In a move that is stirring debate across the healthcare and immigration arenas, Governor Greg Abbott has taken a step that will change how public hospitals in Texas operate. An executive order signed by Abbott now mandates that these hospitals collect information on patients' immigration status. The policy, aimed at tracking the financial load of medical care for undocumented migrants, is set to take effect on November 1, 2024.

Historically, Texas public hospitals have not been required to inquire about a patient's immigration status. However, Abbott's rationale, as reported by Chron.com, is clear: “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." He adds, "Texans should not have to shoulder the burden of financially supporting medical care for illegal immigrants.”

The implications of this directive from the Governor's office reach beyond the political sphere into the day-to-day operations of healthcare provision. According to a statement obtained by Click2Houston, Carrie Williams, a spokesperson for the Texas Hospital Association, emphasized the novelty of the order: "This would be a new requirement, and we are reviewing it as quickly as possible." Williams also noted that currently, "hospitals don’t ask about patient immigration status as a condition of treatment."

This executive order entails that public hospitals begin reporting the cost data associated with undocumented immigrants' care to the Texas Health and Human Services Commission on a quarterly basis, starting in March 2025. The underpinning intent is for the state to eventually bill the federal government for these expenses. Acknowledging the potential for a significant procedural shift, the Texas Hospital Association has reserved further comment until a more thorough analysis of the order can be completed.