Hospitals must now report noncitizen patients to feds—and publish it
H.R. 6801 — American Citizenship Healthcare Integrity Act of 2025 · Filed by Nancy Mace (R-SC) · 1 cosponsor · Introduced Dec 17, 2025 · Referred to committee
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What it does
This bill requires all hospitals participating in Medicare to ask patients whether they are U.S. citizens or nationals on intake forms, and to report annually to the federal government on the number of noncitizens treated and the dollar amount of uncompensated care provided to them. The Secretary of Health and Human Services must then publish an annual public report aggregating this data across all hospitals.
Why we flagged it
The bill's stated purpose is 'integrity,' but its mechanism is to identify and track noncitizen patients, aggregate uncompensated-care costs, and create public pressure on hospitals to reduce care to this population. The framing obscures a de facto deterrence and cost-allocation tool.
What the text implies
- Hospitals may face political or financial pressure to deny or delay care to noncitizens once uncompensated-care data is publicly reported, creating a two-tier system.
- Patients (including legal immigrants, visa holders, and mixed-status families) may avoid seeking care due to citizenship questions, worsening preventable disease and emergency-room utilization.
The full analysis lists 5 implications of this text.
Who stands to gain
For-profit hospital chains (UHS, HCA, Tenet) — potential cost reduction if care to noncitizens decli; Private insurers — reduced cross-subsidization if uncompensated care is reduced; Pharmaceutical companies (PFE, BMY) — potential negative impact if patient volume declines among non