I 
119TH CONGRESS 
1ST SESSION H. R. 6801 
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. 
IN THE HOUSE OF REPRESENTATIVES 
DECEMBER 17, 2025 
Ms. MACE (for herself and Ms. BOEBERT) introduced the following bill; which 
was referred to the Committee on Ways and Means, and in addition to 
the Committee on Energy and Commerce, for a period to be subsequently 
determined by the Speaker, in each case for consideration of such provi-
sions as fall within the jurisdiction of the committee concerned 
A BILL 
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. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘American Citizenship 
Healthcare Integrity Act of 2025’’. 
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SEC. 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 hos-
pital 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 an-
nually thereafter, to submit to the Secretary a 
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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 fur-
nished by such hospital, critical access hos-
pital, or rural emergency hospital; and 
‘‘(II) the dollar amount of any uncom-
pensated care furnished by such hospital, 
critical access hospital, or rural emergency 
hospital to such individuals.’’; and 
(2) by adding at the end the following new sub-
section: 
‘‘(l) REPORT ON COST OF HOSPITAL SERVICES FUR-
NISHED 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 de-
termined based on the findings of reports submitted 
pursuant to subsection (a)(1)(Z)(ii); and 
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‘‘(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.’’. 
Æ 
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