Texas Hospitals Report $121 Million in Care for Immigrants Without Legal Status

Texas hospitals spent over $121 million in a month treating immigrants without permanent legal status, according to a document released Friday by the Texas Health and Human Services Commission. The November 2024 report is the first under Gov. Greg Abbott's executive order, which requires hospitals to collect and disclose these expenditures quarterly.

Gov. Abbott said the reporting requirement pressures the federal government to pay more for healthcare for unauthorized immigrants. Health advocates worry that the move may deter immigrants from accessing the necessary medical care.

The Texas Hospital Association (THA) stressed that hospitals must care all patients regardless of immigration status or capacity to pay. "Hospitals remain open and ready to serve Texans’ acute care needs," THA added.

According to the memo, Texas hospitals registered almost 31,000 undocumented immigrants in November, costing $121 million. Emergency Medicaid, which provides limited emergency services to eligible individuals, may have covered some of those costs.

The executive order requires hospitals to inquire about patients' citizenship status during intake but notes that patients are not required to answer and that their responses will not affect their care.

In Florida, officials cited high undocumented immigrant healthcare expenses and imposed similar regulations. Critics claim such data are misleading and ignore the larger issue of uninsured care. Texas' $3.1 billion in unreimbursed healthcare costs are primarily because one in six residents is uninsured.

The HHSC will release its first annual report on January 1, 2026, after quarterly updates in the coming months.