The Trump administration is pursuing what health policy experts describe as unprecedented access to the medical records of millions of federal employees, retirees, and their family members. A notice from the Office of Personnel Management, sent to insurers in December, instructs 65 insurance companies to provide monthly reports containing identifiable health data on more than 8 million Americans enrolled in federal health benefits plans.
The data requested includes medical claims, pharmacy claims, encounter data, and provider information — meaning OPM could potentially see what prescriptions employees filled or what treatments they sought from their doctors. The notice states that the data will help "ensure they provide competitive, quality, and affordable plans." But it does not instruct insurers to redact identifying information, according to a detailed investigation by KFF Health News.
That omission has set off alarms. "They are going to get very, very detailed and granular data about everything that happens," said Sharona Hoffman, a health law ethicist at Case Western Reserve University. "The concern here is the more information they have, they could use it to discipline or target people who are not cooperating politically."
The request arrives against a backdrop of mass federal layoffs and firings, with some employees alleging political retaliation. The administration has also repeatedly tested legal boundaries around sharing sensitive personal data across government agencies for immigration enforcement and fraud investigations. Michael Martinez, senior counsel at Democracy Forward, which filed a public comment opposing the proposal, warned of scenarios where health information on millions of Americans could be misused once in OPM's hands.
OPM spokespeople did not respond to repeated requests for comment. Several legal and health policy experts consulted by KFF Health News interpreted the request as seeking identifiable rather than anonymized data, raising serious questions about both legality and data security. For now, insurers and advocacy groups are watching closely to see whether the administration moves forward — and what safeguards, if any, would accompany such a massive collection of sensitive health information.
