Texas hospitals faced a staggering burden in fiscal year 2025, accumulating over $1 billion in healthcare costs tied to illegal immigrants. This figure, the first of its kind tracked by the state, emerged from data compiled by the Texas Health and Human Services Commission and sourced by Texas Scorecard. The reported costs reflect 313,742 hospital visits related to individuals not legally present in the United States. By the end of the fiscal year, the total expenses culminated at $1.05 billion.
For context, Texas has a fiscal calendar that runs from September 1 to August 31. However, hospitals were only mandated to begin reporting data in November. This timing raises questions about the accuracy of reported figures, suggesting that the actual annual costs could be much higher than projected. With costs averaging around $105 million each month, the situation calls for further scrutiny.
The scale of these expenses is significant. They account for approximately 1% of the state’s tax-funded resources, a figure that can’t be overlooked in ongoing discussions about budget priorities. These insights stem from an executive order signed by Governor Greg Abbott in August 2024, which aimed to enhance accountability regarding healthcare usage among those without legal status in the U.S. The directive mandated that hospitals provide quarterly updates on patients not lawfully present, detailing not only visits but also costs incurred during hospital stays.
Texas, being a border state, has seen dramatic surges in immigration, with crossing numbers hitting an all-time high under the current administration. This surge has placed intense strain on the healthcare system. “The pressure on Texas healthcare facilities is unprecedented,” noted Andrew Mahaleris, press secretary for Governor Abbott. These comments underline the urgency of the situation facing healthcare providers in the state.
In breakdowns of the data, the most substantial share of the reported costs originated from inpatient discharges for non-Medicaid and non-CHIP patients, amounting to $565.4 million across nearly 41,000 discharges. This figure captures the high cost of treating undocumented patients who lack access to programs like Medicaid, which traditionally support vulnerable populations.
Emergency department visits for non-Medicaid and non-CHIP patients added another $205.5 million to the mounting expenses. Additionally, patients enrolled in Medicaid or CHIP still represented considerable costs, with data showing $255.3 million tied to inpatient discharges and $24.3 million stemming from emergency department visits.
The reporting period for fiscal year 2025 began with a snapshot of November 2024, in which hospitals logged 30,743 visits that resulted in over $102 million in costs. As the year progressed, the data revealed a concerning trend: between December 2024 and February 2025, hospitals recorded 149,619 visits costing $330.8 million, followed by substantial figures in the subsequent months—$319.3 million from March to May and $298.3 million from June through August.
The implications of these numbers are vast. They shed light on both the financial challenges local governments and healthcare systems face and the ongoing debate regarding immigration policies. As Texas continues to grapple with these realities, the need for a structured discussion on healthcare funding, immigration reform, and the overall sustainability of the system becomes ever more urgent.
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