Texas governor issues order to track cost of health care for undocumented immigrants

Some advocates are worried a recent executive order in Texas could push immigrants away from seeking medical care.

Texas Gov. Greg Abbott signed an executive order calling for the state to "collect information regarding patients who are not lawfully present in the United States and the cost of the care provided to such patients."

The order is set to take effect Nov. 1.

Christian Piatt is the spokesman for Human Rights Initiative of North Texas, which provides legal services primarily for undocumented asylum=seekers.

Piatt said, "The effects of that, whether intended or not, will cause people to feel intimidated and hesitant to access these basic services that we believe all people are entitled to. They're coming from an environment in another country, in their home country, where the government is not trustable, right? They have been persecuted by their government, so they're going to be wary of any government at all."

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Gov. Abbott's office declined an interview but referred us to their statement announcing the order, it says, "Texans should not have to shoulder the burden of financially supporting medical care for illegal immigrants."

According to Abbott's office, when the final cost is determined, the state will seek to have the federal government reimburse the money.

This goes beyond Texas and is part of a larger effort to keep American taxpayer dollars from funding health care for undocumented immigrants.

In August, 15 Republican attorneys general sued the Biden administration over a rule that would allow DACA recipients to apply for health care coverage via the Affordable Care Act.

Kansas Attorney General Kris Kobach said the Biden administration "shouldn't get a free pass to violate federal law."

A similar tracking effort in Florida hospitals released its first report this year.

The state found undocumented immigrants made up 0.8% of hospital visits from June to December 2023 — accounting for less than 1% of total operating costs of $566 million.

Alexis Tsoukalas is a senior policy analyst with the Florida Policy Institute.

"We know that immigrants are vital to Florida, including undocumented immigrants. We know that undocumented immigrants are paying about $1.8 billion in state and local taxes, just in Florida alone. ... And of course, even if you are not able to work, or you're not working, you're a child, you're an older adult, you still have value as a person," Tsoukalas said.

There is some evidence that policies like these can have a chilling effect on migrants seeking care.

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A Politico analysis found Medicaid expenditures for undocumented immigrants in Florida dropped dramatically after hospitals began to ask patients about their immigration status.

Plus a 2020 survey found a quarter of mixed-status families avoided some noncash government benefit programs for fear of it impacting future green-card applications.

In a statement, the Texas Hospital Association said while it is still reviewing the order, "Hospitals are required by law to provide life-saving treatment to anyone, regardless of ability to pay or status."