Gov. Greg Abbott issued an executive order Thursday afternoon directing Texas public hospitals to start reporting health care costs for undocumented immigrants.
While Abbott’s order takes aim at people entering the country without authorization during the Biden-Harris administration, the declaration would also apply to the estimated 52,000 El Paso residents who make up the county’s undocumented population. Many have lived in El Paso for years and pay property taxes to support UMC.
The order contradicts the Texas Department of State Health Services’ guidelines, which advise health care workers should not ask for immigration status information. The federal government does not require health care providers to collect immigration status from their patients.
Abbott’s order applies to University Medical Center of El Paso and Children’s Hospital, which is owned by UMC.
“We are aware of the executive order that was issued today by Governor Abbott. We will be reviewing it with our team to fully understand its implications and requirements,” UMC spokesperson Ryan Mielke said in a statement.
Fernando Garcia, executive director of the Border Network of Human Rights in El Paso, released a statement criticizing Abbott for “using immigrants as scapegoats for his failed policies and political frustrations, painting a one-sided picture of the realities happening at the border and in the state of Texas.”
While volunteer-run clinics can provide treatment for minor aches and ailments, more serious conditions – such as broken bones from falling from the border wall and injury from high-speed Texas DPS chases – require hospitalization.
Garcia pointed out some of the injuries people have sought treatment for occurred under Abbott’s Operation Lone Star. Last year Texas National Guard strung up razor wire on the border that caused lacerations on migrants who got caught in them. Texas National Guard members have also shot pepper balls at migrants, causing welts and bruises.
“This executive order is nothing less than a policy of attrition that will result in undocumented immigrants fearing to seek out medical attention and a shameless attempt to make the state of Texas a hostile place for our communities,” Garcia said.
Abbott’s order only applies to public hospitals and doesn’t affect private sector hospitals.
Undocumented immigrants are not eligible for government health insurance. UMC is the only public hospital in El Paso, providing health care to uninsured migrants and asylum seekers passing through, as well as long-term residents of the El Paso area who may be undocumented.
Starting Nov. 1, public hospitals will have to collect the cost of inpatient and emergency care provided to undocumented immigrants.
Hospitals will report this data every quarter to Texas HHSC, as well as provide an annual report of costs to the governor, lieutenant governor and speaker of the house starting Jan. 1, 2026.
The executive order directs hospitals to inform patients that the information they collect will not affect their patient care, as mandated by federal law.
Abbott said in a press release Texans should not shoulder the responsibility of financially supporting medical care for undocumented immigrants.
“Texas will hold the Biden-Harris Administration accountable for the consequences of their open border policies, and we will fight to ensure that they pay back Texas for their costly and dangerous policies,” he said in a statement.
It’s unclear if and how Texas would be paid back. The executive order states the federal government “may or should be obligated” to reimburse the state for costs.
Marisa Limón Garza, executive director at Las Americas Immigrant Advocacy Center in El Paso, described Abbott’s action as “part of a larger pattern of xenophobia and racial discrimination that we must call out.”
“Instead of taking steps to improve access to adequate healthcare for all Texans, Abbott is wasting time and resources by directing medical staff to focus on the status of the person in their care, proving once again that the governor is comfortable scapegoating migrants for failed public services across Texas,” she said in an email to El Paso Matters.
6 p.m. Thursday, Aug. 8. This story has been updated with a comment from Marisa Limón Garza, executive director at Las Americas Immigrant Advocacy Center in El Paso.
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