Constitutional A-score of 36.5 driven primarily by civil_rights (4.0) due to healthcare data being repurposed for immigration enforcement creating chilling effects on vulnerable populations accessing medical services, rule_of_law (3.5) reflecting inter-agency data sharing without clear statutory authorization or privacy protections, and separation (2.5) showing executive agency coordination that may bypass legislative intent of healthcare programs. Enforcement_action mechanism adds 1.25x modifier as this represents operational policy with immediate implementation. Federal scope with broad population impact (immigrants and mixed-status families deterred from Medicaid) adds 1.15x. Severity multipliers: durability 1.2 (policy can persist administratively), reversibility 0.9 (technically reversible but data already shared), precedent 1.15 (normalizes health-enforcement data fusion). B-score of 17.8 reflects moderate hype: outrage_bait (6) from privacy violation angle, media_friendliness (7) as concrete policy confirmation, novelty (5) as formal acknowledgment of practice, but limited meme_ability (3). Layer 2 shows pattern_match (5) with surveillance state narratives and mismatch (4) between healthcare mission and enforcement use. Low intentionality (4) as routine policy confirmation. Delta of +18.7 clearly places on List A as constitutional damage significantly exceeds distraction value.