Texas hospitals incurred over $1 billion in medical costs attributed to illegal immigrants during fiscal year 2025, which was the first year the state started tracking these figures.
The Texas Health and Human Services Commission (HHSC) gathered this data, revealing that there were 313,742 visits from individuals not legally present in the U.S., leading to total costs of approximately $1.05 billion by the fiscal year’s end.
It’s worth noting that Texas’ fiscal year goes from September 1 to August 31, but hospitals only began reporting figures in November.
On average, the costs were about $105 million monthly, though the real annual costs could be much higher.
To give some context, these hospital expenses represent around 1% of what’s funded by state tax dollars.
The data was obtained following an executive order from Governor Greg Abbott in August 2024, mandating the tracking of “illegal aliens” using public hospitals in Texas.
The executive order instructed hospitals to provide HHSC with quarterly updates, detailing non-legally present patients, including inpatient discharges, emergency room visits, and the costs for their care.
In a state like Texas, which frequently sees more people accessing healthcare under the Biden administration, the system has been under considerable strain, as highlighted by Abbott’s press secretary, Andrew Maharelis.
Notably, the predominant costs arose from inpatient discharges of patients who were neither covered by Medicaid nor CHIP, amounting to 40,947 discharges that totaled $565.4 million.
CHIP, for those unfamiliar, refers to the Children’s Health Insurance Program, which provides affordable health coverage to children from families with income levels that disallow Medicaid eligibility.
Additionally, emergency room visits for these non-Medicaid and non-CHIP patients added another $205.5 million in healthcare costs, according to the report.
The expenses for patients enrolled in Medicaid or CHIP were also significant, including $255.3 million from inpatient hospital discharges and $24.3 million attributed to emergency department visits.
In the initial reports submitted for November 2024, hospitals recorded 30,743 visits costing over $102 million, as reported by the state.
Subsequent reports continued to show elevated costs.
From December 2024 through February 2025, hospitals reported 149,619 visits costing $330.8 million. Following that, from March to May 2025, the reported costs hit $319.3 million, and from June to August 2025, they were at $298.3 million.
