Data from the Texas Health and Human Services Commission (HHSC) reveals that hospitals in Texas incurred costs exceeding $1 billion for care provided to individuals classified as unauthorized immigrants during fiscal year 2025. This figure, which surpasses earlier estimates, reflects the impact of a reporting requirement established by Texas Governor Greg Abbott in August 2024.

Initially, a report released in November 2024 estimated costs at approximately $122 million, but this was deemed low due to the early stages of the reporting process. The HHSC documented over 31,000 hospital visits by unauthorized immigrants in that month alone. By the end of the fiscal year, hospitals recorded a total of 313,742 visits linked to unauthorized immigrants, resulting in costs of approximately $1.05 billion.

The largest share of these expenses, around $565 million, was attributed to inpatient discharges for patients not covered by Medicaid or the Children's Health Insurance Program (CHIP). Emergency room visits accounted for an additional $230 million, while inpatient care expenses totaled $820 million, indicating that long-term care significantly contributes to overall costs.

It is noteworthy that the reported data does not cover a complete fiscal year, as it excludes the first two months—September and October—due to the recent implementation of the reporting system. The figures reflect ongoing challenges faced by Texas, a border state experiencing high levels of immigration, which has placed considerable strain on its healthcare system. The reported costs represent about 1% of the state’s tax-funded resources, underscoring the financial implications of healthcare access for unauthorized immigrants in Texas.