A new report shows that Texas is facing a huge financial burden when it comes to covering health care for migrants who are in the state illegally.
According to the Texas Health and Human Services Commission (HHSC), the cost of unpaid care for non-citizens topped $121.8 million in November 2024 alone — and officials believe the true figure could be even higher.
Health Care Usage by Non-Citizens in Texas
In just one month, non-citizens used hospitals across Texas more than 31,000 times, according to the HHSC report.
This includes:
- Inpatient discharges
- Emergency department visits
- Other hospital services
The numbers were collected as part of a new reporting requirement ordered by Governor Greg Abbott last August.
The order demands that Texas hospitals submit quarterly reports to HHSC, detailing care provided to patients not lawfully present in the U.S., including:
- How many times they visited hospitals
- What kinds of services they received
- The estimated cost of care
Why the Cost Estimates Might Be Too Low
The $121.8 million figure is likely an underestimate. That’s because hospitals rely on self-reported information from patients about their immigration status during intake.
Some patients may not answer these questions honestly, or may refuse to answer at all, leading to undercounting.
Still, this is the first report of its kind in Texas. If the costs remain similar each month, Texas could be looking at nearly $1.46 billion per year in unpaid health care bills linked to non-citizen patients.
Similar Reporting in Florida
Texas isn’t alone in taking steps to track these costs. Florida passed a similar law requiring hospitals to report the number of uninsured migrants they treat each month.
A recent Florida report found that migrants in that state racked up $660 million in unpaid medical bills.
These figures highlight a growing concern for state governments trying to balance rising healthcare costs with the obligation to provide emergency care.
Governor Abbott’s Response
When he signed the executive order last year, Governor Greg Abbott said:
“Texans should NOT have to foot the bill for illegal immigrants’ healthcare.”
He emphasized that state taxpayers shouldn’t be left paying for medical care provided to people who entered the country illegally.
However, it’s important to note that no hospital in Texas or Florida is allowed to refuse medical care to anyone who needs it, regardless of their immigration status. Federal law requires that emergency medical services must be provided to all patients.