Governor Greg Abbott is tackling out-of-control healthcare costs with a new executive order that has everyone clutching their pearls. The big ask? Texas hospitals taking Medicaid or CHIP funds must include a straightforward question on their intake forms: “Are you a U.S. citizen?”
And just like that—bam!—the outrage machine is in full swing, with critics screaming “discrimination” and “unethical” like it’s their full-time job. But let’s take a step back and look at what this policy is really about—it’s a necessary move toward getting the state finances in order.
Here’s the reality: Texas taxpayers are the ones covering the cost when undocumented immigrants use public hospitals for emergency and inpatient care.
Abbott’s plan isn’t about denying care; it’s about figuring out who’s using the system so the state can bill the federal government for reimbursement. In other words, it’s not some xenophobic witch hunt—it’s math.
Predictably, groups like the ACLU and certain doctors have leaped into the fray, calling for open defiance of the order. One physician went viral on TikTok, urging patients to leave the citizenship question blank. Bold move, doc. But let’s be clear: refusing to provide basic billing information doesn’t stick it to the governor—it sticks it to the hospitals already stretched thin.
To his credit, Abbott has ensured that federal law remains front and center: patients must be informed that their care won’t be impacted by their answer—or even their decision not to answer. The state isn’t asking for immigration papers at the ER; it’s asking for transparency about the costs burdening its healthcare system.
Yes, this policy could make some uncomfortable. That’s the point—it’s uncomfortable to acknowledge that an overtaxed system needs reform. The status quo of pretending the problem doesn’t exist isn’t sustainable.
Abbott’s executive order doesn’t just tackle an economic issue; it forces a long-overdue conversation about accountability in healthcare. Hospitals will still treat everyone, no matter their background, but now they’ll have the information needed to get proper reimbursements.
Let’s cut through the drama and be real: this isn’t about being heartless—it’s about being practical. Governor Abbott’s policy prioritizes Texas taxpayers and gives the healthcare system a much-needed financial tune-up after years of bleeding money unchecked.
