Report: Immigration Status is a Challenge to Texas Health Care

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In November 2024, Texas Governor Greg Abbott executed a new policy via executive order directing state hospitals to ask patients about their citizenship status and report responses to Texas Health and Human Services. 

The policy was a response to the increasing number of undocumented individuals getting health care at hospitals, claiming that it created a financial burden on Texas taxpayers. 

As a result of this policy, Texas hospitals are seeing fewer undocumented individuals, according to a recent analysis by The Texas Tribune.  

Let’s review the data and what it means for Latino health care across Texas. 

Undocumented Immigrant Hospital Visits in Texas 

Prior to the executive order, Texas hospitals received 30,000 visits from undocumented immigrants, according to the analysis examining data obtained from the Texas Health and Human Services Commission.   

Just a few months after the executive order went into effect, visits from undocumented individuals dropped by 32% with undocumented visits only accounting for 20,345 visits in August 2025.  

What’s more, visits from patients with legal status increased by 14% and undocumented patients accounted for only 2% of visits across the state during the same reporting period with several hospitals reporting no undocumented individuals.  

The decrease was especially evident in regions closer to the border or regions with a higher undocumented population.  

During the reporting period, hospitals in Laredo experienced a 48% decrease in visits from undocumented patients, going from 1,700 visits in November 2024 to 889 visits in August 2025, according to data used in the analysis. 

Hospitals in larger metropolitan areas also experienced significant decreases. 

One Dallas County Hospital District went from seeing 4,000 undocumented hospital visits to a little over 1,300 visits by August 2025.  

The analysis also found that while hospital visits by undocumented individuals are down, the cost for hospital visits have increased exponentially from an average of $3,409 in November 2024 to $5,100 in August 2025. 

The report points out that this is a stark contrast to the claim that the financial responsibility of hospital visits by undocumented individuals are being placed on Texans.  

Impact on Latino Health 

Health experts interviewed in The Texas Tribune article warn that this policy has had disastrous impacts on the health of undocumented immigrants living in the state, including delay of care. 

Latinos are among the populations that face several non-medical drivers of health issues, such as lack of insurance, limited access to transportation and health care facilities, and living in areas with fewer healthy food options.  

This means that Latinos are heavily affected by obesity and chronic diseases, such as heart disease and cancer.

What’s more, many undocumented Latinos rely heavily on hospitals for regular health care because they won’t be turned away due to lack of insurance. 

The policy discourages undocumented Latinos from going to hospitals to receive life-saving care, resulting in worse health outcomes. 

This policy also comes during a time when fears of deportation are at an all-time high. Undocumented individuals are avoiding places such as churches, schools, workplaces, and doctor’s offices. 

During a time of high distrust in health care, the policy adds an extra challenge to care, according to the report.  

A prime example of the policy’s impact on undocumented health care can be found in hospitals located along the Texas-Mexico border in Hidalgo.  

Hospitals there experienced a 40% drop in undocumented visits.  

The Texas Tribune interviewed Dr. Ivan Melendez, a family practice doctor serving as the county’s chief medical officer.  

Melendez reported that more patients are waiting to seek treatment and come in when they are in a worse state of health. 

What’s more, increased fear of deportations has some calling in to find out if law enforcement authorities are at the facility before visiting.  

Rising fears culminate in fewer regular health visits, and the delay of care prolongs recovery while some don’t recover at all, the article cited. 

Combating Incorrect Information About Immigration Policies 

One of the best ways to combat incorrect information about immigration policies is to stay informed and understand your rights. 

While hospitals in two states — Texas and Florida — have laws requiring hospitals to ask patients about their immigration status, patients are not required to supply an answer, according to the National Immigration Law Center. 

Care is not determined or inhibited by the answer to the question. 

What’s more, health care providers may also choose not to provide information about immigration status to law enforcement individuals unless there is a warrant.  

Additional health information is protected by the Health Insurance Portability and Accountability Act (HIPAA).  

Health care providers and hospitals should also understand their rights and take action to make their facilities safe for their patients. 

Hospitals can implement policies that designate private areas, avoid collecting information about immigration status, have lawyers on standby to call when law enforcement agents show up, and provide educational materials in multiple languages to inform patients of their rights. 

To enter a health care facility that’s been deemed a private area, law enforcement officers must have a warrant or obtain authorized consent.  

For more ways to stay informed, visit the National Immigration Law Center’s “Know Your Rights” web page. 

What does health care look like where you live? 

What kind of health care inconsistencies are plaguing your community?  

Find out by downloading a Salud America! Health Report Card for your town!  

Enter your county name and get auto-generated local data with interactive maps and comparative gauges on several health indicators. This can help you visualize and explore local issues in education, housing, transportation, food, health, and more.  

See how your county stacks up compared to the rest of your state and nation.  

Then email the Report Card to local leaders to raise awareness, include the data in a presentation or grant proposal, or share it on social media to drive healthy changes in your community! 

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