Texas hospitals were slammed with nearly $122 million in healthcare costs in a single month — all tied to illegal immigrants, according to a new report released under an executive order by Gov. Greg Abbott.
The staggering total covers just one month, November 2024, and was revealed in the first report issued by the Texas Health and Human Services Commission (THHSC) after Abbott’s August directive to track the financial toll of treating “individuals not lawfully present” in the U.S.
More than 31,000 hospital visits by illegal immigrants were logged during that month, generating $121.8 million in care expenses that Texas hospitals are now absorbing without reimbursement.
“Many of these illegal immigrants are straining the Texas hospital system, which is why Governor Abbott directed the Texas Health and Human Services Commission to begin assessing the cost of care,” said Abbott’s press secretary Andrew Mahaleris. He credited President Trump’s border crackdown for a recent decline in illegal crossings and expressed hope that the deportation surge may reduce these burdens on state resources.
Under federal law, hospitals are required to treat everyone regardless of legal status or ability to pay. But now, thanks to Abbott’s order, the state is finally quantifying just how heavy the cost is falling on Texas taxpayers and healthcare providers.
Though the current report only includes November’s data, the THHSC plans to release quarterly updates going forward, culminating in a full-year report by January 2026. That will provide an even broader picture of how illegal immigration impacts one of the state’s most critical public services.
This comes amid mounting frustration in border states, which bore the brunt of a chaotic four years under Joe Biden’s immigration policies. Mahaleris didn’t hold back in contrasting that past with the present: “Texas is hopeful that [Trump’s] efforts to remove those who entered unlawfully may also cause these healthcare costs to decline.”
The situation in Texas is just one snapshot of a larger national debate over illegal immigration, public resources, and who should ultimately foot the bill. A bill introduced by Republican Rep. Mike Olcott in Fort Worth would go even further by codifying Abbott’s executive order into permanent state law, ensuring this data collection becomes a standard practice moving forward.
The Texas Hospital Association acknowledged the data collection requirement but warned that it should not scare people away from seeking emergency care. “Hospitals are required by law to treat anyone who comes through the door, regardless of ability to pay, regardless of their demographics,” the association said in a statement. “Hospitals remain open and ready to serve Texans’ acute care needs.”
Still, the fact remains: as border enforcement tightens and deportation efforts accelerate under Trump’s renewed agenda, the cost of illegal immigration is no longer just a talking point — it’s a bottom-line crisis for state healthcare systems. And thanks to Abbott’s push for transparency, Texans now have the numbers to prove it.
