In July, the Trump administration unveiled two policies: the “Making Health Technology Great Again” initiative and the executive order “Ending Crime and Disorder on America’s Streets.” At first glance, one seems aimed at health care modernization and the other at public safety. But beneath their branding lies a shared infrastructure (and agenda) that poses a profound threat to the civil rights, privacy and bodily autonomy of millions of Americans.

Taken together, these policies are not just reforms. They are the building blocks of a techno-carceral state, where health data becomes a tool of surveillance, disability is cast as disorder and care becomes indistinguishable from control.

The health technology initiative, launched through the Centers for Medicare & Medicaid Services (CMS), invites beneficiaries to opt in to a digital ecosystem that aggregates their health data, from medical records to app-tracked wellness metrics and insights generated by artificial intelligence. The program operates within the machinery of the Department of Government Efficiency (DOGE) — a centralized federal database with broad access to other records. That means health data could be used alongside criminal justice, education, housing and welfare data to construct predictive profiles of risk.

Meanwhile, the executive order on crime mobilizes federal, state and local agencies to use predictive analytics and AI to identify potential threats and maintain public order. It explicitly calls for cross-agency coordination and urges the integration of behavioral, health and welfare data to assess who might pose a risk before a crime is ever committed.

In effect, both policies are using the same centralized infrastructure to redefine who is surveilled, who is profiled and who is punished.

This convergence is particularly alarming for people with disabilities and other marginalized groups. Under the health technology initiative, individuals’ diagnoses, behavioral histories and wearable-generated metrics are all being compiled in a digital profile. Under the public safety order, that same data — especially anything interpreted as a behavioral risk factor — could be flagged by AI as indicative of potential danger.

In a country where disabled people are overrepresented in jails and prisons, psychiatric institutions and police encounters, this isn’t just theoretical. It’s the automation of a system that has long equated neurodivergence, psychiatric disability and non-normative behavior with threat.

When health data is funneled into law enforcement, we blur the line between patient and suspect. The result? People seeking care may become targets of surveillance; entrenching existing patterns where disability, neurodivergence and poverty are not only criminalized— but now automated and scaled. Under DOGE’s centralized structure, the Department of Homeland Security and the Department of Justice can be granted access to CMS health data. Further, Trump’s executive order instructs these agencies to coordinate surveillance with public health and welfare agencies to address disorderly elements in communities, even when that person has not committed a crime. Taken together, these policies insinuate that for some people, simply existing is the crime.

These policies don’t affect everyone equally. They will hit hardest those living under constant surveillance and structural vulnerability:

— Disabled people, whose medical and behavioral data may now be used to justify coercive treatment, confinement or denial of services.

— Black, Latino and Indigenous communities, which have long been subjected to racially biased policing and now face a wave of algorithmic profiling fueled by health data.

— Low-income and Medicaid recipients, who often cannot “opt out” of federal systems without losing access to services and support.

— Immigrants, who may be targeted using data to label them as “public charges” or security threats based on medical histories.

When participation in a health program opens the door to policing, surveillance and punishment, consent becomes a fiction, and care becomes conditional.

What we are witnessing is not the modernization of health care. It is the expansion of the surveillance state under the pretext of health and safety. These policies do not address root causes of community instability or poor health outcomes. Instead, they construct a digital scaffolding for preemptive punishment, codifying the idea that certain bodies and minds are risks to be managed, not people to be supported.

Moreover, this is not just about two unrelated policies. It’s about infrastructure convergence: using digital health modernization as an entry point for predictive policing and social control. When care data is absorbed into carceral logic, we are not modernizing — we are rebuilding eugenic-era social control with 21st century tools.

Used together, these policies enable a new form of techno-carceral governance. Health data isn’t just being used to improve wellness; it’s being repurposed as a mechanism for profiling, punishment and preemption — under the banner of efficiency and order.

To resist this dystopian merger of care and control, we must act urgently:

— Enact legal firewalls between health data systems (such as CMS) and law enforcement agencies (such as DHS and DOJ).

— Prohibit the use of AI-generated health risk scores in policing, surveillance or immigration proceedings.

— Establish true consent standards, ensuring that participation in any federal digital health system is fully informed, revocable and without coercion.

— Demand oversight by civil rights organizations, disability justice leaders and impacted communities — especially those historically excluded from policy decisions.

Because when surveillance is branded as health care, and criminalization is rebranded as prevention, we risk losing not just our rights but also our ability to live free, dignified and self-directed lives.

If you care about civil liberties, disability justice, racial equity and public health, this is the time to pay attention. The infrastructure is being built now. The consequences will come next.

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Kate Caldwell, Ph.D, is director of research and policy at Northwestern Law’s Center for Racial and Disability Justice.

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