Greg Abbott asks Texas hospitals to check immigration status of patients: Can a patient refuse to declare?

Of all US states, Texas has some of the most strict immigration laws on the books, and this week, Governor Greg Abbott issued an executive order that tightens those laws even more and could affect the medical care that undocumented immigrants receive.

The Governor has directed the Texas Health and Human Services Commission (HHSC) to collect information on the immigration status of individuals who use Texas public hospitals for emergency and inpatient care.

Texas Immigration Law: Can a Patient Refuse to Share Their Immigration Status?

The order claims to be focused on calculating the cost that undocumented immigrants cost the state of Texas. However, immigration rights activists worry that the information could be transferred to authorities.

The ACLU of Texas is concerned that the order turns hospital staff into “shadow immigration officers” and that it will make undocumented immigrants think twice about receiving medical attention, even when they are suffering from a serious condition.

The state would like to clarify that this measure does NOT prohibit medical care for undocumented immigrants. The executive order instructs hospitals to inform patients that federal law mandates that any response to such inquiries will not impact their care.

Patients can be asked about their immigration status, but they can decline to disclose it should they so choose.

Will data on undocumented immigrants be shared with immigration authorities?

The data query will not result in a report of a patient’s immigration status to immigration authorities. However, the executive order states that hospitals must report the healthcare costs spent on undocumented immigrants.

In addition, HHSC will be required to report annually to the Governor and the Texas Legislature all costs for emergency and inpatient care of undocumented immigrants so that the Texas government can seek reimbursement from the federal government.

Beginning November 1, 2024, hospitals and other identified providers will be required to collect information on the cost of medical care provided to undocumented immigrants.

Separately, covered hospitals will be required to share such data with HHSC every quarter, with initial submissions no later than March 1, 2025.

Additionally, beginning January 1, 2026, HHSC will be required to report annually to the Governor, Lieutenant Governor, and Speaker of the House on the prior year’s costs for health care provided to undocumented immigrants.