Texas Hospitals Face Over $1 Billion in Costs for Immigrant Care

Texas hospitals incurred over $1 billion in healthcare costs attributed to illegal immigrants during the fiscal year 2025, marking a significant financial impact as the state began tracking these figures. The data, compiled by the Texas Health and Human Services Commission (HHSC) and acquired by Texas Scorecard, revealed that hospitals recorded 313,742 visits linked to individuals not legally present in the United States, culminating in total costs of $1.05 billion by the end of the fiscal year.

As the state’s fiscal year runs from September 1 to August 31, hospitals were mandated to start reporting these figures in November 2024. The average monthly cost during this period approached $105 million, indicating that the actual annual expenditures could be considerably higher. This amount represents nearly 1% of Texas’ tax-funded resources.

Executive Order and Data Collection

The reported data stemmed from an executive order signed by Governor Greg Abbott in August 2024. This mandate required the agency to monitor the number of “individuals not lawfully present” in the U.S. utilizing Texas public hospitals. Hospitals were instructed to provide HHSC with quarterly reports detailing patients not legally present, including metrics such as inpatient discharges, emergency department visits, and the associated costs of care.

The healthcare system in Texas, a border state, has faced unprecedented challenges due to rising immigration numbers under the Biden administration. Andrew Mahaleris, Abbott’s press secretary, emphasized the strain on resources during a discussion with Fox News Digital.

The largest portion of the costs arose from inpatient discharges for patients who were neither on Medicaid nor enrolled in the Children’s Health Insurance Program (CHIP), totaling $565.4 million across 40,947 discharges. Emergency department visits for non-Medicaid and non-CHIP patients contributed an additional $205.5 million.

Patient Demographics and Financial Breakdown

In addition to the costs incurred from non-Medicaid patients, those enrolled in Medicaid or CHIP also represented significant expenditures, including $255.3 million linked to inpatient discharges and $24.3 million for emergency department visits. Hospitals initially reported data for November 2024, documenting 30,743 visits that cost over $102 million.

Subsequent months continued to show high costs. From December 2024 through February 2025, hospitals logged 149,619 visits totaling $330.8 million. Between March and May 2025, the reported costs soared to $319.3 million, followed by $298.3 million from June to August 2025.

The financial implications of these healthcare costs underscore the challenges faced by Texas hospitals as they manage rising patient numbers, particularly from vulnerable populations. The situation reflects broader national debates surrounding immigration policy and its impact on public resources.