Texas hospitals wrestle with governor’s order to report immigration status of patients

Hospitals in Texas are being directed to collect information on the immigration status of patients and the cost of caring for patients who aren’t in the country legally.

Texas Gov. Greg Abbott has issued an order directing hospitals to collect information on the immigration status of patients and the cost of caring for those who aren't here legally.

Texas Gov. Greg Abbott issued an executive order last week directing hospitals to gather the information and report it to the state. Hospitals will have to start collecting the information on Nov. 1.

Hospitals are bound to provide emergency care to all patients and are now dealing with potentially difficult requirements. Critics of the governor’s order say that it could deter people from going to hospitals with serious or even life-threatening conditions.

The Texas Hospital Association says it continues to analyze the governor’s order.

In a statement, the association said, “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. Hospitals are required by law to provide life-saving treatment to anyone, regardless of ability to pay or status.”

In a statement accompanying his order, Abbott said the order is designed to gather information on how much Texas hospitals are spending on caring for those who aren’t in the U.S. legally.

"Due to President Joe Biden and Vice President Kamala Harris’ open border policies, Texas has had to foot the bill for medical costs for individuals illegally in the state,” Abbott said in the statement. “Texans should not have to shoulder the burden of financially supporting medical care for illegal immigrants.”

Under the order, hospitals are directed to collect information on the costs of inpatient care and emergency care to patients who are in the country without legal permission. Hospitals will be required to file quarterly reports to the state, with the first report due March 1, 2025. Hospitals will also be directed to file annual reports of the previous year’s cost of care beginning in 2026.

The executive order also directs hospitals to tell patients that their response to questions about their immigration status won’t have any bearing on their ability to get the care they need. “Any response to such information requests will not affect patient care,” the order says.

The order applies to all acute care hospitals that participate in the Medicaid program, the Children’s Health Insurance Program, and other providers identified by the Texas Health and Human Services Commission.

Stephen Love, CEO of the Dallas-Fort Worth Hospital Council told NBC 5 in Dallas that hospitals comply with federal law to ensure patients receive appropriate care.

“Regarding the executive order and how the state wants to collect data, hospitals always comply with federal, state and local regulations and requirements. We will obviously work with the state agencies to comply with new procedures, regulations or requirements,” Love told NBC 5.

The ACLU of Texas says it will consider all options to ensure people receive healthcare. Sarah Cruz, policy and advocacy strategist for border and immigrants’ rights at the ACLU of Texas, say the order could cause lasting damage.

“By conscripting health care workers as shadow immigration officers, the governor is once again playing politics with peoples’ lives," Cruz said in a statement. "Federal guidance is clear that anyone can access medical care regardless of immigration status. Texas has some of the worst health care outcomes in the country. This latest abuse of emergency authority could make things even worse.”

United We Dream, an organization that advocates for the rights of immigrants, blasted the governor’s order.

“Access to medical care should never be determined by a person’s immigration status. This dangerous action will make immigrants afraid to seek out medical care and put their health & lives at risk,” the group said on X.

Fernando Garcia, executive director of the Border Network for Human Rights, which pushes for immigration reform, said in a statement, “This Executive Order is nothing less than a policy of attrition that will result in undocumented immigrants fearing to seek out medical attention and a shameless attempt to make the state of Texas a hostile place for our communities.”