Governor orders Texas hospitals to report costs of undocumented care

Texas Gov. Greg Abbott has issued an executive order ordering hospitals in the state to collect information on undocumented immigrants receiving inpatient and emergency care, and to report healthcare costs incurred as a result. 

The executive order comes in response to the Biden administration's "reckless open border policies" and Texas will use this data to seek reimbursement from the federal government, according to Mr. Abbott.

"Texans should not have to shoulder the burden of financially supporting medical care for illegal immigrants," Mr. Abbott said in an Aug. 8 news release. "Texas will hold the Biden-Harris Administration accountable for the consequences of their open border policies, and we will fight to ensure that they pay back Texas for their costly and dangerous policies."

At the governor's direction, Texas Health and Human Services will immediately begin to:  

  • Direct hospitals and certain other providers to collect information regarding the cost of care provided to illegal immigrants, beginning by Nov. 1.
  • Direct covered hospitals to report such data to HHSC each quarter, with initial submissions due March 1, 2025.
  • Direct those hospitals to inform patients that federal law mandates that any response to such questions will not affect patient care.
  • Report annually, beginning on Jan. 1, 2026, to the governor, the lieutenant governor, and the Speaker of the House on the previous year's costs for care provided to illegal immigrants.

"This would be a new requirement, and we are reviewing it as quickly as possible. Right now, hospitals don't ask about patient immigration status as a condition of treatment," the Texas Hospital Association said in a statement. "Hospitals are required by law to provide life-saving treatment to anyone, regardless of ability to pay or status."

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