Sponsors (2)
The bill would give policymakers clearer, more transparent data on uncompensated care by citizenship—helping to target funding and estimate Medicare/Medicaid impacts—but at the cost of higher administrative burdens, potential diversion of care resources, privacy risks, and a real risk that non‑citizens will avoid needed medical care.
Policymakers, taxpayers, and hospitals will get aggregate data on uncompensated care by patient citizenship, enabling more accurate measurement of costs by citizenship status and better-targeted funding or reimbursement policies (with public disclosure improving transparency).
Medicare and Medicaid spending impacts tied to uncompensated care will be estimated, informing federal and state budget decisions and policy choices about program costs and funding responsibilities.
Non‑citizen patients and immigrant communities may avoid or delay seeking medical care because intake asks about citizenship, increasing public‑health risks and worsening health outcomes for those populations.
Recording and reporting patients' citizenship status creates privacy and civil‑liberties risks if data are mishandled or accessed for immigration enforcement, exposing vulnerable people to harm.
Collecting and reporting citizenship data increases administrative burden and costs for hospitals—especially rural and critical access facilities—straining already tight finances and potentially threatening service viability.
Based on analysis of 2 sections of legislative text.
Requires hospitals to collect patients' U.S. citizenship/nationality on intake forms, report counts and uncompensated-care dollars for non‑citizens annually, and directs HHS to publish an annual summary.
Requires hospitals, critical access hospitals, and rural emergency hospitals to add a U.S. citizenship/nationality question to patient intake forms and to report annually to HHS the prior year’s count of non‑citizen/non‑national patients and the dollar amount of uncompensated care provided to those patients. The Department of Health and Human Services must publish an annual public report that aggregates uncompensated care to non‑citizens/non‑nationals and estimates Federal Medicare and Medicaid expenditures that would not have occurred absent that uncompensated care. The collection requirement begins 180 days after enactment; hospitals must submit the first annual report within one year and then each year thereafter; HHS must publish its first public report within one year and then annually. The text does not provide new funding or specify penalties or privacy protections for the collected data.
Introduced December 17, 2025 by Nancy Mace · Last progress December 17, 2025