NCPA - National Center for Policy Analysis


July 18, 2006

Uninsured Hispanic immigrants with uncertain immigration status have flocked in recent years to public hospital emergency rooms and maternity wards in Texas, California and other border states.  Their care has swelled costs for struggling hospitals and increased the health care bills that fall to states and counties, giving ammunition to opponents of illegal immigration who complain of undue burdens on local taxpayers, says the New York Times.

As a result, health care has become one of the sorest issues in the border states' debate over illegal immigration.  Facing harsh criticism from residents, public hospitals are confronted with an uneasy decision: demand immigration documents from patients and deny subsidized care to those who lack them, or follow the public health principle of providing basic care to anyone who needs it.

In Texas, two of the biggest public hospitals chose differently.

  • The Parkland Health and Hospital System, which serves Dallas County, offers low-cost care to low-income residents with no questions asked about immigration status.
  • In Fort Worth, in neighboring Tarrant County, JPS Health Network requires foreign-born patients to show legal immigration documents to receive financial assistance in nonemergencies, like elective surgery and the treatment of routine or chronic illnesses.

Across Texas, the debate over illegal immigration has spilled into county commission hearings and hospital board meetings.  A study ordered by commissioners in Harris County, which includes Houston, found that about one-fifth of the patients in its health system last year were immigrants without documents, most of them from Mexico.  Their numbers had increased 44 percent in three years, the study found, and their care had cost the county $97.3 million, about 14 percent of the health system's total operating costs.

Source: Julia Preston, "Texas Hospitals Reflect the Debate on Immigration," New York Times, July 18, 2006.

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