Rep. Chip Roy (R-TX) is introducing legislation that would require hospitals participating in federal health care programs to ask patients to indicate their immigration status.
The hospitals would have to report aggregate totals, including the number of patients who say they are not lawfully present in the United States.
Roy’s “Illegal Alien Patient Reporting Act” would amend Title XI of the Social Security Act and exclude hospitals from participation in federal healthcare programs if they fail to comply with the legislation’s reporting requirements.
“For years, Americans have watched overcrowded emergency rooms, rising healthcare costs, and strained hospital resources while being kept in the dark about the potential billions of taxpayer dollars spent on healthcare for those who are in the country illegally,” Roy told Breitbart News.
“That lack of accountability is unacceptable and absurd,” the Texas Republican continued. “The Illegal Alien Patient Reporting Act delivers the transparency and accountability Americans deserve by ensuring hospitals report the extent to which illegal aliens are adding to the fiscal burden of our healthcare system.”
Under the bill, hospital admission, registration, and other intake forms would be required to ask patients or their authorized representatives to indicate the patient’s immigration status.
The question would have to be followed immediately by a statement explaining that the response would not affect the patient’s care or result in the patient’s immigration status being reported to a law enforcement entity, except when the patient is an alien suspected of or charged with certain crimes.
Those exceptions include state or local criminal offenses, offenses under Sections 274, 275, or 276 of the Immigration and Nationality Act, or offenses under Title 18 of the United States Code.
Hospitals would also be required to request documentary evidence when a patient or representative reports that the patient is an alien lawfully admitted for permanent residence. The one-pager accompanying the legislation says that evidence could include the patient presenting a green card.
No later than 30 days after the end of each calendar quarter, hospitals would have to submit reports to the secretaries of Health and Human Services and Homeland Security covering patients admitted to the hospital or treated in its emergency department during the quarter.
The reports would include the number of patients who declined to answer the immigration-status question and the number who identified themselves as citizens or nationals of the United States, lawful permanent residents, nonimmigrants, otherwise lawfully present in the country, or not lawfully present.
The “otherwise lawfully present” category includes patients with temporary protected status, deferred action or deferred enforced departure (including under the June 15, 2012, memorandum titled “Exercising Prosecutorial Discretion with Respect to Individuals Who Came to the United States as Children”), asylum, parole, withholding of removal, Cuban or Haitian entrant status, special immigrant juvenile status, or protection under the United Nations Convention Against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment.
The reporting category for people not lawfully present would include whether a patient was an unaccompanied alien child (UAC), as defined under the Homeland Security Act of 2002.
Hospitals would separately report the number of patients who said they were lawful permanent residents but failed to provide documentary evidence of that status.
The bill would also require the HHS secretary to submit a report to Congress by October 1 each year, beginning in 2026. That report would aggregate information collected from hospitals during the preceding calendar year.
It would also include information concerning the costs of uncompensated care for people who are not lawfully present in the United States, the effect of that care on hospitals’ ability to provide services to the public and the cost of those services, hospitals’ funding needs, and other related information the secretary may require.
The HHS secretary, in coordination with the DHS secretary, would be permitted to issue regulations implementing the requirements. Those regulations could not require hospitals to disclose patients’ names or other personally identifying information to either department.
Roy’s one-pager says that Americans have faced crowded emergency rooms and competition for limited medical resources while lacking a precise accounting of the nation’s annual hospital costs for illegal aliens. It cites a 2023 report estimating that state and local governments spend “at least $21 billion in taxpayer funds” each year on health care for illegal aliens and says that figure could increase following the arrival of at least ten million illegal aliens during the Biden-Harris border crisis.
The document also points to a Florida law enacted in 2023, saying it revealed that state taxpayers paid $566 million for health care for illegal aliens in 2022.
“Federal taxpayers should be privy to the costs of illegal aliens admitted to hospitals that accept federal healthcare subsidies,” it states. “American taxpayers ought to know the full scope of how much they pay for illegal aliens’ healthcare costs.”
Although the one-pager says a hospital that fails to comply would have its federal funds revoked, the legislative text states that a noncompliant hospital would be excluded from participation in federal healthcare programs.
Several immigration policy organizations endorsed Roy’s proposal.
“The Immigration Accountability Project stands fully behind Congressman Roy’s Illegal Alien Patient Reporting Act,” Grant Newman, director of government relations for the Immigration Accountability Project, said. “By requiring hospitals to track and report the immigration status of patients, we can finally pull back the curtain on the massive costs of uncompensated care for illegal aliens. It is time for accountability in our healthcare system.”
Joe Chatham, director of government relations for the Federation for American Immigration Reform (FAIR), said:
The Biden administration embraced mass migration and allowed millions of illegal aliens into our country, leading medical expenses for illegal aliens and their families to spike to over $40 billion annually. The Illegal Alien Patient Reporting Act is a crucial step in providing transparency, showing the true cost of illegal immigration to American taxpayers, and holding illegal aliens accountable. FAIR applauds Congressman Roy for introducing this important bill to ensure our laws are upheld and that American citizens come first.
RJ Hauman, president of the National Immigration Center for Enforcement (NICE), pointed to the Florida figures cited in Roy’s one-pager.
“For decades, Washington has hidden the healthcare cost of illegal immigration and handed American taxpayers the bill,” Hauman said. “Florida finally asked the question and found taxpayers paid $566 million in one year. Nationally, the cost is already estimated at least $21 billion, and that may be the floor.”
“Congressman Roy’s bill does not touch patient care,” he continued. “It simply requires hospitals taking federal dollars to report the data taxpayers deserve to see. If Democrats and their sanctuary allies really believe illegal aliens ‘pay their way,’ they should have no problem proving it.”
“NICE fully supports the Illegal Alien Patient Reporting Act and urges every member serious about fiscal accountability and immigration enforcement to cosponsor it,” he added.
“Congressman Roy has been one of the strongest immigration enforcement lawmakers ever to serve in Congress,” Hauman concluded. “Hill Country sent him to Washington to fight, and he damn well did. He will keep fighting in his next chapter, and we will be right there with him.”
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