HR 6801 (introduced December 17, 2025) — Summary
Overview
- Purpose: To amend title XVIII of the Social Security Act (Medicare) to require hospitals participating in Medicare to collect and affirmatively determine the citizenship status of patients as a condition of Medicare participation, and to mandate reporting on the cost of furnishing hospital services to noncitizens.
- Status: Introduced in the U.S. House of Representatives on December 17, 2025.
- Legislative actions to date:
- Referred to the House Committee on Ways and Means.
- Referred to the House Committee on Energy and Commerce.
- Referral is for consideration of provisions within each committee’s jurisdiction.
Key Provisions
1) Citizenship Status as a Condition of Participation
- Hospitals participating in the Medicare program would be required to ask patients for their citizenship status.
- The collection would be tied to Medicare participation eligibility or ongoing participation, establishing citizenship status as a condition of hospital participation in Medicare.
2) Reporting on Costs for Noncitizens
- Hospitals would be required to prepare and submit reports detailing the cost of furnishing hospital services to noncitizens (i.e., individuals who are noncitizens of the United States).
- The reporting requirement would aim to illuminate the financial impact of serving noncitizen patients on hospital operations and Medicare costs.
Affected Parties
- Hospitals and health systems that participate in the Medicare program (title XVIII of the Social Security Act).
- Medicare program administrators and regulators responsible for hospital participation requirements.
- Noncitizen patients who receive hospital services (implications for data collection and potential downstream impacts on care processes, privacy, and patient experience).
Procedural and Timeline Aspects
- The bill is introduced and referred to the following committees for consideration of provisions within their jurisdiction:
- Committee on Ways and Means
- Committee on Energy and Commerce
- Any substantive movement would depend on committee action, potential amendments, and floor consideration in the House, followed by any Senate action and presidential approval.
Potential Impact and Considerations
- Administrative and Compliance Effects:
- Hospitals would need to implement processes to collect citizenship status consistently and in a compliant manner.
- Data handling and privacy considerations for sensitive demographic information.
- Administrative costs associated with collecting data and preparing the required cost reports.
Policy and Program Implications:
- The measure could influence hospital payment planning and governance if citizenship data affect Medicare participation status, although the bill text frames citizenship as a participation condition rather than directly tying it to payment rates.
- The cost reporting could inform federal policy discussions about the financial aspects of providing services to noncitizens.
Legal and Constitutional Considerations:
- Depending on final text, questions could arise about the permissible scope of citizenship data collection and whether it aligns with existing privacy, anti-discrimination, and health information protections.
Notes
- As an introduced bill, specifics such as definitions, data collection methods, reporting formats, timelines for compliance, and penalties for noncompliance are not provided in the summary and would be clarified in the bill’s text and committee amendments.
