In a contentious development that has intensified the already fraught debate over immigration policies in the United States, Texas Governor Greg Abbott has issued an executive order mandating that hospitals across the state collect and report data on the immigration status of patients. This directive is part of a broader effort by the state government to quantify the financial burden that undocumented migrants purportedly place on Texas’s healthcare system, a burden Governor Abbott argues has been exacerbated by the federal government’s border policies.
The executive order requires public hospitals and healthcare providers in Texas to compile quarterly reports detailing the number of inpatient discharges and emergency room visits by undocumented migrants. Additionally, these reports must include an estimation of the costs associated with providing care to this population. The collected data is to be forwarded to the Texas Health and Human Services Commission (HHSC), which will then relay the information to state officials for further analysis.
Governor Abbott has positioned this order as a necessary response to what he describes as the Biden administration’s “open border policies,” which he claims have left Texas with the financial responsibility of caring for individuals who are in the state illegally. “Texans should not have to shoulder the burden of financially supporting medical care for illegal immigrants,” Abbott asserted in a statement accompanying the order. He further argued that the data collected would hold the federal government “accountable” for the alleged “costly and dangerous” consequences of its border policies.
The financial implications of providing healthcare to undocumented migrants have long been a point of contention in Texas, a state that shares a lengthy border with Mexico and is a primary entry point for many migrants. In 2021, Teaching Hospitals of Texas estimated that “uncompensated charity care” cost the state’s hospitals approximately $7 billion. However, this figure does not specify how much of this cost is attributable to undocumented migrants, leaving the actual financial impact unclear. Governor Abbott’s order appears to be an attempt to provide a more detailed accounting of these costs, ostensibly to support his administration’s broader immigration policy goals.
However, the order has sparked immediate and fierce opposition from a variety of quarters. Critics argue that the mandate could have serious negative consequences, both for the healthcare system and for the vulnerable populations it serves. One of the primary concerns is that the order could lead to racial profiling, as healthcare providers may be pressured to scrutinize patients based on their appearance, language, or perceived nationality.
Sylvia Garcia, a Democratic U.S. Representative whose district includes parts of Houston, has been vocal in her criticism of the order, describing it as a form of “social engineering” that risks transforming doctors into de facto immigration enforcement officers. “This is not what healthcare is about,” Garcia told CBS, emphasizing that the order could undermine the trust between patients and healthcare providers.
Gabriel Rosales, the Texas state director for the League of United Latin American Citizens (LULAC), echoed these concerns, warning that the order would likely deter undocumented migrants from seeking necessary medical care. “It’s going to immediately intimidate the community, our immigrant community, from trying to get the help that they need,” Rosales told Border Report. He described the directive as “completely uncalled for” and argued that it would exacerbate existing health disparities by discouraging a vulnerable population from accessing healthcare services.
Experts in immigration policy and healthcare have also expressed concerns about the potential chilling effect of the order. Julia Gelatt, an analyst at the Washington-based Migration Policy Institute, pointed out that while people are legally entitled to receive medical care regardless of their immigration status, the very act of asking patients about their status could deter them from seeking care. “We know that asking questions can make people worried about immigration consequences and whether or not it’s safe to seek care,” Gelatt told CBS.
The order is the latest in a series of aggressive actions taken by Governor Abbott’s administration in its ongoing battle with the federal government over immigration policy. Texas has been at the forefront of efforts to challenge the Biden administration’s approach to border security, engaging in legal battles and implementing controversial measures such as bussing migrants to Democratic-led cities and constructing floating barriers along the Rio Grande to deter crossings.
While the Abbott administration contends that these measures are necessary to protect the state’s interests and resources, critics argue that they often serve to politicize and inflame the immigration debate, creating a climate of fear and division. The executive order requiring hospitals to collect migrant data is likely to further entrench these divisions, as supporters and opponents of the policy clash over its implications for public health, human rights, and the broader immigration landscape in the United States.
As the order goes into effect, its impact will be closely watched by both advocates and adversaries of the policy. The data collected may indeed provide a clearer picture of the costs associated with undocumented migrants in Texas’s healthcare system, but at what cost to the individuals and communities it targets? The answer to that question may not become fully apparent until the effects of the order are felt in hospitals and healthcare facilities across the state.
