Section 1. Short title
This Act may be cited as the American Citizenship Healthcare Integrity Act of 2025.
Section 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.
(C) ; 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.