Overview of the New Requirement

In an executive order signed by Governor Greg Abbott in August 2024, Texas hospitals must now collect data on patients who are “not lawfully present in the United States.” This requirement was set to take effect on November 1, 2024, with hospitals expected to report their findings to the Texas Health and Human Services by March 1, 2025. This initiative aims to increase transparency and improve understanding regarding uncompensated care within the state’s healthcare system.

Legislative Movement

The House Committee on Public Health is reviewing a bill proposed by Fort Worth Republican Representative Mike Olcott, which aims to codify Abbott’s executive order into law. During committee hearings, Victoria Grady, the Texas Health and Human Services Commission’s director of provider finance, emphasized that the bill will clarify submission protocols, particularly regarding data collection methods.

“We don’t currently require them to only submit it to us electronically,” Grady mentioned, adding that inconsistent submission formats necessitate additional processing work for health officials.

Grady noted that approximately 558 out of 600 hospitals met the March 1 reporting deadline, generating substantial data that has not yet been released to the public. She indicated that the number of visits by patients without lawful status is in the tens of thousands, with associated healthcare costs running into millions.

Financial Implications for Rural Hospitals

Representative Olcott pointed out that understanding the proportion of uncompensated care related to undocumented individuals could be crucial for rural hospitals, many of which are struggling financially. He highlighted the distressing statistic that 181 rural hospitals have closed since 2005, a trend that raises concerns over access to medical care in underserved areas.

Controversy Surrounding the Bill

While some support the bill for its potential to improve data on healthcare costs, immigrant rights advocates have raised concerns regarding its impacts on vulnerable populations. Priscilla Lugo, an advocate for immigrant rights, argued that such legislation could endanger human trafficking victims who require medical care. She stated, “Texas should never be a place where an abused person cannot walk into a hospital and get the care and intervention they need.”

Olcott responded to these allegations, clarifying that the bill does not include any measures for immigration enforcement, emphasizing a focus purely on data collection.

The Uninsured Population in Texas

According to the Texas Hospital Association, approximately one in six Texans lacks health insurance, translating to around 17% of the state’s population, which significantly exceeds the national average of 8%. In 2023, it was reported that Texas hospitals faced $3.1 billion in unreimbursed medical care.

The bill proposed by Olcott, however, is currently pending review in committee, with its future uncertain as discussions continue.