Texas hospitals — including major systems in Houston — reported spending $121 million in November 2024 caring for undocumented immigrants, according to a new state report prompted by an executive order from Gov. Greg Abbott.
According to a recent memo issued by the Texas Health and Human Services Commission (HHSC) on Friday, Texas hospitals expended over $121 million in a single month providing care to immigrants who lacked permanent legal status. The November 2024 report provides an initial glimpse of data collected under Gov. Greg Abbott's recent executive order, which mandates that hospitals track these expenses.
Health advocates have cautioned that the policy could have unintended consequences, despite Gov. Abbott's assertion that the data is intended to compel Washington to assume a greater portion of the costs. Cesar Espinosa, executive director of Houston-based immigrant advocacy group FIEL, stated, "Policies such as this can intimidate patients and deter them from seeking lifesaving care."
Texas hospitals recorded more than 31,000 visits from undocumented patients in November alone, resulting in a total of $121 million in expenditures, according to the HHSC memo. It is still uncertain how much of that expense hospitals were able to recover through programs such as emergency Medicaid, which provides emergent services to low-income patients regardless of their immigration status.
Hospitals are mandated by federal law to provide emergency care to all patients, irrespective of their immigration status or financial status. The Texas Hospital Association stated on Friday that hospitals are prepared to meet the acute care needs of Texans.
The executive order requires hospitals to inquire about the citizenship status of patients during the intake process; however, patients are permitted to decline to provide an answer without it affecting their treatment.
Critics contend that these figures do not tell the complete story, although similar policies in Florida have also resulted in high-cost figures. Texas currently has one of the highest uninsured rates in the nation, with approximately one in six residents lacking health coverage. This is a significant contributor to the state's estimated $3.1 billion in annual unreimbursed healthcare costs.
The initial comprehensive annual report from HHSC is due on January 1, 2026.
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