A proposal to allow the Office of Personnel Management (OPM) to collect the personally identifiable health information of federal employees and their family members has attracted strong criticism due to privacy and security risks, and the potential for HIPAA violations and data misuse.
Per the December 12, 2025, notice about the information collection request (ICR) – Federal Employees Health Benefits (FEHB) and Postal Service Health Benefits (PSHB) Programs Service Use and Cost Data – OPM requires insurance carriers to submit FEHB and PSHB program claims data to OPM. Under the proposal, insurance carriers are required to make monthly submissions of claims-level data, including the protected health information of current and former federal workers and their family members, including personal identifiers. According to OPM, the data will “enable OPM to oversee health benefits programs and ensure they provide competitive, quality, and affordable plans.” While there are clear benefits to be gained from collecting and analyzing the data, such as lowering costs and improving care quality, the proposal has raised significant privacy and security concerns.
The Trump administration is seeking unprecedented access to workers’ medical information– information protected under the Health Insurance Portability and Accountability Act (HIPAA). The data being sought is not government data; it is protected health information maintained by HIPAA-regulated entities. Information submitted to OPM under the proposal would populate a government database, but OPM has failed to fully explain exactly how that information will be used, maintained, and protected. As such, there are legitimate concerns that the requested data may be used for reasons other than the stated purpose, especially given the Trump administration’s attempts over the past 12 months to obtain personal information from the Social Security Administration and the Internal Revenue Service.
“OPM is collecting service use and cost data from FEHB and PSHB Carriers, including medical claims, pharmacy claims, encounter data, and provider data. This data will enable OPM to oversee health benefits programs and ensure they provide competitive, quality, and affordable plans,” explained OPM in the notice. “OPM requires Carriers to report necessary information and permit audits and examinations to manage the FEHB Program effectively.”
In the notice, OPM explains that under HIPAA, covered entities such as health plans are permitted to disclose protected health information – including service use and cost data – to health oversight agencies, including OPM, for oversight activities authorized under 45 CFR 165.512(d)(1). The notice calls for 65 carriers to make ongoing, monthly submissions of claims-level data and quarterly manufacturer rebate data for federal employees and retirees. The carriers hold data for more than 8 million Americans, including federal workers, mail carriers, retired members of Congress, and their immediate family members.
The use of such broad terms for data categories has set alarm bells ringing. OPM will potentially be provided with a huge volume of sensitive, personally identifiable information, including information about treatments sought and received. Encounter data, for instance, could potentially encompass full medical records and doctors’ notes, information over and above what is necessary for the stated health oversight activities.
De-identified data could potentially be used to achieve the stated purpose, but OPM makes no mention of stripping out personal identifiers. As such, there are legitimate concerns from privacy groups that OPM could create a huge database of highly sensitive information that could easily be misused. For instance, for targeting specific employees based on the healthcare services they sought and received, or assisting the administration with its DEI, gender-affirming care, and reproductive health care initiatives, or any other healthcare services being targeted.
Aside from the potential for data misuse, the proposal will create significant compliance and legal risks for the carriers. OPM states in the notice that the HIPAA Privacy Rule permits disclosures of protected health information for health oversight activities, but requests a broad swathe of protected health information, the provision of which will likely violate the minimum necessary standard. The minimum necessary standard – 45 CFR 164.502(b), 164.514(d) – applies to data disclosed for health oversight activities. “When using or disclosing protected health information or when requesting protected health information… a covered entity or business associate must make reasonable efforts to limit protected health information to the minimum necessary to accomplish the intended purpose of the use, disclosure, or request.”
In its current form, the proposal lacks detailed information about the purpose for the disclosure, and the broad categories of data requested will require carriers to walk a HIPAA compliance tightrope. While the Trump administration may have no intention of enforcing HIPAA compliance regarding the OPM data disclosures, future administrations may take an entirely different view, and the data disclosures will expose carriers to significant legal risk. It is currently unclear how carriers intend to comply with the proposal.
While HIPAA permits disclosures of protected health information for health oversight activities, they are not required disclosures under HIPAA. Carriers may choose to only disclose information that they deem appropriate and necessary, although, without further detail about the exact purposes for the disclosures, it will be difficult to determine what information is appropriate and necessary, and the compliance and administrative burden would be significant.
In addition to concerns about protected health information being provided to the government and how that information will be used, concerns have been raised about OPM’s ability to protect a database of highly sensitive protected health information, given the extent to which government entities are targeted by threat actors, and OPM’s and the Trump administration’s history of safeguarding sensitive data. OPM experienced two massive data breaches in 2015, one involving the personal information of 4.2 million current and former federal employees and another involving the theft of the personal records of more than 22 million Americans. The Chinese government is alleged to have been behind the attacks.
The proposal has attracted significant criticism. The Association of Federal Health Organizations (AFHO) points out that this is not the first time that OPM has sought to establish a healthcare claims data warehouse, having made a similar proposal in 2010. The same HIPAA compliance concerns that were voiced 16 years ago still apply to the latest proposal. AFHO had argued that only de-identified data should be shared; however, today, the sharing of de-identified data with OPM carries significant compliance risks. AFHO is concerned that, given the detailed information OPM already has on enrolees and their family members, there is a risk that de-identified data could be re-identified, and the HIPAA Privacy Rule does not permit the sharing of de-identified data when there is a risk of reidentification. AFHO suggests an agreement between OPM and the CMS to use the CMS edge server system to query data, thereby eliminating the risk of re-identification, or to enter into a contract with the Health Care Cost Institute, which could translate raw data into actionable insights.
Robert H. Shriver, III, Managing Director of Civil Service Strong, a project of Democracy Forward Foundation, voiced strong opposition to ICR. Specifically, due to the failure of OPM to justify the proposed data collection and clearly state exactly how the data will be used, the failure to explain how data will be safeguarded, and the risk of data abuse. “OPM’s ICR is especially concerning given the Trump-Vance Administration’s explicit contempt for federal workers and its pattern of recklessness with highly sensitive data,” wrote Shriver in comments in response to the ICR notice. He said the Trump administration has demonstrated that it cannot be trusted with sensitive data, citing the recent admission by the Trump administration that sensitive Social Security Administration data was sent to unauthorized individuals, shared on nongovernmental servers, and, through DOGE activities in particular, it is “playing fast and loose with government data.”
Jonathan Foley, a former OPM employee who advised on the FEHB program under the Obama and Biden administrations, believes there are valuable benefits to be gained from collecting and analysing personally identifiable data, but warned of the considerable potential for data misuse and the privacy risks. In his comments in response to the notice, Foley said the Trump administration has a poor record of properly handling sensitive information and has attempted to link identifiable data across federal programs and use it for reasons unrelated to the original purpose for which the data was collected. Foley suggests that de-identified data could be collected and maintained by a trusted entity other than OPM, with guardrails preventing federal authorities from demanding direct access to the data from that trusted entity. CVS Health suggests that OPM should convene a stakeholder working group to determine the specific data elements required to support the requested goals and to establish a consistent reporting framework.
Most recently, on April 17, 2026, a group of 16 Democratic members of the House Oversight Committee wrote to OPM Director Scott Kupor and Office of Management and Budget Director Russell Vought, calling for the withdrawal of the proposed plan due to the potential for data misuse, HIPAA violations, and concern that OPM lacks the necessary safeguards to responsibly protect sensitive data. “More than 8 million Americans receive health insurance under the FEHB and PSHB programs, including federal workers, mail carriers, and their immediate family members. They should be able to make medical decisions in consultation with their doctors—not the federal government,” wrote the senators. “We therefore demand that OPM halt all plans to collect private health insurance data and provide a briefing on the decision to enact this policy.” The senators have asked the Directors to explain the decision to obtain such an expansive dataset without any guardrails or protections for employee privacy.
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