Hospitals in Texas have recently implemented a policy where they inquire about patients’ citizenship or immigration status if they accept Medicaid or the Children’s Health Insurance Plan (CHIP). The decision to adopt this new practice is a result of an executive order issued by Governor Greg Abbott, aimed at collecting information on the expenses incurred in providing healthcare to undocumented immigrants.
In August, Abbott signed the order, asserting that Texas incurs a significant portion of the expenses related to medical care for individuals who are not legally present in the United States.
According to a report by the Texas Hospital Association (THA), Texas has the highest uninsured rate in the nation at 17%, leaving approximately five million residents without health insurance. Last year, hospitals in Texas provided over $8 billion in care for the uninsured, but more than $3 billion of that amount went unreimbursed. It is worth noting that a majority of the uninsured individuals in Texas are citizens.
Texas has approximately 1.6 million undocumented immigrants residing within its borders. Interestingly, these individuals actually use hospital services less often compared to citizens. It is important to note that the costs associated with providing healthcare services to undocumented immigrants only account for a portion of the overall expenses incurred by the state’s healthcare system.
Hospitals have a responsibility to assure patients that their access to care will not be affected by their citizenship status, despite the policy in place. Here is a breakdown of what patients should know about this rule and how it impacts them:
Do I Have to Answer the Question?
Patients are not obligated to reveal their immigration or citizenship status. According to advocacy groups like the American Civil Liberties Union (ACLU), hospitals are required to inquire about this information, but patients have the right to decline or express their preference not to respond.
Will treatment be denied?
According to The Texas Tribune, hospitals cannot deny care based on a patient’s response—or lack thereof—to a citizenship or immigration status inquiry. Regardless of legal status, individuals have access to emergency and necessary medical care under federal law. According to Abbott’s order, their responses should have no bearing on patient treatment.
If I Feel Pressured, What Can I Do?
Patients can request to speak with a supervising nurse, guest relations staff, or a patient rights advocate if they feel unfairly questioned. You can also report concerns to the ACLU using their online intake form.
Why Are Hospitals Asking This Question?
According to Abbott, the executive order tries to quantify how much hospitals spend on unauthorized immigrants’ care. Abbott has previously criticized federal immigration rules for putting a strain on state resources. However, hospitals are required to utilize the data exclusively for statistical purposes and not to share personally identifying information with any state entity.
When Will I Be Asked?
You can ask the question at any point during a patient’s visit, but it won’t affect the standard of care.
Does This Apply to Clinics?
According to the Texas Hospital Association, the law only applies to hospitals and not to urgent care clinics or other healthcare facilities they run.
What If I Don’t Speak English?
Patients who are uncomfortable addressing their rights or concerns in English should seek an interpreter in their preferred language.
