Governor Greg Abbott of Texas has issued an executive order mandating that public hospitals in the state collect data on the immigration status of patients. The order, announced on August 8, 2024, requires hospitals to track and report the costs associated with providing medical care to undocumented immigrants. This move is part of Abbott's broader strategy to address the financial impact of what he describes as the Biden administration's "open border policies." For more details, see the official announcement from the Governor's office.

The Texas Health and Human Services Commission (HHSC) is tasked with implementing the order, which will take effect on November 1, 2024. Hospitals are directed to begin collecting information on inpatient discharges and emergency visits by undocumented individuals and report this data quarterly, with the first submissions due by March 1, 2025. The HHSC will compile these reports and submit annual summaries to the Governor and Texas Legislature starting January 1, 2026.

Abbott's directive has drawn sharp criticism from immigration advocates and Democratic lawmakers, who argue that the policy could deter undocumented immigrants from seeking necessary medical care, fearing potential legal repercussions. Critics, including Texas Representative Sylvia Garcia, have condemned the order as a form of "social engineering" that risks turning healthcare providers into immigration enforcement agents. They warn that such measures could lead to racial profiling and undermine public health efforts by discouraging individuals from accessing healthcare services.

The Texas Hospital Association has expressed concerns about the order's implementation, noting that hospitals currently do not inquire about a patient's immigration status as a condition for treatment. They emphasize that federal law requires hospitals to provide emergency care to anyone, regardless of their immigration status.

Governor Abbott has defended the order, stating that it is necessary to quantify the costs Texas incurs due to federal immigration policies and to seek reimbursement from the federal government. He argues that Texans should not bear the financial burden of healthcare.