Sponsors (2)
The bill increases transparency and data to inform federal budgeting about uncompensated care for non‑citizens, but does so at the cost of potential deterrence of immigrant patients, privacy/discrimination risks, administrative burdens on providers, and possible measurement uncertainty that could skew policy debates.
Taxpayers, policymakers, and Medicare/Medicaid stakeholders will receive annual estimates linking uncompensated care for non‑citizens to federal Medicare and Medicaid outlays, improving data for budgeting and policy decisions.
Hospitals and health systems will be required to produce annual counts and dollar estimates of uncompensated care provided to non‑citizens, increasing transparency about care costs.
Immigrants and other patients may avoid or delay seeking care because intake forms will ask about citizenship status, which can worsen health outcomes and public‑health risks.
Immigrants and patients face increased privacy and discrimination risks from collecting and reporting citizenship data, which could be misused or disclosed.
Taxpayers and policymakers may receive misleading or uncertain estimates if the method for linking uncompensated care to federal Medicare/Medicaid outlays is methodologically uncertain, risking misinformed policy debates.
Based on analysis of 2 sections of legislative text.
Medicare-participating hospitals must ask patients their U.S. citizenship/national status and report annually counts and uncompensated-care costs for noncitizens, with HHS publishing aggregate federal cost estimates.
Official title: 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.
Introduced December 17, 2025 by Nancy Mace · Last progress December 17, 2025
Requires Medicare-participating hospitals (including critical access and rural emergency hospitals) to ask patients whether they are U.S. citizens or nationals starting 180 days after enactment, and to submit annual facility reports counting non‑citizen/non‑national patients and the dollar value of uncompensated care they received. The Department of Health and Human Services must publish an annual public report, based on those facility submissions, showing uncompensated-care costs for noncitizens/non‑nationals and estimated Federal Medicare and Medicaid expenditures that would not have occurred without that uncompensated care.