Texas Governor Greg Abbott’s Executive Order No. GA-46, effective Friday, mandates that Texas public hospitals collect and report healthcare cost data related to undocumented immigrants. Issued on August 8, 2024, the order stems from Abbott’s assertion that the Biden-Harris administration’s open border policy is straining Texas taxpayers by raising medical care costs as undocumented immigrants access publicly funded healthcare services.
Abbott criticized the federal government for allegedly neglecting immigration laws, which he claims has led to over 11 million unlawful border crossings during the current administration.
The executive order requires hospitals to gather specific data, including the number of emergency visits and inpatient discharges of undocumented immigrants, and report these figures quarterly to the Texas Health and Human Services Commission starting March 1, 2025. Furthermore, hospitals must submit an annual report detailing the healthcare costs incurred by undocumented immigrants to state leaders beginning January 1, 2026.
In his statement, Abbott emphasized that Texans should not bear the financial burden of supporting undocumented immigrants’ medical care, holding the Biden-Harris administration accountable for what he views as detrimental policies.
However, critics, including Carolina Canizales from the Immigrant Legal Resource Center, challenge Abbott’s claims, pointing out that undocumented Texans significantly contribute to the state’s economy, having paid nearly $5 billion in state and local taxes in 2022.
Canizales argues that Abbott’s rationale is flawed, stating that $11 billion has been spent targeting communities of color, including COVID relief funds allocated to his Operation Lone Star initiative.
Operation Lone Star, launched in March 2021, aims to curb unlawful immigration and related criminal activities at the Texas-Mexico border, which Abbott attributes to the federal government’s lax enforcement of immigration laws.
This executive order underscores an ongoing legal conflict regarding immigration authority, highlighted by recent US Supreme Court rulings that emphasize the federal government’s constitutional supremacy in immigration matters.
These include a ruling favoring federal agents against Texas in a dispute over border infrastructure and an extension of a stay blocking Texas laws that would criminalize unlawful immigration under the Supremacy Clause.