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Texas Hospitals Now Required to Ask Patients About Legal Status

Texas hospital immigration policy, Texas hospital legal status questions, Texas patient immigration status/ Newslooks/ Starting Friday, Texas hospitals must ask patients if they are legally in the U.S., under a mandate by Governor Greg Abbott. While patients are not obligated to respond and care will not be affected, the new policy has sparked concerns about deterring individuals from seeking medical help. Hospitals are required to begin reporting patient data and associated costs to the state by March.


  • New Requirement: Texas hospitals must now ask patients about their legal status, though patients are not required to respond.
  • Data Collection: Hospitals will track costs for undocumented patients but are not required to report personal details.
  • Florida’s Precedent: Similar laws in Florida have reportedly deterred some patients from seeking care, despite assurances of continued service.
  • Hospital Preparations: Texas health providers emphasize patient care remains unaffected and are working to inform the public.

Deep Look

Beginning Friday, hospitals across Texas must ask patients whether they are legally in the United States, as part of a new policy ordered by Republican Governor Greg Abbott. This mandate requires Texas hospitals to gather information on patients’ legal status and report costs associated with treating undocumented individuals to the state by March, sparking widespread concern over potential impacts on immigrant communities seeking healthcare.

Under Abbott’s directive, hospitals must ask patients if they are U.S. citizens or lawfully present in the country. While patients have the option to withhold this information, and federal law protects their right to receive care regardless, critics worry that this requirement may discourage immigrants from seeking needed medical attention. Similar requirements were introduced in Florida last year, under the leadership of Governor Ron DeSantis, and advocates there report that many immigrants remain hesitant to seek care due to fears of legal repercussions or deportation, even when assured otherwise.

Patient Data and Reporting Requirements

According to the Texas Health Department, hospitals will begin submitting data on inpatient and emergency room visits in March, but the reports will not include personal information like names or other identifying details. Hospitals are tasked with categorizing patients as U.S. citizens, lawful residents, or undocumented individuals. The reports will include data on Medicaid and CHIP-covered patients, as well as the costs associated with treating uninsured patients, which is intended to document the financial impact of healthcare services for undocumented immigrants.

Governor Abbott, in announcing the policy, argued that the costs of medical care for undocumented individuals should not fall on Texas taxpayers, stating, “Texans should not have to shoulder the burden of financially supporting medical care for illegal immigrants.”

Florida’s Policy as a Model

Florida’s similar policy, enacted last year, has had a mixed reception. Although Florida state reports show that nearly 8% of hospitalized individuals opted not to disclose their immigration status, advocates in the state observed a chilling effect on healthcare-seeking behavior among immigrant communities. According to data from June to December 2023, less than 1% of emergency room and hospital patients in Florida admitted to being undocumented. Healthcare advocates in Florida say that despite outreach efforts, it took about a year for fears among immigrant communities to lessen.

Texas health advocates and hospitals have worked to raise awareness of patients’ rights, emphasizing that their care will not be impacted by their decision to disclose—or withhold—their immigration status. Carrie Williams, spokesperson for the Texas Hospital Association, assured the public that Texas hospitals “continue to be a safe place for needed care,” reinforcing that medical providers are committed to upholding quality care standards regardless of a patient’s response to the new questions.

Hospital Preparations and Public Outreach

In preparation for the change, hospitals across Texas have been implementing new protocols and working to inform the public about the new rules. Guidance from the Texas Hospital Association and other healthcare groups has emphasized that patient care will remain unaffected and that providers must remind patients of their right to withhold answers to questions about their immigration status. Health advocates in Texas have launched public awareness campaigns to ensure patients understand these rights, employing methods like text messages, posters, and emails to reach immigrant communities.

While the policy aims to assess the financial burden associated with treating undocumented immigrants, advocates and healthcare providers will closely monitor the impact on healthcare access and patient trust, especially among immigrant populations. Texas’s new approach to immigration in healthcare marks a new chapter in the state’s ongoing legal and political battles over immigration policy, with significant implications for both healthcare access and patient behavior.

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