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Texas Hospitals in November paid $118.8 million in health care costs in November from patients who were not permitted to be “legally” in the country, according to data released Friday by the Texas Health and Human Services Commission.
Texas hospitals reported the costs of more than 30,000 hospital visits by undocumented immigrants to the state health agency after Gov. Greg Abbott asked Texas Hospital to disclose whether they were “legally in the US.” Abbott said the report’s purpose was to hold it accountable for border policies open to the Biden-Harris administration and to request a federal rebate for the costs of care. He argued in his order that undocumented immigrants would increase the cost of healthcare for all Texans.
“Now, Texas has reliable data on the dramatic financial impact of illegal immigrants on the hospital system,” Abbott’s reporter Andrew Mahalleris issued a statement in an email Friday.
Policy analysts previously told the Texas Tribune he was worried about the state’s numbers to release at undocumented immigrant hospital costs.
Friday’s report doesn’t say how costs are paid from undocumented patients who generally don’t have health insurance compared to that of uninsured US citizens who used the Texas Hospital System in November. The report also does not clarify whether the hospital will later be costly or recovered.
For each left-leaning think tank, Linkaules, manager of the Health and Food Justice Program, said $121.8 million is a reduction in buckets compared to the costs incurred by all uninsured Texans.
Recent estimates from the US Census Bureau show that Texas has the most uninsured tax rate in the country. In 2023, approximately 4.8 million or 19% of Texas children and adults under the age of 65 lacked health insurance.
The state has 1.7 million undocumented immigrants.
“I don’t even know how much of our collective funding gives to documented people compared to undocumented people. But I know that the majority of Texas uninsured people are citizens,” she said.
Patients are informed that they are not legally required to provide citizenship status to hospitals, and that their answers cannot put their access to health care at risk.
On Friday, the Texas Hospital Association doubled the hospital’s promise to care for Texans who need it.
“The fact that hospitals are needed to collect this data should not be a deterrent for those who need care,” according to the news release.
Immigration advocates fear that the risk of deportation can prevent undocumented immigrants from responding to questions and seeking care from hospitals. Its cold effects contribute to the reasons why data collected by hospitals are suspicious, Cowles said.
“What happens to data that isn’t filled out? There are a lot of Texas residents who refuse to fill out the immigration form. Is that all that together? There are a lot of questions about the report,” Cowles said.
Cowles said the 10-character report is not about addressing what is increasing the cost of healthcare for the Texans.
“If this is a project that gets good data, this is a failed project,” Cowles said. “What we need is a pilot study or research that really tries to grasp the entire pool of uncompensated care in Texas. Because the actual costs come from citizens, especially those in rural areas where uninsured fees are much higher. ”
Estimates from the Texas Hospital Association have shown for many years that undocumented immigrants, including Medicaid, have not received access to health insurance plans, typically using fewer hospitals than American citizens, who are not covered by insurance, usually with fewer hospitals than American citizens who are not covered by insurance. Even emergency Medicaid spending, which covers hospital costs for immigrants that are not documented by design, has declined over the past five years.
Rep. Mike Alcott of R-Fort Worth said he has introduced House Bill 2587 codified Abbott’s order seeking the civil rights status of hospital patients, saying knowing undocumented patient costs is important in the state’s struggle to keep rural hospitals open.
“Since 2005, 181 small rural hospitals have been closed primarily for uncompensated care,” Alcott said at a hearing for his bill on Monday. “The goal is simply to know if the percentage of care that is not compensated is due to the people here.”
A report of the year’s worth of data collected from hospital providers on undocumented costs from immigrants is expected to be released in early 2026.
Disclosure: All Texas and Texas Hospital Associations were financial advocates for the Texas Tribune, a non-profit, nonpartisan news organization funded in part by donations from members, foundations and corporate sponsors. Financial supporters have no role in Tribune journalism. Find the complete list of them here.
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