Critics of this initiative worry that it could discourage individuals, particularly those without legal status, from seeking necessary medical care, despite assurances that patients are not obliged to disclose their information. This policy mirrors a similar law enacted in Florida last year, under Governor Ron DeSantis, who has been vocal about federal immigration policies and their implications at the U.S.-Mexico border.
In preparation for this change, Texas hospitals have spent months strategizing and reassuring patients that their level of care will remain unchanged. Under Abbott’s executive order, hospitals are now required to inquire whether patients are U.S. citizens and if they are legally present in the country.
Patients retain the right to withhold this information, and hospital staff must inform them that their responses will not affect the quality of care they receive, in accordance with federal law. The state will not require hospitals to begin submitting reports until March, and early drafts of the data collection forms created by state health officials do not include fields for patients’ names or personal identifiers.
Healthcare providers will document details of patient visits, specifically noting whether individuals are legally present, U.S. citizens, or undocumented. This data will also include costs associated with care for those covered by Medicaid or the Children’s Health Insurance Program (CHIP), as well as expenses incurred by uninsured patients.
Governor Abbott stated during the announcement of this policy, “Texans should not bear the financial burden of medical care for illegal immigrants.”
Similar laws in Florida have raised concerns among healthcare advocates, who argue that such regulations have instilled fear among undocumented immigrants, leading to fewer individuals seeking emergency medical care—even in facilities exempt from these laws.
Initial data from Florida, acknowledged to be limited, indicates that around 8% of hospitalized individuals and approximately 7% of those visiting emergency rooms chose not to respond to the immigration status question from June to December 2023. Notably, less than 1% of emergency room patients reported being “illegal” residents of the U.S.
Immigrant rights and healthcare advocates in Texas are mobilizing efforts to educate the public about their rights. Similar campaigns in Florida have utilized text messages, posters, and emails to disseminate information, though advocates there have noted that fear among potential patients remains pervasive even after nearly a year.
Healthcare providers are receiving guidance from the state and the Texas Hospital Association to navigate this new landscape. Carrie Williams, a spokesperson for the association, emphasized, “The main point for patients is that this will not change the care they receive at hospitals. Texas hospitals remain a safe place for necessary care.”
As Texas embarks on this new healthcare policy, the implications for patient care and public health remain to be seen.
