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Undocumented immigrants in Texas are foregoing medical care amid ongoing fears of being detained or deported, a new report suggests.
Part of President Donald Trump’s nationwide crackdown on immigration, enforcement activities in Texas have created a climate of fear in immigrant communities. Arrests in Dallas courtrooms by ICE agents have caused people to miss immigration hearings, and now, The Texas Tribune reports, fear is keeping undocumented immigrants from accessing medical care.
According to a recently released report, hospital visits by undocumented immigrants in Texas declined by 32% from November 2024, when officials reported roughly 30,000 visits, to last August, when 20,345 visits were reported. Visits by individuals legally present to be in the U.S. rose by 14% in that time period, while visits from undocumented patients accounted for 2% of all reported visits statewide, The Tribune reported.
Still, the data obtained from hospitals may not tell the full story. Those numbers only reflect visits from self-identified undocumented immigrants, and patients may choose not to answer the question altogether.
Texas Gov. Greg Abbott signed an executive order in 2024 requiring hospitals in the state to ask patients about their immigration status. That same executive order requires public hospitals to report healthcare costs for undocumented immigrants, which Abbott insists are being paid for by the taxpayer. Texas public hospitals reported over $1 billion in costs associated with treating undocumented immigrants in 2025, according to data from the Texas Health and Human Services Commission.
“Texans should not have to shoulder the burden of financially supporting medical care for illegal immigrants,” Abbott wrote in a release announcing the order. “That is why today I issued an Executive Order requiring the Texas Health and Human Services Commission to collect and report healthcare costs for illegal immigrants in our state. Texas will hold the Biden-Harris Administration accountable for the consequences of their open border policies, and we will fight to ensure that they pay back Texas for their costly and dangerous policies.”
Barriers to Care
Experts have warned that the numbers released by HHS aren’t straightforward, as they don’t include recouped costs and fail to account for costs associated with treating uninsured citizens, who are more prevalent in Texas than anywhere else in the U.S. And while the data could just reflect a decline in patients choosing to answer questions on their immigration status, health policy groups believe undocumented immigrants are avoiding care even more than in the past.
“Substantial shares of immigrants are saying they have avoided seeking medical care due to immigration related fears,” Drishti Pillai, the director of immigrant health policy at KFF, a health policy organization that reports on the intersection of immigration and healthcare, told The Tribune.
Trump reversed a DHS policy in early 2025 to allow enforcement operations in “protected areas,” including churches, schools, colleges, daycares, and medical centers like hospitals and clinics. Since the reversal, ICE agents have been spotted at hospitals around the country, with a KFF report stating that officers have entered exam rooms without a warrant.
In a New York Times/KFF survey from 2025, close to 50% of likely undocumented immigrants surveyed said they had avoided medical care because of immigration-related concerns. That survey also found that one in seven adult immigrants, including those with legal status, had avoided medical care over immigration fears. There have been reported instances of DACA recipients and other legal immigrants being detained in Texas.
Fewer Vaccinations
Philip Huang, director of Dallas County Health and Human Services, told the Tribune that fears about immigration likely led to a decline in childhood vaccinations administered by the county health department before the school year began in August. In 2024, Dallas County administered 16,412 vaccines, while in August 2025, clinics administered 9,578 vaccines.
In an interview, Huang said that while declines in vaccination rates have been seen across the board, the largest drops have been reported among Hispanic populations. He also said he believes that fears over immigration enforcement are a “big contributing factor” to the decline.
“Our community outreach team, when they’re out in the field, is hearing more of those concerns specifically,” Huang said.
DHHS is not required to ask about immigration status when providing care to underinsured and uninsured families at community clinics. The information the department does collect is basic, but Huang said people are still asking, “Why are you collecting this information?”
The reluctance to engage with county health workers comes at a time when nearly eliminated diseases such as measles are resurging in North Texas communities. In January, it was reported that vaccination rates in Dallas classrooms had fallen below the “herd immunity” threshold for measles protection.
Huang said that any segment of the population delaying vaccination or care should concern everyone.
“When you get those high levels and the sort of herd immunity levels of vaccine coverage, it protects everyone in the community,” Huang said. “When you don’t get that, that’s when you’re vulnerable. These infectious diseases can impact anyone. And so when the community is less protected, it affects everyone.”
