By james art 
To Texas Governor Greg Abbott Executive order No. GA-46 takes effect Friday, requiring Texas public hospitals to collect information and report health care costs on undocumented immigrants.
Governor Abbott issued the executive order on August 8, 2024, finding that the Biden-Harris administration was pursuing an “open border policy” that was costing Texans by imposing higher taxes and increasing health care costs by allowing of undocumented immigrants to enter across the southern border and use publicly funded medical care.
In the order, Governor Abbott specifically alleged that the administration ignored federal laws requiring the federal government to “build barrier infrastructure, detain illegal immigrants, screen potential immigrants, and expeditiously remove aliens filing frivolous asylum claims.” He attributed the eleven million illegal border crossings during the Biden-Harris administration to their immigration practices.
The executive order specifically requires hospitals to collect information, including the number of hospital discharges and emergency visits of undocumented immigrants and the resulting health care costs. In addition, hospitals must report the data to the Texas Health and Human Services Commission quarterly, beginning no later than March 1, 2025. In addition, hospitals must annually report health care spending information collected from the fiscal year to Governor Abbott , Lt. Gov. Dan Patrick and Speaker of the House Dade Phelan, effective January 1, 2026.
Governor Abbott expressed in a press release:
Texans should not shoulder the burden of funding the medical care of illegal immigrants… Texas will hold the Biden-Harris administration accountable for the consequences of their open border policies, and we will fight to ensure that they repay Texas for its expensive and dangerous policies.
Carolina Canizales, senior strategist for the Immigrant Legal Resource Center of Texas, found Abbott’s rationale for the executive order unwarranted, stating:
We know that undocumented Texans contribute to the wealth of our economy. In 2022, undocumented Texans paid nearly $5 billion in state and local taxes. So Abbott’s premise that Texans are shouldering the burden of health care for undocumented Texans is false…. [N]the early $11 billion was wasted on targeting instead of helping our communities of color, that includes $1 billion in COVID relief money, to fund Abbott’s Operation Lone Star.
Governor Greg Abbott explained in an official statement in 2023 that it started Operation Lone Star in March 2021 as a military operation to stop illegal immigration, criminal immigration and criminal activity on the southern Texas border, which he attributed to the reluctance of the Biden-Harris administration to enforce immigration law.
Abbott’s executive order is part of a broader conflict during the Biden-Harris administration between the federal government’s asserted constitutional supremacy over immigration and Texas’ asserted constitutional right to have the U.S. protected from invasion. In January 2024, the US Supreme Court found that the Supremacy Clause ruled in favor of US Homeland Security agents in their dispute with Texas over agents cutting fences on Texas’ southern border. Two months later, the U.S. Supreme Court indefinitely extended the stay, blocking the enforcement of a Texas law that criminalized illegal immigration to the U.S. through Texas under the Supremacy Clause.