WEST VIRGINIA LEGISLATURE

2026 REGULAR SESSION

Introduced

House Bill 4059

By Delegates Horst and Mazzocchi

[Introduced January 14, 2026; referred to the Committee on Health and Human Resources]

A BILL to amend and reenact the Code of West Virginia, 1931, as amended, by adding two new sections, designated §15-17-10 and §16-67-1; relating to public safety and immigration data; requiring political subdivisions and the Department of Health to collect and report data regarding costs expended on undocumented immigrants; providing for reports to be submitted; and authorizing rules.

Be it enacted by the Legislature of West Virginia:

Chapter 15. Public Safety.

Article 16. Federal Immigration Enforcement.

§15-16-10. The Saving Citizens' Resources Act.

(a) Each political subdivision of this state, as defined in §29-12A-3, shall declare, on a quarterly basis, the amount of money that it spent on housing, sheltering, feeding, transporting, and education noncitizen immigrants who reside in its jurisdiction and who do not possess a Permanent Resident Card, work visa, or student visa, or who are otherwise undocumented.

(b) All county commissions and city councils shall report on their expense accounts any expenditures or spending on persons within their jurisdictions who do not possess a Permanent Resident Card, work visa, or student visa, or who are otherwise undocumented and who are receiving county or city resources. The report shall include the dates, amounts, purposes of the funding, and the frequency of receipt.

(c) Any county or city found to be noncompliant in this requirement shall be found to be in violation of this state's laws against sanctuary cities, including, but not limited to, the provisions of this article.

CHAPTER 16. PUBLIC HEALTH.

Article 67. Immigration Data.

§16-67-1. Patient immigration status data collection.

(1) Each hospital that accepts Medicaid must include a provision on its patient admission or registration forms for the patient or the patient’s representative to state or indicate whether the patient is a United States citizen or lawfully present in the United States or is not lawfully present in the United States. The inquiry must be followed by a statement that the response will not affect patient care or result in a report of the patient’s immigration status to immigration authorities.

(2) Each hospital must submit a quarterly report to the department within 30 days after the end of each calendar quarter which reports the number of hospital admissions or emergency department visits within the previous quarter which were made by a patient who indicated that he or she was a citizen of the United States or lawfully present in the United States, was not lawfully present in the United States, or declined to answer.  

(3) By March 1 of each year, the department shall submit a report to the Governor, the President of the Senate, and the Speaker of the House of Delegates which includes the total number of hospital admissions and emergency department visits for the previous calendar year for which the patient or patient’s representative reported that the patient was a citizen of the United States or lawfully present in the United States, was not lawfully present in the United States, or declined to answer. The report must also describe information relating to the costs of uncompensated care for aliens who are not lawfully present in the United States, the impact of uncompensated care on the cost or ability of hospitals to provide services to the public, hospital funding needs, and other related information.

(4) The department may adopt rules relating to the format and information to be contained in quarterly reports and the acceptable formats for hospitals to use in requesting information regarding a patient’s immigration status on hospital admission or registration forms. The rules may not require the disclosure of patient names or any other personal identifying information to the department.

NOTE: The purpose of this bill is to require political subdivisions and the Department of Health to collect and report data regarding the cost expended on undocumented immigrants.

Strike-throughs indicate language that would be stricken from a heading or the present law and underscoring indicates new language that would be added.