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TX Public Hospitals Must Ask If Patients Are Legal Immigrants

In a significant shift in healthcare policy, Texas public hospitals are now required to inquire about patients’ citizenship status, following an executive order issued by Republican Governor Greg Abbott, which took effect on November 1, 2024. 

The Mandate: What Hospitals Must Ask

Under the new executive order, Texas hospitals are obligated to ask patients two key questions: 

  • Whether they are U.S. citizens
  • If they are lawfully present in the country

This requirement applies to both inpatient and emergency care settings, casting a wide net over the patient population. The implementation of this policy marks a significant change in how hospitals interact with patients during the admission process.

Patient Rights and Protections

While the mandate requires hospitals to ask about citizenship status, it’s crucial to understand that patients retain the right to decline answering these questions. Hospital staff are required to inform patients that their responses (or lack thereof) will not affect the care they receive. This provision is in line with federal laws that ensure emergency 

The primary objective of this executive order is to gather data on the costs associated with providing medical care to undocumented immigrants. Texas plans to use this information to seek reimbursement from the federal government for these expenses. Hospitals are required to report the collected data to Texas Health and Human Services by March 1, 2025, and continue reporting on a quarterly basis thereafter.

“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,” said Governor Abbott. 

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These reports will include a breakdown of hospital visits and associated costs but will not contain patient names or personal information. This anonymized approach aims to protect individual privacy while still providing the state with the statistical data it seeks.

As the policy takes effect, its true impact on healthcare delivery and patient behavior in Texas remains to be seen.

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