In a move igniting robust discussion across the state, Governor Greg Abbott made headlines yesterday by issuing an executive order targeting healthcare costs incurred by illegal immigrants. The directive tasks the Texas Health and Human Services Commission (HHSC) with collecting data on such costs from public hospitals and reporting them to state officials, as announced in a statement on the governor's official website.

Abbott's move is framed as a stand against what he labels as the "reckless open border policies" of President Joe Biden and Vice President Kamala Harris, policies Abbott claims leave Texas to "foot the bill" for undocumented individuals. "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,” Governor Abbott said, in a statement that was reported on his official webpage. The governor asserts that this executive order is not only about financial recoupment but accountability as well.

Specific instructions have been laid out for hospitals and healthcare providers in Texas. According to the governor's website, information regarding the cost of medical care provided to illegal immigrants is to be collected by November 1. Hospitals will be responsible for reporting this data on a quarterly basis, with the first reports due by March 1, 2025. Moreover, they must advise patients that their access to care will not be impacted by their participation, as federal law requires.

This annual reporting, which is set to begin on January 1, 2026, hopes to pave the way for Texas to seek reimbursement from the federal government for the costs incurred. The governor's executive order specifies that the collected data should be presented to high-ranking state officials, including the Lieutenant Governor, and the Speaker of the House – emphasizing the perceived gravity of the issue and the state's intent to seek federal assistance in covering these expenses.