State hospitals will soon be required to track and report the immigration statuses of their patients thanks to Texas Gov. Greg Abbott’s latest executive order. In a news release, Abbott stated that beginning Nov. 1, public hospitals will be required to track the cost of healthcare incurred by illegal immigrants seeking treatment so that the state can be reimbursed by the federal government.
“Texans should not have to shoulder the burden of financially supporting medical care for illegal immigrants,” Abbott said. “Texas will hold the Biden-Harris Administration accountable for the consequences of their open border policies, and we will fight to ensure that they pay back Texas for their costly and dangerous policies.”
The order has drawn frustration from advocates for immigrant rights in large part because of the financial contribution immigrants have been shown to make in the state. Earlier this summer, a report from the American Immigration Council found that Dallas' immigrant community contributed billions to the economy.
After Abbott’s announcement, the Department of Health and Human Services told the Austin-American Statesman that the office "will implement Governor Abbott's executive order and will provide guidance to hospitals in the coming weeks." A DHHS web page titled "Immigrant Rights Healthcare Factsheet,” which advised medical physicians not to ask patients about their immigration status, was deleted from the DHHS website shortly after Abbott’s order.
“This would be a new requirement, and we are reviewing it as quickly as possible,” Carrie Williams, spokesperson for the Texas Hospital Association, said in a statement after the executive order was released. “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.”
“[Abbott is] just playing games with people’s lives.” — Gabriel Rosales, Texas Director of the League of United Latin American Citizens
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In a statement sent to the Observer, W. Stephen Love, President of the Dallas-Fort Worth Hospital Council, said the region’s hospitals will continue to comply with the Emergency Medical Treatment and Labor Act ( EMTALA ), which states that any individual who enters a hospital or emergency room requiring medical care must be treated. The hospitals will work with the Texas Health and Human Services Commission to comply with any new procedures the executive order might necessitate, Love added.
Gabriel Rosales, Texas Director of the League of United Latin American Citizens (LULAC), told the Observer that the executive order will exacerbate existing fears that immigrants in Texas have when dealing with the government. Rosales thinks it is likely the order will lead to people refusing to seek medical care, even when it is necessary.
“With the conditions and the narratives and the policies [Abbott] has set forth in Texas, you already have that situation where people are scared to go get help, to call the police. He seems to want to empower vigilantes to be able to call the [Immigration and Naturalization Service],” Rosales said. “A huge concern of ours is that you're going to have a rogue hospital.”
Abbott’s order states that immigration status tracking will be used for billing purposes and that hospitals will be required to tell patients that federal law mandates they receive care no matter what their immigration status is, but Rosales worries the “cruel policy” could lend itself to racial profiling and “rogue” doctors reporting patients who are in the country illegally.
The order will apply to any hospitals enrolled in Medicaid and the Children's Health Insurance Program. The Observer reached out to the UT Southwestern System and the Parkland Health to ask how the Dallas-based hospitals will respond to the order. UT Southwestern did not respond to comment, and Parkland directed us to Abbott’s press office.
The hospitals’ first report is due to the state on March 1, 2025.
Rosales said several attorneys are now looking for “legal remedies” to the order, but for now LULAC will focus on educating community members about their rights so that no one stops seeking medical care.
“[Abbott is] just playing games with people’s lives,” Rosales said. “He's pretty disrespectful, very hateful to the community. … The violence it has already impacted our community, as you saw in El Paso, because of such rhetoric, and coming from the highest office here in Texas doesn't help. What we're trying to do here is build a community for everyone.”
