In a win for President Donald Trump’s immigration crackdown, a recent court ruling has cleared the way for U.S. Immigration and Customs Enforcement to resume using states’ Medicaid data to find people who are in the country illegally.

The case is ongoing. But for now, immigrants — including those who are in the country legally — will have to weigh the benefits of gaining health coverage against the risk that enrolling in Medicaid could make them or their family members easier for ICE to find.

Last summer, 22 states and the District of Columbia sued the Trump administration to block information sharing between ICE and Medicaid, the state-federal health insurance program that primarily covers people with low incomes. But at the end of December, a federal judge ruled that ICE can pull some basic Medicaid data to use in its deportation proceedings, including addresses, phone numbers, birth dates and citizenship or immigration status.

The court ruled that in the states that sued, ICE is not allowed to collect information about lawful permanent residents or citizens, nor records about sensitive health information. In the 28 states that didn’t sue, however, the court did not place any limits on the Medicaid information ICE can access.

The U.S. District Court in San Francisco essentially said that government agencies can share some data, including basic identifying information. “That kind of data sharing is clearly authorized by statute,” the decision states.

But the court also ruled that agencies can’t share more sensitive data without adequately explaining why they need it. In his ruling, U.S. District Judge Vince Chhabria wrote that ICE and federal Medicaid information-sharing policies were “totally unclear and do not appear to be the product of a coherent decisionmaking process.” He said the states had shown they would “suffer irreparable harm from these vague and likely overbroad” policies.

By law, federal Medicaid money cannot be used to cover people who are in the country illegally.

But in recent years, nearly half of states, including some led by Republicans, have chosen to use their own Medicaid money to extend coverage to certain groups of people, such as children and pregnant women, regardless of immigration status.

Advocates for immigrants and some state officials worry that ICE’s use of Medicaid data will cause widespread fear among immigrant families, keeping them from seeking the health care that states have said they’re eligible to receive. California’s health department recently called the administration’s actions “a grave breach of public trust.”

“States have constantly reassured people that their health care information won’t be used against them, and that’s changed,” said Tanya Broder, senior counsel for health and economic justice policy at the National Immigration Law Center, an advocacy organization focused on immigrant rights.