Texas hospitals spent millions on care for illegal immigrants

Texas hospitals reportedly treated tens of thousands of patients who were in the United States unlawfully, resulting in over $121 million in healthcare costs.

The Texas Health and Human Services Commission released data Friday showing that Texas hospitals “incurred $121.8 million in health care costs for persons not lawfully present in the U.S.” in November 2024.

Additionally, individuals who are not lawfully present in the U.S. visited Texas hospitals over 31,000 times in November alone. 

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During a Texas House of Representatives Public Health Committee hearing earlier this week, an executive for the Texas Health and Human Services Commission detailed what the agency has learned from data collected by 558 hospitals in the state. 

The hearing comes as lawmakers consider legislation from Republican Rep. Mike Olcott that would codify Gov. Greg Abbott’s executive order from last summer, which required hospitals to collect patients’ immigration status in an annual report. 

Per the order, Texas hospitals were instructed to collect information on Nov. 1, 2024, on patients unlawfully in the U.S. Hospitals were told to gather the number of inpatient discharges, the number of emergency visits and the cost of providing care to such patients. 

The hospitals in the state were expected to turn in their first months of data by March 1. Lawmakers at the hearing addressed the findings based on the available data.

“The number of visits was in the thousands, the tens of thousands, and the costs were in the millions,” Victoria Grady, director of provider finance at HHSC, said, according to The Texas Tribune. “We should be finalizing the data by the end of the week.”

Grady said part of the reason for the delay in the data becoming public is that the agency sometimes receives the data in paper form. On occasion, the data is mailed to the HHSC, and the agency then has to manually input the data onto a spreadsheet, according to The Texas Tribune.

Olcott compared House Bill 2587 to Senate Bill 1718 in Florida, which passed in 2023. The Florida bill requires hospitals that accept Medicaid to include a question on the admission forms about the patient’s immigration status.

In addition, Senate Bill 1718 requires hospitals to submit quarterly reports to the Agency for Health Care Administration to help determine healthcare costs. 

“Since 2005, we’ve had 181 small rural hospitals close primarily due to uncompensated care,” Olcott said. “The goal of this is simply to know what percentage of that uncompensated care are due to people here illegally.”

While hospitals are required by federal law to provide emergency medical treatment to patients regardless of their immigration status or ability to pay, the purpose of Olcott’s bill is to determine how often illegal migrants are receiving more than basic medical care and what the cost could be for taxpayers in the state of Texas. 

“The point of this bill is to simply get a handle on how much this is occurring, and how much is it costing Texas taxpayers, and these hospitals,” the Republican state representative said.

If passed, House Bill 2587 would formalize the order, requiring hospitals to annually report on the “uncompensated hospital care” provided to individuals who were persons not lawfully present at the time health care services were provided to those patients.”

According to the Texas Hospital Association, hospitals in the state spend $3.1 billion a year on uninsured care that is not reimbursed by any supplemental payments. The association also noted that one out of six residents in the state have no health insurance, and about one in four Texans have coverage through government sources, including Medicare and Medicaid.