Texas Governor Greg Abbott has issued an executive order requiring hospitals in the state to inquire about patients’ immigration status to determine the costs of providing medical care to undocumented individuals. The order mandates hospitals to compile data on inpatient discharges and emergency visits by immigrants living in the U.S. without authorization, as well as the costs of treating them. Abbott directed the Texas Health and Human Services Commission to collect this information starting November 1 and provide regular reports to state authorities. The order applies to hospitals enrolled in Medicaid, the Children Health Insurance Program, and other health care centers identified by the commission. Abbott justified the move by attributing the economic burden of providing medical services to migrants entering the country illegally to record levels of migrant apprehensions at the U.S.-Mexico border in recent years.
Abbott stated that Texas has had to cover the medical costs for individuals illegally in the state due to President Biden and Vice President Harris’ open border policies. His directive assures patients that the information collection will not affect their care and emphasizes that federal law requires hospitals to provide emergency treatment to any individual regardless of their immigration status. However, immigration rights advocates may criticize the order, as similar policies have discouraged immigrants from seeking medical care out of fear of legal repercussions. Democrat Rep. Sylvia Garcia of Texas condemned Abbott, accusing him of social engineering and attempting to turn doctors providing medical care to immigrants into ICE officers. Julia Gelatt from the Migration Policy Institute emphasized that people are allowed to seek care regardless of their citizenship, but asking questions can create worries about immigration consequences and safety in seeking care.
In his order, Abbott hinted that Texas would seek reimbursement from the federal government for these expenses, although the process is unclear. This action by Texas is part of a broader trend of Republican-led states enacting stricter immigration laws and measures. Last year, Florida’s Republican Governor Ron DeSantis signed a harsh immigration state law that requires hospitals to collect information on patients’ immigration status. Several red states, following Texas’ lead, have passed laws criminalizing unauthorized immigration at the state level and empowering state officials to prosecute suspected violators. These state laws have faced legal challenges by the Justice Department, which argues that immigration policy is the purview of the federal government. Texas, under Abbott’s leadership, has been aggressively challenging the Biden administration on immigration, filing lawsuits against major immigration actions, busing migrants to Democratic-led cities, fortifying the banks of the Rio Grande with razor wire, and arresting migrants on trespassing charges.
Abbott’s latest move reflects the ongoing political and legal battles over immigration policy in the United States, with conservative states pushing for stricter measures in response to what they see as insufficient action by the federal government. Despite criticisms from immigration rights advocates and Democrats, Abbott’s order underscores the continued focus on immigration issues at the state level and the efforts to address the financial costs associated with providing medical care to undocumented individuals. The clash between state and federal authorities on immigration is likely to persist, with implications for the treatment and rights of immigrants in the U.S. as well as for the broader political landscape and policy debates. Abbott’s directive signals a concerted effort by Texas to take matters into its own hands and assert control over immigration policy within its borders, setting the stage for further legal and political battles over the rights and treatment of undocumented individuals in the state.