Recently, he and his medical assistant noticed a decline in the number of Spanish-speaking patients visiting the clinic. It seems that word is spreading about ICE using insurance claims data to track, arrest and deport people who seek medical care. As fear spreads, even U.S. citizens and legal immigrants may now be avoiding doctor visits.

Expect to see similar trends in Harris County, where nearly one in four residents is foreign-born and many live in mixed-status households. If ICE can access claims databases, millions in the Houston area risk having their medical records used for immigration enforcement. That kind of breach doesn’t just threaten privacy — it discourages entire families from seeking care.

Doctors have an ethical duty to protect patient confidentiality. When patients no longer trust that what they share stays private, they may withhold important information — or stay away entirely. That undermines doctors’ ability to diagnose and treat them.

The danger isn’t just personal. If people with contagious, potentially deadly diseases avoid seeking care out of fear of ICE, they put all of us at risk. One infected, untreated person can spark an outbreak.

ICE’s use of these databases serves as a stark reminder that tools designed for legitimate purposes, such as detecting insurance fraud, can be quietly turned into instruments of surveillance. ICE’s misuse of medical claims data not only threatens undocumented migrants but also, by eroding trust in the public health system, endangers all Americans.

Policymakers must close these loopholes and set a clear boundary: Health care is for healing, not for hunting.