On Thursday, Gov. Greg Abbott (R-TX) issued an executive order mandating all hospitals and healthcare providers to report the number of visits and costs incurred by illegal immigrants. 

Abbott’s executive order will go into effect Nov. 1, with hospitals expected to report all data to the Health and Human Services Commission by March 1, 2025. From then on, the information must be reported to the commission on a quarterly basis.

Previously, hospitals did not ask patients about their legal status in the United States. Abbott said that how patients answer will not affect their care. Hospitals are required by law to provide life-saving treatment to patients regardless of their ability to pay. Abbott intends to use this information to bill the Biden-Harris administration for costs incurred by Texas.

“Due to President Joe Biden and Vice President Kamala Harris’ open border policies, Texas has had to foot the bill for medical costs for individuals illegally in the state,” Abbott said in a statement Thursday. “Texans should not have to shoulder the burden of financially supporting medical care for illegal immigrants.”

Under the Biden-Harris administration, more than 11 million people have illegally crossed the southern border. To deal with the crisis, Abbott has bussed and flown migrants to “sanctuary cities” such as New York City and Chicago, which have quickly become overwhelmed with the rising numbers and costs associated with caring for the migrants. 

It’s uncertain how much it is costing Texas hospitals to care for illegal immigrants, but a report from Attorney General Ken Paxton in 2021 estimated $579 million and $717 million each year for public hospital districts to provide uncompensated care for illegal immigrants.  

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While Texas is pushing to hold the Biden administration accountable for the migrant crisis, California passed legislation that only balloons the state’s burden of cost to care for migrants. This past January, California became the first state to provide health insurance for illegal immigrants. Federal lawmakers estimated that the law providing illegal immigrants free healthcare will cost between $3 billion to $6 billion a year.