Impact of Undocumented Immigrants on Texas Hospital Costs
In November, Texas hospitals reported significant healthcare expenses totaling $121.8 million for services rendered to individuals not lawfully present in the United States. This information emerges from a recent data release by the Texas Health and Human Services Commission.
Governor’s Directive
Following a directive from Governor Greg Abbott, hospitals were mandated to inquire about the legal status of new patients starting November 1. The Governor indicated that this measure aims to address the Biden-Harris administration’s perceived leniency on border issues and to seek federal reimbursement for healthcare costs incurred by undocumented immigrants. Abbott’s order asserts that these individuals contribute to rising medical expenses for Texans.
The Financial Burden
Abbott’s press secretary, Andrew Mahaleris, remarked that this data provides clear evidence of the financial strain that illegal immigration places on the state’s healthcare system. However, analysts have raised concerns regarding the comprehensiveness of the data, noting that it does not compare the costs associated with undocumented patients to those faced by uninsured U.S. citizens in Texas.
Context of the Uninsured in Texas
According to recent estimates, Texas holds the highest uninsured rate in the nation, with around 4.8 million residents lacking health insurance as of 2023. This statistic includes about 1.7 million undocumented immigrants, contributing to a complex landscape of healthcare needs and financial challenges within the state.
Insights from Experts
Lynn Cowles, a health and food justice program manager at Every Texan, emphasized that while the reported costs are significant, they are modest compared to the overall expenses linked to uninsured U.S. citizens. Cowles indicated, “We don’t even know how much of our collective funds go to those who are documented compared to those who are undocumented. But we do know that the majority of uninsured people in Texas are citizens.”
Implications for Healthcare Access
Patients are informed that they are not legally obligated to disclose their immigration status, and their answers will not affect their access to care. However, immigration advocates have raised alarms that the requirement to answer such questions may deter undocumented individuals from seeking necessary medical treatment. Cowles noted the potential inaccuracies in the data collected, stating, “What happens to the data that doesn’t get filled out?”
Looking Forward
A bill filed by State Representative Mike Olcott aims to formally require hospitals to ask about patients’ citizenship status. Olcott highlighted the necessity of obtaining this information to better understand the percentage of uncompensated care attributed to undocumented individuals, especially in light of the 181 rural hospitals that have closed since 2005, largely due to uncompensated care challenges.
Conclusion
The financial report detailing a full year of undocumented immigrant healthcare costs is anticipated in early 2026. As Texas continues to grapple with its healthcare system’s challenges, the interplay between immigration status and access to medical care remains a critical issue impacting both policy and patient outcomes.
Disclosure: Every Texan and Texas Hospital Association have previously supported The Texas Tribune, a nonprofit organization that operates independently of its financial backers.