Texas hospitals must ask patients starting Friday whether they are in the U.S. legally and track the cost of treating people without legal status following an order by Republican Gov. Greg Abbott that expands the state’s clash with the Biden administration over immigration.
KPRC 2 first reported back in August about Abbott’s order.
Critics fear the change could scare people away from hospitals in Texas, even though patients are not required to answer the questions to receive medical care.
The mandate is similar to a policy that debuted last year in Florida, where Republican Gov. Ron DeSantis is also a frequent critic of the federal government’s handling of illegal crossings along the U.S.-Mexico border.
Texas hospitals have spent months preparing for the change and have sought to reassure patients that it won't affect their level of care.
We’ve heard back from several Houston hospitals, including Houston Methodist, which said in a statement:
“As required by Texas law, when registering patients, we will ask if they are legal residents or not. A patient can answer yes, no or decline to answer. We will then report the total numbers on a quarterly basis.”
Memorial Hermann shared this statement:
“Beginning Nov. 1, 2024, Memorial Hermann hospitals will be in compliance with the new state requirement.”
St. Luke’s Health referred KPRC 2 to the statement from the Texas Hospital Association, as part of their comment.
Harris Health, meanwhile shared this statement with KPRC 2′s Jason Nguyen:
“Harris Health is a mission-driven organization that deeply values every member of our community, and the people who choose to work here are committed to providing compassionate care to all who seek our services.
“As required by the Texas Governor’s Executive Order GA-46, Harris Health is prepared to fully comply with this new reporting requirement to Texas Health and Human Services.
“We want to assure all of our patients and community members that no personal information will be shared by Harris Health with the state or other agencies as a result of the requirement, and that regardless of how they answer the citizenship status question, it will in no way interfere with their receiving healthcare at Harris Health emergency rooms or hospitals.”
Here’s what to know:
- Required to ask, not required to answer
- Under the executive order announced by Abbott in August, hospitals must ask patients if they are citizens in the U.S. and whether they are lawfully present in the country.
- Patients have the right to withhold the information and hospital workers must tell them their responses will not affect their care, as required by federal law.
Tracking hospital costs and patient data
- Hospitals are not required to begin submitting reports to the state until March. An early draft of a spreadsheet made by state health officials to track data does not include fields to submit patient names or personal information.
- Providers will fill out a breakdown of visits by inpatient and emergency care patients and document whether they are lawfully present in the country, citizens or not lawfully present in the U.S.
- The reports will also add up costs for those covered by Medicaid or the Children’s Health Insurance Program, known as CHIP; and the cost for patients without it.
“Texans should not have to shoulder the burden of financially supporting medical care for illegal immigrants,” Abbott said when he announced the policy.
Texas is following Florida’s lead
Florida enacted a similar law last year. Health care advocates contend the law has made immigrants who need of emergency medical care fearful and led to fewer people seeking help, even from facilities not subject to the law.
Florida’s early data is — by the state's own admission — limited. The data is self-reported. Anyone can decline to answer, an option chosen by nearly 8% of people admitted to the hospital and about 7% of people who went to the emergency room from June to December 2023, according to Florida's state report. Fewer than 1% of people who went to the emergency room or were admitted to the hospital reported being in the U.S. “illegally.”
Texas hospitals have been preparing
Immigrant and health care advocates have sought to educate the Texas public about their rights. In Florida, groups used text messages, posters and emails to get the word out. But advocates there have said they didn’t see fears subside for about a year.
Health care providers received directives from the state and guidance from the Texas Hospital Association.
“The bottom line for patients is that this doesn’t change hospital care. Texas hospitals continue to be a safe place for needed care,” said Carrie Williams, spokesperson for the hospital association.
