Texas hospitals spent millions caring for non-citizens, according to HHSC

AUSTIN, Texas - Texas hospitals have seen tens of thousands of patients who were not lawfully in the United States and spent millions of dollars on their care since information on a patient's immigration status has been required to be collected.

What we know:

Gov. Greg Abbott signed an executive order in August 2024 that required Texas hospitals to collect information on "patients who are not lawfully present in the United States."

Hospitals were required to begin collecting information on Nov. 1, 2024, and report the data to Texas Health and Human Services by March 1, 2025.

On Monday, the House Committee on Public Health heard testimony about Fort Worth Republican Rep. Mike Olcott's bill that would make Abbott's executive order a law.

Victoria Grady, Texas Health and Human Services Commission director of provider finance, said the bill would help provide clarity to hospitals about how and what data to submit.

"We don't currently require them to only submit it to us electronically," Grady said. "We've received some submissions by some hospitals by mail so we're retyping the numbers that they've sent us in our spreadsheets, and we'd really like to get it electronically."

Grady said 558 of the 600 hospitals that were required to send in their data met the March 1 deadline. That data has not been released publicly.

"I can tell you the number of visits was in the thousands, the tens of thousands, and the costs were in the millions," Grady said. "We should be finalizing the data by the end of the week."

Olcott said the bill would help in understanding the percentage of uncompensated care that goes to those who did not enter the country legally.

"Small rural hospitals are struggling financially," Olcott said. "Is it all because of illegal immigrants? No. How much of it is because of that? I don't know the answer to that."

Olcott said 181 rural hospitals have closed since 2005.

The other side:

Immigrant rights advocate Priscilla Lugo argued that the bill harms human trafficking victims. She said that 28% of human trafficking victims are seen for medical while they are being trafficked. 

"Texas should never be a place where an abused person cannot walk into a hospital and get the care and intervention they need," Lugo said.

Olcott said there was no immigration enforcement included with the bill.

"I want to emphasize there's not one single element of immigration enforcement in this bill," Olcott said.

Uninsured in Texas

The Texas Hospital Association estimates around one in six Texans does not have health insurance. That works out to around 17% of Texans who do not have medical coverage. Well above the U.S. average of 8%.

In 2023, THA said $3.1 billion in medical care was not reimbursed.

Olcott's bill was left pending in committee.