American Citizenship Healthcare Integrity Act of 2025
Summary
What This Bill Does
The American Citizenship Healthcare Integrity Act amends Medicare provider agreements. Beginning 180 days after enactment, hospitals, critical access hospitals, and rural emergency hospitals must include an intake-form question asking whether each patient is a citizen or national of the United States. Within one year after enactment, and annually thereafter, each facility must report to the Secretary of Health and Human Services the number of patients who are not citizens or nationals and the dollar amount of uncompensated care furnished to them. HHS must publish an annual public report with aggregate hospital data and estimates of federal Medicare and Medicaid expenditures attributable to uncompensated care for those patients.
Who Benefits and How
Immigration policy staff, budget analysts, and members of Congress benefit from standardized annual data on non-citizen patient counts and uncompensated care at Medicare-participating hospitals. Taxpayers and public watchdogs benefit from visibility into federal Medicare and Medicaid spending estimates tied to uncompensated care. HHS benefits from a uniform reporting stream across hospital types.
Who Bears the Burden and How
Hospitals, critical access hospitals, and rural emergency hospitals must revise intake forms, ask a sensitive citizenship-status question, collect responses, and submit annual reports. HHS staff must aggregate data and estimate federal Medicare and Medicaid spending. Patients who are not U.S. citizens or nationals may face privacy concerns or confusion during intake even though the bill is structured as reporting, not direct eligibility denial. Hospital compliance teams must manage accuracy, patient communication, and uncompensated-care calculations.
Key Provisions
- Requires Medicare-participating hospitals to ask every patient whether the patient is a U.S. citizen or national.
- Requires annual hospital reports to HHS on non-citizen patient counts and uncompensated care amounts.
- Directs HHS to publish annual aggregate data and estimate related Medicare and Medicaid spending.
- Applies the new intake-form requirement beginning 180 days after enactment.
Evidence Chain:
This summary is generated from the full bill text using AI analysis. Expand "Detailed Analysis" below for identified beneficiaries/burden bearers with clause-level evidence links.
At a Glance
What This Bill Does
Requires Medicare-participating hospitals, critical access hospitals, and rural emergency hospitals to ask each patient whether the patient is a U.S. citizen or national, report non-citizen patient counts and uncompensated-care amounts to HHS annually, and requires HHS to publish annual aggregate spending estimates.
Key Policy Areas
Healthcare, Immigration, Medicare, Government Oversight
Primary Purpose
Requires Medicare-participating hospitals, critical access hospitals, and rural emergency hospitals to ask each patient whether the patient is a U.S. citizen or national, report non-citizen patient counts and uncompensated-care amounts to HHS annually, and requires HHS to publish annual aggregate spending estimates.
Policy Domains
Substantive provisions
Identified Gains
- Congressional budget analysts
- Taxpayers
- HHS program analysts
- Immigration policy staff
Identified Costs
- Hospitals
- Critical access hospitals
- Rural emergency hospitals
- HHS reporting staff
- Non-citizen patients
- Hospital compliance teams
Sponsors
Nancy Mace
R-SC | Primary Sponsor
Legislative Progress
In CommitteeMs. Mace (for herself and Ms. Boebert) introduced the following …
Referred to the Committee on Ways and Means, and in …
Introduced in House
Stakeholder Effects
cui bono?How this legislation distributes effects. Mention counts reflect frequency, not effect magnitude.
Critical access hospitals, Hospitals, Rural emergency hospitals
Bill Structure & Actor Mappings
Who is "The Secretary" in each section?
- "the_secretary"
- → Secretary of Health and Human Services
We use a combination of our own taxonomy and classification in addition to large language models to assess meaning and potential beneficiaries. High confidence means strong textual evidence. Always verify with the original bill text.
Learn more about our methodology