During the fiscal year 2025, Texas hospitals recorded over $1 billion in medical costs associated with care provided to illegal immigrants. This marks the first year the state monitored these expenses, gathering data through the Texas Health and Human Services Commission (HHSC).
The figure totaled $1.05 billion, thanks to around 313,742 visits by individuals not legally present in the U.S. Hospitals were obligated to start reporting this information in November, leading to an average monthly cost of about $105 million. It’s worth noting that the real annual figure could be much larger.
To give you some context, this total accounts for roughly 1% of healthcare costs funded by state tax dollars. The data collection stems from an executive order by Governor Greg Abbott, issued in August 2024, which mandated reporting on public hospital usage by non-lawfully present individuals. Abbott’s order required hospitals to submit quarterly documentation detailing patient visits, including discharges and emergency visits.
As a border state, Texas has observed a surge in people seeking medical care since the Biden administration took office. This has placed considerable strain on the healthcare system, as noted by Abbott’s press secretary, Andrew Maharelis.
Breaking down the costs, inpatient discharges for patients without Medicaid or Children’s Health Insurance Program (CHIP) coverage represented the largest financial burden. Specifically, there were 40,947 discharges costing about $565.4 million. Emergency department visits for the same group added another $205.5 million in expenses.
Patients enrolled in Medicaid or CHIP also incurred substantial costs, totaling $255.3 million in inpatient discharges and $24.3 million for emergency visits.
The initial data collection included only the month of November 2024, which recorded 30,743 visits costing upwards of $102 million. Subsequent reports indicated that costs remained high through early 2025, with 149,619 visits from December to February resulting in $330.8 million. March to May accounted for $319.3 million, with June through August seeing costs of $298.3 million.
