Hospitals in Texas that accept Medicaid or the Children's Health Insurance Plan (CHIP) have begun asking patients about their citizenship or immigration status as of this month. This new policy stems from an executive order issued by Governor Greg Abbott, which seeks to gather data on the cost of care provided to undocumented immigrants.
Abbott signed the order in August, claiming that Texas "absorbs a large percentage of the costs associated with medical care for individuals who are not lawfully in the United States."
With the highest uninsured rate in the nation at 17%, Texas has approximately five million residents without health insurance, the Texas Hospital Association (THA) reported. Last year, hospitals provided over $8 billion in care for the uninsured, with more than $3 billion remaining unreimbursed. However, most uninsured Texans are citizens.
While Texas is home to about 1.6 million undocumented immigrants, they utilize hospital services less frequently than citizens and represent only a portion of the overall costs borne by the state's healthcare system.
Despite the policy, hospitals are required to assure patients that their citizenship status would not affect their access to care. Here's a breakdown of what patients need to know about this rule and how it affects them:
Do I Have to Answer the Question?
No, patients are not required to disclose their immigration or citizenship status. Advocacy groups, including the American Civil Liberties Union (ACLU), emphasize that while hospitals must ask the question, patients can refuse to answer or say they do not wish to respond.
Will Treatment Be Denied?
Hospitals cannot deny care based on a patient's response — or lack thereof — to the question about citizenship or immigration status, as reported by The Texas Tribune. Federal law ensures access to emergency and necessary medical care, regardless of immigration status. Abbott's order specifically states that patient care should not be affected by their answers.
If I Feel Pressured, What Can I Do?
Patients who feel improperly questioned can ask to speak with a supervising nurse, guest relations staff, or a patient rights advocate. Concerns can also be reported to the ACLU using an online intake form.
Why Are Hospitals Asking This Question?
The executive order aims to quantify how much hospitals spend on care for undocumented immigrants, according to Abbott, who has criticized federal immigration policies for burdening state resources. However, hospitals are instructed to use the data only for statistical purposes and not share identifiable information with any state agency.
When Will I Be Asked?
The question can be posed at any point during a patient's visit but is not meant to influence the quality of care.
Does This Apply to Clinics?
No. The rule applies only to hospitals, not urgent care clinics or other healthcare facilities they operate, according to the Texas Hospital Association.
What If I Don't Speak English?
Patients uncomfortable discussing their rights or concerns in English should request an interpreter in their preferred language.
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