Public Hospitals to Collect Patient’s Immigration Status

What Governor Abbott's executive order means for Filipinos in DFW. 

By André Averion, Communications Manager

Published August 14th, 2024.

Starting Nov. 1, 2024, Governor Greg Abbott's latest executive order will require public hospitals to collect information on immigration status, potentially creating barriers to healthcare access for some in the Filipino community in DFW. 

Officially issued Aug. 8, Executive Order GA-46 will direct the Texas Health and Human Services Commission (HHSC) to collect demographic information on patients who use any Texas public hospitals for inpatient and emergency care in order to determine if they are undocumented or illegal immigrants. If the patient is undocumented, the hospital will collect and report health care costs in order for the State of Texas to seek reimbursement from the federal government, although government sources have not yet concluded how this reimbursement will happen. 

Under federal law, regardless of immigration status, individuals will still receive life-saving treatment and responses to questions about the immigration status will not impact treatment care. However, local healthcare leaders and media outlets have been noting that intimidation and fear are present in local communities, discouraging treatment.

Filipino immigrants, particularly those who are undocumented or have precarious immigration status, may avoid seeking medical care due to fear of their information being reported. 

Filipino Americans who are legal residents or citizens might feel uneasy about the collection of immigration information, which the process has yet to be addressed. Concerns about privacy or being racially profiled could discourage them from accessing healthcare services, especially if they fear being mistaken for undocumented immigrants.

There’s also concern with Filipino healthcare workers facing strain with their relationship to communities they serve if they have to collect immigration status information from patients. Filipino-born healthcare workers are the largest population of foreign-born providers in the US, with 1 in 7 immigrant healthcare workers being Filipino. 

Community clinics, urgent care clinics, and primary care doctors are not included in the order, which local physicians have recommended visiting for preventative care in order to avoid public health risks from healthcare avoidance. 

Across all immigrant groups, Filipinos have an easier time being naturalized as US citizens, and as of 2022 are identified as the 4th largest overall immigrant group in the US, following behind Mexicans, Indians and Chinese. The latest data from The Migration Policy Institute estimates Filipinos as the sixth largest undocumented group in the US with 309,000 undocumented immigrants, however this only accounts for less than 3% of all undocumented immigrants.

Currently there is no confirming evidence that being identified as an undocumented immigrant at a public hospital will lead to deportation or prosecution, as the executive order only lays out the intention to record costs associated with treating undocumented immigrants. There is no written intent that undocumented immigrants will be individually reported to authorities. Normally the breakdown of patient costs and their demographic is protected by the Health Insurance Portability and Accountability Act of 1996 (HIPAA), however it does allow for the collection and sharing of patient information under certain circumstances, such as a legal mandate.

Public hospitals would have to report data to the state health commission quarterly, beginning in March 2025. The state agency will begin providing an annual report of costs to the governor, lieutenant governor and speaker of the Texas House beginning in January 2026.

“Texans should not have to shoulder the burden of financially supporting medical care for illegal immigrants,” Abbott said in a press release, “Texas will hold the Biden-Harris Administration accountable for the consequences of their open border policies, and we will fight to ensure that they pay back Texas for their costly and dangerous policies.”