(Texas Scorecard) – The Texas Health and Human Services Commission has released its first round of data under an executive order issued by Gov. Greg Abbott, revealing that hospitals in the state incurred over $121 million in health care costs in a single month for people not lawfully present in the United States.
The data, covering November 2024, shows that Texas hospitals reported 31,012 visits from illegal aliens, with total costs amounting to $121,779,579. The largest portion of the cost—over $62 million—came from inpatient discharges for non-Medicaid and non-CHIP patients. Emergency room visits accounted for more than $36 million combined.
The report follows the implementation of an executive order issued by Gov. Abbott in August 2024 that mandates quarterly reporting by hospitals on the cost of providing care to people in the country illegally.
“Due to President Joe Biden and Vice President Kamala Harris’ open border policies, Texas has had to foot the bill for medical costs for individuals illegally in the state,” Abbott said when announcing the order. “Texans should not have to shoulder the burden of financially supporting medical care for illegal immigrants.”
Under the executive order, hospitals are required to inform patients that their responses to questions about legal status will not affect their care, as required by federal law.
While this initial release covers just a single month, HHSC plans to release full quarterly data going forward. The first annual report, covering the full year of data, is set to be released on January 1, 2026.
Abbott has previously said the purpose of the reporting is to “hold the Biden-Harris Administration accountable” and to demand federal reimbursement for the state’s growing costs due to illegal immigration.
In 2021, Attorney General Ken Paxton estimated that Texans were already paying between $579 million and $717 million per year in uncompensated care for illegal aliens.
With the first month’s data already topping $121 million, the new reports could put the annual figure even higher.