Bill Summary
The "American Citizenship Healthcare Integrity Act of 2025" aims to amend the Social Security Act by requiring hospitals participating in the Medicare program to inquire about the citizenship status of patients during the intake process. Specifically, hospitals must add a question regarding citizenship to their intake forms within 180 days of the bill's enactment. Furthermore, they are mandated to report annually to the Secretary of Health and Human Services on the number of non-citizen patients they serve and the total amount of uncompensated care provided to these individuals.
Additionally, the legislation requires the Secretary to produce and publicly share an annual report detailing the financial impact of uncompensated care for non-citizens, including the total cost incurred by hospitals and the corresponding federal expenditures that arose from providing such care. This legislation emphasizes accountability and aims to assess the financial implications of healthcare services provided to non-citizens under Medicare.
Possible Impacts
The proposed "American Citizenship Healthcare Integrity Act of 2025" could have several significant impacts on various groups of people. Here are three examples:
1. **Non-Citizen Patients**: Non-citizens may face increased barriers to accessing healthcare services. By requiring hospitals to ask about citizenship status, non-citizen patients might feel deterred from seeking medical attention due to fear of discrimination or being reported to immigration authorities. This could lead to worsened health outcomes as individuals may avoid necessary care, affecting public health overall.
2. **Healthcare Providers and Hospitals**: Hospitals, especially those that are critical access or rural emergency hospitals, may experience administrative burdens from the new requirement to collect and report citizenship status. These facilities may need to invest in additional training for staff, adjust intake processes, and allocate resources to comply with the reporting requirements. This could divert attention and funding away from patient care and other essential services.
3. **Healthcare Policy and Funding**: The act could lead to changes in how healthcare funding is allocated, particularly regarding uncompensated care for non-citizens. The requirement for annual reports on the cost of services provided to non-citizens may influence public perception and political discussions surrounding healthcare funding and immigration policies. This could result in shifts in federal and state funding strategies, impacting healthcare access and delivery for various populations, including citizens who may rely on services that could be underfunded as a result of these changes.
[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6801 Introduced in House (IH)]
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119th CONGRESS
1st Session
H. R. 6801
To amend title XVIII of the Social Security Act to require hospitals to
ask the citizenship status of patients as a condition of participation
in the Medicare program and to require reports on the cost of
furnishing hospital services to noncitizens.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
December 17, 2025
Ms. Mace (for herself and Ms. Boebert) introduced the following bill;
which was referred to the Committee on Ways and Means, and in addition
to the Committee on Energy and Commerce, for a period to be
subsequently determined by the Speaker, in each case for consideration
of such provisions as fall within the jurisdiction of the committee
concerned
_______________________________________________________________________
A BILL
To amend title XVIII of the Social Security Act to require hospitals to
ask the citizenship status of patients as a condition of participation
in the Medicare program and to require reports on the cost of
furnishing hospital services to noncitizens.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``American Citizenship Healthcare
Integrity Act of 2025''.
SEC. 2. REQUIRING HOSPITALS TO ASK THE CITIZENSHIP STATUS OF PATIENTS
AS A CONDITION OF PARTICIPATION IN MEDICARE.
Section 1866 of the Social Security Act is amended--
(1) in subsection (a)(1)--
(A) in subparagraph (X), by striking ``and'' at the
end;
(B) in subparagraph (Y), by striking the period at
the end and inserting ``, and''; and
(C) by inserting after subparagraph (Y) the
following new subparagraph:
``(Z) beginning 180 days after the date of the enactment of
this subparagraph, in the case of a hospital, critical access
hospital, or rural emergency hospital--
``(i) with respect to each intake form (or its
equivalent) provided in connection with items or
services furnished by such hospital, critical access
hospital, or rural emergency hospital to an individual,
to ask on such form whether such individual is a
citizen or national of the United States; and
``(ii) not later than 1 year after the date of the
enactment of this subparagraph, and annually
thereafter, to submit to the Secretary a report
including, with respect to the previous year--
``(I) the number of individuals who are not
citizens or nationals of the United States to
whom items or services were furnished by such
hospital, critical access hospital, or rural
emergency hospital; and
``(II) the dollar amount of any
uncompensated care furnished by such hospital,
critical access hospital, or rural emergency
hospital to such individuals.''; and
(2) by adding at the end the following new subsection:
``(l) Report on Cost of Hospital Services Furnished to
Noncitizens.--Not later than one year after the date of the enactment
of this subsection, and annually thereafter, the Secretary shall make
publicly available a report on, with respect to the previous year--
``(1) the dollar amount of any uncompensated care furnished
by hospitals, critical access hospitals, and rural emergency
hospitals to individuals who are not citizens or nationals of
the United States, as determined based on the findings of
reports submitted pursuant to subsection (a)(1)(Z)(ii); and
``(2) the amount of Federal expenditures under this title
and title XIX that would not have been made in the absence of
such uncompensated care, as determined by the Secretary.''.
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