Chip Roy Bill Would Force Hospitals to Report Patients' Immigration Status; GOP Rep. Riley Moore Says Legal Migration Hurts Workers More Than Illegal

Rep. Chip Roy (R-TX) is introducing the "Illegal Alien Patient Reporting Act," a bill that would require hospitals participating in federal healthcare programs to ask patients about their immigration status and report aggregate totals to the Department of Health and Human Services and the Department of Homeland Security, according to Breitbart News.

The bill would amend Title XI of the Social Security Act. Hospitals that refuse to comply would be barred from participating in federal healthcare programs, a significant financial threat given how dependent most hospitals are on Medicare and Medicaid reimbursement.

Under the bill's text, hospital intake forms would ask patients or their representatives to state immigration status, followed immediately by a disclosure that the answer will not affect care or trigger a report to law enforcement, with exceptions for patients suspected of or charged with specific crimes under the Immigration and Nationality Act or Title 18 of the U.S. Code, per Breitbart's reporting.

Patients claiming lawful permanent resident status would need to show documentary evidence, such as a green card. Hospitals would file quarterly reports breaking down patients by category: citizens, green card holders, nonimmigrants, those "otherwise lawfully present" (including Temporary Protected Status and deferred action recipients), those not lawfully present, and those who decline to answer.

Roy's stated rationale

"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.

Roy made a similar case to the Daily Signal, framing the bill as a fiscal-transparency measure rather than an enforcement tool: "Taxpayers deserve an honest accounting of how federal health care dollars are being used and whether hospitals are bearing costs associated with treating those who are in the country illegally."

Heritage Action's Daniel West backed the bill in comments to the Daily Signal, calling it "a commonsense reform bringing essential transparency and accountability to our strained healthcare system" and arguing Congress "owes it to the American people" to track how tax dollars flow through Social Security-adjacent programs.

The Daily Signal's headline framed the bill as targeting "Social Security recipients," which is broader than the bill's actual text. The legislation amends Title XI of the Social Security Act, the section governing Medicare and Medicaid administration, not Social Security retirement benefits. Illegal immigrants are not eligible for Social Security retirement benefits under existing law. The bill is about hospital reporting tied to federal healthcare programs, not the Social Security check itself. Readers relying only on that headline could walk away with a mistaken impression of what the bill does.

The unresolved question: what does this actually cost hospitals and patients?

Neither Breitbart nor the Daily Signal cited a specific cost estimate for what unlawfully present patients currently cost the healthcare system, or what compliance would cost hospitals in staff time and legal exposure. The bill's backers assert the costs are large and hidden. Emergency rooms are required under federal law (EMTALA) to treat anyone regardless of ability to pay or immigration status, and that underlying obligation is untouched by this bill. The real effect, if the bill becomes law, would be data collection, not a change in who gets treated.

Riley Moore: legal immigration, not just illegal, is squeezing American workers

Separately, Rep. Riley Moore (R-WV) told Breitbart News that legal migration programs are doing more damage to ordinary American workers than illegal border crossings, an argument that breaks from the traditional GOP focus purely on the southern border.

"The American worker is the only worker on Planet Earth that has to compete with labor from all over the world inside their own borders," Moore said. "Nobody else has to do that."

Moore pointed to the H-1B visa program specifically, saying it is "being abused at levels I don't think most understand," both by applicants and by large corporations using the program to displace American workers. He cited Microsoft's Xbox division, which laid off 3,200 employees and then sought thousands of H-1B visas, as what he called the clearest recent example.

Moore's claim that visa programs keep at least 1.5 million foreign workers in jobs otherwise sought by U.S. graduates is presented in Breitbart's reporting but not independently verified against government visa data. Vice President JD Vance has also raised concerns about the effects of legal migration on American families, according to Breitbart, suggesting this argument has some traction beyond a single House member.

Employers and many economists argue H-1B visas fill genuine skills gaps in fields like software engineering, and that companies must prove they tried to hire domestically and pay prevailing wages under program rules. Critics like Moore counter that the prevailing-wage rules are routinely gamed and that enforcement is weak. Such allegations are easy to make and hard to independently verify without Department of Labor audit data, and no such audit data was cited in these sources.

What happens next

Roy's bill has been introduced but has no hearing date, cosponsor list, or CBO cost estimate reported yet. Moore's push on visa reform remains a talking point rather than filed legislation in the sourced material. Whether either effort gains floor time depends on House GOP leadership's priorities and whether Vance's public sympathy for the argument translates into White House backing.