Texas hospitals must apply for citizenship status starting November 1 – NBC 5 Dallas-Fort Worth

An executive order from Republican Gov. Greg Abbott that goes into effect in Texas on Friday, Nov. 1 is sparking controversy.

Starting Friday, hospitals in Texas will be required to inquire about a patient's citizenship status.

Immigration advocates are sounding the alarm as hospital systems work to understand and prepare for the new requirement.

The reason for the new law, according to state officials, is data collection.

In August, Abbott signed the order requiring inpatient or emergency care staff to ask patients if they are U.S. citizens. The order does not specify whether patients are legally required to answer the question.

Abbott said he wants to collect data on the cost of caring for undocumented patients. He claimed that Texas covers a large portion of the costs associated with providing medical care to people who are not legally in the United States.

According to the Texas Hospital Association, five million Texans are uninsured. Texas also has the highest uninsured rate in the country at 17%. However, according to the Texas Tribune, most uninsured Texans are citizens.

Critics such as the American Civil Liberties Union of Texas said the order instilled fear in communities.

“This order should not impact anyone’s access to health care — period,” ACLU of Texas senior attorney David Donatti told NBC affiliate KXAN in Austin. “Whether you are native-born, a U.S. citizen, an immigrant or whatever your status, you should have access to the health care you need and the facility should not be able to prevent you from receiving that type of care. “From a federal law perspective, this is crystal clear.”

The Asian Pacific American Medical Student Association also issued a statement expressing concern about a similar law passed by Republican Gov. Ron DeSantis in Florida earlier this year.

“Increasing fear and anxiety among undocumented immigrants have led to steep declines in health care utilization in Florida, preventing a population already suffering from disproportionate health disparities from receiving life-saving health care, emergency obstetric care and more,” it said the APAMSA statement. “Texas advocacy and community health groups fear a similar outcome.”

However, local hospitals are reminding people that they will not be denied medical attention if they choose not to respond or are unaware of their status.

“Hospitals will do the right thing. And even if someone shows up to the emergency room and it's a true emergency, we will treat them regardless of their legal immigration status or ability to pay,” said Steve Love, president and CEO of the DFW Hospital Council: “We will be the way “We’re not going to change how we treat patients, we’re going to do the right thing.”

Love said hospitals are taking steps to train staff on the new requirements.

“It is fundamentally a question about citizenship. The hospitals have worked with their staff and their legal counsel to ensure they are collecting the data appropriately. “They are cooperating fully with the Health and Social Care Commission on what this should look like. I think they are still working through some of the logistics involved,” he said.

The state health department has also responded, saying that people should not be discouraged from seeking medical care because this law is only for data collection.

Hospitals will begin collecting this information for the state on November 1 and must report this data back by March 2025.