New data from the Texas Health and Human Services Commission surpasses earlier estimates.
Texas hospitals incurred more than $1 billion in health care costs for patients not lawfully present in the United States during fiscal year 2025, according to new data obtained from the Texas Health and Human Services Commission.
The figures were collected under an executive order issued by Gov. Greg Abbott in August 2024, which requires hospitals to report the cost of inpatient and emergency care provided to individuals in the country illegally. Under Abbott’s order, hospitals are also required to inform patients that responses regarding immigration status will not affect their care, as required by federal law.
Statewide totals show 313,742 hospital visits from patients not legally present in the U.S., costing hospitals $1.05 billion during the reporting period. The largest share of the expense—more than $565 million—came from inpatient discharges for non-Medicaid and non-CHIP patients.
Emergency department visits accounted for roughly $230 million, while total inpatient care exceeded $820 million, underscoring that long-term hospitalizations, not emergency treatment alone, are driving much of the cost.
Although hospitals are required under federal law to deliver the care, unpaid medical costs are ultimately passed along to Texans. Taxpayers absorb the burden through higher insurance rates, public hospital funding, and state health programs.
