This bill requires hospitals that accept Medicaid or Children's Health Insurance Program funding to ask patients during admission whether they are U.S. citizens or have legal immigration status. Hospitals must include this question on admission forms and assure patients in writing that their answers will not affect their care or be reported to immigration authorities. The bill affects all hospitals participating in these federal health programs and applies starting immediately upon enactment. Hospitals must annually report to the federal government the total uncompensated care they provide to non-citizens and non-lawfully residing individuals, as well as funds received for emergency deliveries. Hospitals that fail to comply with these requirements would lose their Medicaid and CHIP reimbursement eligibility, though the bill clarifies that nothing prevents hospitals from reporting suspected criminal activity to law enforcement regardless of a patient's immigration status.