On August 8th, 2024, Gov. Greg Abbott (R-TX) issued Executive Order No. GA-46, mandating Texas public hospitals to collect data on healthcare utilization by undocumented immigrants, including number of inpatient discharges, emergency services, and healthcare costs. Abbott justified the action by claiming that Texas has had to absorb increased healthcare costs associated with federal “open border” policies and seeks federal reimbursement for the expenditures. The action follows Abbott’s yearslong clashes with the Biden administration on immigration, with at least a dozen lawsuits fought between Texas and the federal government over the issue. 

The mandate does not impact legal access to care, which is protected under federal law regardless of one’s immigration status. However, a similar law enacted by Gov. Ron DeSantis (R-FL) earlier this year nevertheless impacted healthcare access negatively. Increased fear and apprehension among undocumented immigrants have led to a sharp decline in utilization of health care services in Florida, discouraging a population that already experiences disproportionate health disparities from receiving lifesaving preventive healthcare, emergency obstetric care, and more. Texas advocacy and community health groups fear a similar outcome. 

National APAMSA unequivocally supports immigrant health care access for undocumented immigrants, migrant health and safety, and protection of undocumented patients in our policy compendium (20.001, 20.002, 20.003). We strongly oppose Texas Executive Order No. GA-46 and the threat it poses to eliminating health disparities, achieving health equity, and increasing health care access—core values of our organization’s advocacy.