Texas Gov. Abbott instructs hospitals to collect data on patients' immigration status

Republican Texas Governor Greg Abbott on Thursday ordered hospitals in the Lone Star State to ask patients about their immigration status to determine medical costs for people in the U.S. illegally. 

By executive order, Abbott directed Texas hospitals to collect data on hospital discharges and emergency department visits by immigrants who are in the U.S. illegally, as well as the medical costs of this population.

Abbott ordered the Texas Health and Human Services Commission to require hospitals to collect the information starting Nov. 1 and to submit regular reports to state regulators. The order applies to hospitals participating in Medicaid and the Children's Health Insurance Program, as well as other medical facilities designated by the commission. 

To justify the move, Abbott pointed to record numbers of migrants apprehended at the U.S.-Mexico border in recent years and argued that Texas bears the financial burden of providing medical care to migrants who enter the country illegally.

Texas Gov. Greg Abbott waves on stage on the third day of the Republican National Convention on July 17, 2024

"Due to President Joe Biden and Vice President Kamala Harris' open border policies, Texas has had to foot the bill for medical costs for individuals illegally in the state," Abbott said in a statement. Abbott's directive said hospitals should tell patients the new information collection "will not affect patient care." He noted in his order that federal law requires hospitals to provide emergency treatment to any individual, irrespective of their immigration status.Still, Abbott's order is likely to be decried by immigration rights advocates, who have said similar policies have had a chilling effect on immigrants, discouraging them from accessing medical care out of fear of legal repercussions. Democrat Rep. Sylvia Garcia of Texas condemned the order, accusing Abbott of "social engineering" and seeking "to make ICE officers out of doctors providing immigrants with medical care." "People are allowed to get care regardless of their citizenship," said Julia Gelatt, an analyst at the Migration Policy Institute, a non-partisan think tank in Washington. "But we know the questions may lead to people's concerns about the impact on immigrants and whether it is safe to receive medical care." In his order, Abbott indicated Texas will try to get the federal government to reimburse the state for these costs, but it is unclear how that would happen.

Migrants attempting to enter the U.S. are chased away with tear gas by Texas National Guard agents at the border with Ciudad Juarez, Mexico, on May 13, 2024.

Texas' action on Thursday is the latest example of Republican-led states enacting stricter immigration laws and policies. Last year, Florida's Republican governor, Ron DeSantis, signed a tough immigration bill that requires hospitals to collect information about patients' immigration status. Led by Texas, several Republican states have also passed laws aimed at criminalizing illegal immigration at the state level and giving state authorities the power to prosecute suspected violators. These laws are being challenged in federal court by the Department of Justice, which has noted that immigration policy has long been a federal responsibility. At Abbott's direction, Texas has launched aggressive political and legal challenges to the Biden administration on immigration, including lawsuits challenging nearly every major immigration policy taken by President Biden. Abbott also ordered state officials to bus tens of thousands of migrants to Democratic-run cities, ordered the National Guard to fortify the banks of the Rio Grande with barbed wire, and ordered state troopers to arrest migrants for trespassing.