The new policy, established by an executive order issued by Gov. Greg Abbottin August, took effect Friday and follows a similar law signed by Florida Gov. Ron DeSantis last year.
Abbott’s order requires hospitals that participate in Medicaid or the Children’s Health Insurance Program to ask patients if they are U.S. citizens or are lawfully present in the country.
Hospitals also must document the cost of caring for undocumented immigrants and report the information quarterly to Texas Health and Human Services beginning March 1, 2025.
“Texans should not have to shoulder the burden of financially supporting medical care for illegal immigrants,” Abbott said when he announced his executive order.
Patients are not required to answer questions about their citizenship status to receive care, and health care providers must, under federal law, inform patients that their status will not affect access to treatment.
Even so, migrant advocates worry the executive order will discourage immigrants from seeking medical attention.
“People’s private medical information should be maintained between them and their healthcare provider, not the state,” Kassandra Gonzalez, a staff attorney with the Texas Civil Rights Project, said in a statement. “Everyone, especially those in need of urgent medical care, should be able to access hospitals without fear – regardless of their immigration status.”
Hospitals will record patients’ answers on a spreadsheet that does not include areas for personal information, according to a draft shared by Texas Health and Human Services.
Texas Hospital Association spokesperson Carrie Williams said the order will not affect patient care.
“The bottom line for patients is that this doesn’t change hospital care,” Williams said. “Texas hospitals continue to be a safe place for needed care.”
Federal law requires emergency care to be provided to all patients regardless of whether they have insurance or can pay for treatment. Abbott’s order does not change that requirement.
Hospital systems in North Texas declined Friday to provide details on how Abbott’s order is being addressed.
At JPS Health Network, based in Fort Worth, citizenship status and the other required information is collected during the patient registration process, a spokesperson said via email. The statement encouraged “all patients to seek care, regardless of their background,” but did not include details on how the system is implementing the new rules.
A spokesperson for Parkland Health, the public hospital district for Dallas County, said in an emailed statement that the hospital system is following the governor’s order. Parkland’s spokespeople did not respond to a follow-up request for additional detail.
A spokesperson for Children’s Health — which includes Children’s Medical Center Dallas — also said the system would “follow and adhere to all local, state and federal health care requirements.” No additional details were provided.
Cook Children’s Health Care System, based in Fort Worth, said the order would not impact patient care. A spokesperson directed additional questions to the Texas Hospital Association and said there was no additional information they could share.
Representatives for UT Southwestern Medical Center and Texas Health Resources did not respond to requests for comment Friday.
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