Texas to require hospitals collect, report illegal immigrant costs

After more than three and a half years of a border crisis, Texas followed Florida on a key immigration issue, this time to determine how much taxpayers are footing the bill for illegal foreign nationals receiving medical care in public hospitals.

Texas Gov. Greg Abbott issued a three-page Executive Order directing the Texas Health and Human Services Commission to collect information on illegal foreign nationals who receive inpatient and emergency care at Texas public hospitals. It also requires HHSC to annually report all inpatient and emergency care costs incurred for illegal foreign nationals to the governor and state legislature in order for the state to seek reimbursement from the federal government.

“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. “Texans should not have to shoulder the burden of financially supporting medical care for illegal immigrants. That is why today I issued an Executive Order requiring the Texas Health and Human Services Commission to collect and report healthcare costs for illegal immigrants in our state. Texas will hold the Biden-Harris Administration accountable for the consequences of their open border policies, and we will fight to ensure that they pay back Texas for their costly and dangerous policies.”

Abbott’s order cites a disaster proclamation he issued on May 31, 2021, due to the surge of illegal border crossers in Texas who “posed and the ongoing and imminent threat of disaster for a number of Texas counties and for all state agencies affected by this disaster.”

Since April 21, 2021, at least 55 counties have declared an invasion and 60 counties have issued disaster declarations citing the border crisis, The Center Square has exclusively reported.

Abbott’s order also cites the record number of “more than 11,000,000 people—a number larger than the population of 40 different states— entering the country illegally in less than four years under the Biden-Harris administration.” His number excludes at least 2 million gotaways, those who evaded capture and are in the country illegally, exclusively reported by The Center Square.

The order cites examples of Biden-Harris “open-border policies that invite mass illegal entry into Texas,” ignore federal laws and have contributed “to the growth of uncompensated medical costs.” Because federal law requires that any individual must be allowed to obtain emergency medical treatment at a publicly funded medical facility regardless of immigration status, or willingness or ability to pay for treatment, Texas is absorbing “a large percentage of the costs associated with medical care for individuals who are not lawfully president in the United States,” he states.

Not only do illegal foreign nationals receiving taxpayer-funded medical care create a burden for taxpayers, but they also increase medical care costs for all Texans, he notes.

“The federal government may and should be obligated to reimburse the state of Texas for the costs that its open border policies have imposed on Texans, costs of which the state had no notice and which it could not have anticipated when agreeing to shared health funding mechanisms on the premise that the federal government would follow federal laws.”

The order directs acute care hospitals enrolled in Medicaid or the Children’s Health Insurance Program and any additional providers identified by HHSC to collect required information beginning Nov. 1, 2024.

It also directs covered hospitals to report the required data to HHSC quarterly, with initial submissions due March 1, 2025; and to report required data annually beginning Jan. 1, 2026, to the governor and heads of the state legislature.

Hospitals are also directed to inform patients that federal law mandates that any response to such questions will not affect their medical care, the order states.

The order follows hearings held this summer by the state legislature and U.S. House to ascertain the taxpayer burden of illegal immigration.

Abbott’s order follows one issued by Florida Gov. Ron DeSantis in September 2021.His 13-page executive order outlines numerous examples of the Biden-Harris administration’s refusal to enforce federal immigration law and the impact on states. DeSantis’ order also addresses thousands of unaccompanied minors being resettled to Florida, the third greatest number behind Texas and California, The Center Square reported.

After the administration began flying hundreds of thousands of illegal foreign nationals from the border to states across the country, DeSantis said, “it is necessary to collect additional data and information on illegal aliens who have resettled in Florida from the Southwest Border, the illegal alien population in Florida generally, and the impact of illegal immigration on the health, safety, welfare, and prosperity of Floridians.”

DeSantis’ order also covers multiple state agencies, requiring them to collect a range of data related to illegal foreign nationals residing in Florida. After it was implemented, his office reported that taxpayers spent nearly $340 million on illegal foreign nationals admitted to Florida hospitals in fiscal 2021, up from $312 million in fiscal 2020.

The state also found that medical facilities appeared to have lost money because they were only “paid for 33% of costs attributed to illegal aliens,” largely through federal subsidies and charity aid, The Center Square reported.