Abbott’s border mandate reveals illegal immigrants rack up $1B+ in hospital costs in 2025

Texas hospitals absorbed more than $1 billion in health care costs tied to illegal immigrants during fiscal year 2025, marking the first year the state formally tracked the data.

Figures compiled by the Texas Health and Human Services Commission (HHSC) and obtained by Texas Scorecard show hospitals recorded 313,742 patient visits involving individuals not legally present in the United States. The total cost of care reached approximately $1.05 billion by the end of the fiscal year.

Texas’ fiscal year runs from September 1 through August 31, though hospitals were not required to begin reporting the data until November. Based on the available reports, hospitals averaged about $105 million per month in costs, suggesting the full-year total may be considerably higher.

The reported expenses amount to nearly 1% of Texas’ tax-funded resources.

Migrants change clothes on the river bank, while a U.S. authority figure stands nearby, with razor wire in the background. — Illegal immigrants across Texas hospitals racked up $1 billion in health care costs during fiscal year 2025. Go Nakamura for NY Post

The data collection stems from an executive order signed by Gov. Greg Abbott in August 2024, which required HHSC to track health care usage by individuals not lawfully present in the country at Texas public hospitals.

Under the order, hospitals must submit quarterly reports detailing inpatient discharges, emergency department visits, and the cost of care associated with these patients. Texas, as a border state, has faced sustained pressure on its health care system due to historically high border crossings in recent years, according to Abbott’s office.

The largest portion of the costs came from inpatient discharges for patients not covered by Medicaid or the Children’s Health Insurance Program (CHIP). These discharges totaled $565.4 million across 40,947 cases.

Emergency department visits for non-Medicaid and non-CHIP patients added another $205.5 million in costs.

Texas Governor Greg Abbott in a black cowboy hat and shirt, seated in a wheelchair with arms crossed. — More than 300,000 visits were recorded as the data was received under an executive order signed by Gov. Greg Abbott. Getty Images

Patients enrolled in Medicaid or CHIP also accounted for significant expenses, including $255.3 million for inpatient discharges and $24.3 million for emergency department visits.

Hospitals initially submitted data only for November 2024, reporting 30,743 visits that cost more than $102 million. Subsequent reports showed that high levels of spending continued throughout the fiscal year.

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