ABC News November 1, 2024

Texas public hospitals now must ask patients if they are in US legally

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Public hospitals in Texas will now be required to ask patients if they are in the U.S. legally and keep a record of the funds spent on illegal migrants after an executive order went into effect Friday.

Public hospitals are required to collect information regarding the "cost of medical care provided to illegal immigrants," the number of inpatient discharges and the number of emergency visits, then submit that data to the Texas Health and Human Services Commission on a quarterly basis, Texas Gov. Greg Abbott wrote in an August statement announcing the measure.

While facilities must ask patients of their legal status, patients are not required to respond.

Jason Fochtman/Houston Chronicle via Getty Images, FILE
In this Feb. 7, 2024, file photo, Texas Childrens Hospital, MD Anderson Cancer Center and the John P. McGovern Texas Medical Center Commons are shown in Houston, Texas.

The new policy will also be enforced at hospitals enrolled in Medicaid, the Children's Health Insurance Program and any other facilities identified by the commission.

The first submission is due on March 1, 2025, according to the governor's office. The commission will then submit the total cost for medical care provided to illegal migrants to the governor, lieutenant governor and the speaker of the house on an annual basis beginning on Jan. 1, 2026.

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Patients are to be told that the collection of this information will not affect patient care, according to the executive order. Federal law mandates patients be told their answers will not affect their medical care.

A similar law was enacted in Florida last year, creating fear among migrants in the state, according to The Associated Press.

Herika Martinez/AFP via Getty Images, FILE
In this June 5, 2024, file photo, migrants seeking asylum in the United States are watched by Texas agents next to the border wall in El Paso, Texas.

The executive order also states that the federal government "may and should be obligated to reimburse the state of Texas for the costs that its open border policies have imposed on Texans."

"Due to President Joe Biden and Vice President Kamala Harris' open border policies, Texas has had to foot the bill for medical costs for individuals illegally in the state," Abbott said in the statement, though migrant encounters at the border began rising while Donald Trump was president in the months after April 2020 through the November election. "Texans should not have to shoulder the burden of financially supporting medical care for illegal immigrants."

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Immigration advocacy groups condemned the action as it went into place Friday.

"Abbott's latest executive order -- which takes effect today and goes against federal law -- is a calculated attempt to drive immigrants into the shadows and make our communities fearful of being targeted in the very places we should feel safe. Going after immigrants in hospitals is just the first step towards enacting Trump's Project 2025 agenda," said Michelle Ming, political director of United We Dream Action, an advocacy group for immigrants.

ABC News' Armando Garcia contributed to this report.