Representative Chip Roy of Texas has introduced legislation that would require hospitals participating in federal healthcare programs to collect and report the immigration status of patients in aggregate form, aiming to quantify the cost of treating illegal aliens within the U.S. healthcare system.
The bill, titled the Illegal Alien Patient Reporting Act, would add an immigration-status question to hospital intake forms. Facilities would then submit quarterly reports to the Departments of Health and Human Services and Homeland Security. Compliance would become a condition of participating in federal healthcare programs, meaning hospitals that refuse could lose access to that funding.
Roy said the measure responds to years of hidden costs. “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,” he said. “That lack of accountability is unacceptable and absurd.”
He added that the bill’s goal is transparency. “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,” Roy said.
Patients would be asked to identify as U.S. citizens or nationals, lawful permanent residents, nonimmigrants, otherwise lawfully present, not lawfully present, or to decline to answer. Those claiming permanent resident status would need to provide documentation, such as a green card. The bill specifies that answers would not affect medical care and would not be reported to law enforcement based solely on immigration status, with limited exceptions tied to existing criminal investigations.
Hospitals would report aggregate totals only. The legislation bars federal agencies from requiring disclosure of patients’ names or other personally identifying information.
The bill would also direct the HHS secretary to submit an annual report to Congress summarizing nationwide data, including estimates of uncompensated care costs, the financial impact on hospitals, and effects on healthcare availability.
A legislative summary accompanying the bill cites estimates that state and local governments spend at least $21 billion annually on healthcare for illegal aliens, and points to a 2023 Florida law that found taxpayers paid roughly $566 million for such care in 2022 alone. “American taxpayers ought to know the full scope of how much they pay for illegal aliens’ healthcare costs,” the summary states.
The proposal has drawn support from immigration enforcement groups. Grant Newman of the Immigration Accountability Project said the bill would bring overdue transparency to uncompensated care costs. The Federation for American Immigration Reform also endorsed the measure. RJ Hauman of the National Immigration Center for Enforcement said the bill focuses solely on data collection. “Congressman Roy’s bill does not touch patient care,” Hauman said. “It simply requires hospitals taking federal dollars to report the data taxpayers deserve to see.”
If enacted, the bill would create the first nationwide system requiring hospitals to disclose aggregate immigration-status data while shielding patients’ personal information from release.
