Governor Greg Abbott has ordered Texas hospitals that participate in Medicaid and the Children’s Health Insurance Program to report the costs of treating undocumented immigrants.
In a news release that included a link to the executive order, Governor Abbott blamed the Biden administration’s immigration and border security policies for shifting health care costs onto taxpayers.
“Texans should not have to bear the financial burden of supporting the health care costs of illegal immigrants,” Abbott said.
Governor Abbott’s order does not provide clear guidance on how hospitals must verify a patient’s immigration or citizenship status, and the governor’s office did not respond to an email requesting additional information.
Carrie Williams, a spokeswoman for the Texas Hospital Association, said the organization is reviewing the order “as expeditiously as possible.”
“Currently, hospitals do not ask about a patient’s immigration status as a condition of treatment,” she said. “Hospitals are required by law to provide life-saving treatment to anyone, regardless of ability to pay or status.”
meanwhile Abbot’s Orders While the proclamation targets people entering the country illegally under the Biden-Harris administration, it also applies to the estimated 52,000 El Paso residents who make up the county’s illegal immigrant population, many of whom have lived in El Paso for years and pay property taxes that help support UMC.
The order is inconsistent with guidelines from the Texas Department of State Health Services. Healthcare professionals should not ask for information about immigration statusThe federal government does not require health care providers to collect immigration status from patients.
Governor Abbott’s order applies to El Paso University Medical Center and the children’s hospital it owns.
“We are aware of the executive order issued by Governor Abbott today, and we will review it with our team to fully understand its implications and requirements,” UMC spokesman Ryan Mielke said in a statement.
Dr. Brian Elmore, an emergency medicine resident at the University of Maryland Medical Center, said Abbott’s order doesn’t make sense, saying most of the migrant patients he treats are in the U.S. legally because they’ve already been processed by border patrol agents and are awaiting immigration hearings.
Many of UMC’s patients also commute from Ciudad Juarez, he added.
“Are we going to have to check their visas now?” Elmore asked. “Is he (Abbott) effectively appointing the hospital people as immigration agents?”
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Fernando Garcia, executive director of the El Paso-based Border Human Rights Network, said in a statement that Governor Abbott was “using immigrants as scapegoats for failed policies and political grievances to paint a one-sided picture of the reality at the border and in Texas.”
“This executive order is nothing less than a draining policy that will result in undocumented immigrants fearful of accessing health care and is a brazen attempt to make Texas a hostile place for our communities,” Garcia said.
Governor Abbott’s order does not apply to private hospitals.
The Republican governor’s order also appears to weaken the message of the Texas Department of State Health Services’ now-removed “Immigrant Rights Health Care Fact Sheet” that people who need health care should not refrain from receiving it because of citizenship concerns.
“Healthcare providers should not ask for information about immigration status,” reads the pamphlet, which was posted online Thursday afternoon but removed after the American-Statesman linked to it. “Hospital emergency rooms must help anyone who needs emergency services. The same applies to local health centers — whether or not you have insurance, money or immigration papers.”
“If someone asks about health insurance, you can say, ‘I don’t qualify for health insurance, so I don’t want to apply for it.'”
The Department of Health and Human Services said it would “implement Governor Abbott’s executive order and provide guidance to hospitals in the coming weeks.”
Some Democrats have criticized Governor Abbott’s order as nothing more than an attempt to score political points.
“Republicans have no strategy other than attacking immigrants,” said state Assemblywoman Gina Hinojosa of Austin. X said in his postformerly Twitter.
State Rep. Gene Wu (D-Austin) Post to X“Texas has the highest level of uninsured health care in the nation. It has the worst mental health care in the nation. It has some of the worst birth (death) rates and infant mortality rates in the nation. But these are Republican priorities.”
According to AboahorderThe Texas Health and Human Services Commission, which oversees the Department of State Health Services, is tasked with:
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- Directs hospitals and additional designated health care providers to collect information by Nov. 1 about the cost of health care provided to undocumented immigrants.
- It would direct covered hospitals to report such data to the Texas Health and Human Services Commission on a quarterly basis, with the first submission due by March 1.
- It directs hospitals to tell patients that federal law requires that answers to such questions will not affect their care.
- Annually, beginning January 1, 2026, report to the Governor, Lieutenant Governor, and Speaker of the House on the amount of health care provided to undocumented immigrants during the previous year.
Illegal immigrants are ineligible for insurance under the Affordable Care Act. Texas Health and Human Services CommissionHowever, illegal immigrants may be eligible for Medicaid coverage for emergency treatment, but only under strictly defined circumstances.
According to Texas Teaching HospitalUnpaid charity care cost Texas hospitals about $7 billion in 2021, the most recent year for which data is available, costs not broken down by citizenship or immigration status.
Elle Matters reporter Priscilla Totiyapunprasert contributed to this report.