Texas House Bill HB2587

Texas 2025 - 89th Regular

• Filed: 2/7/25
• Out of House Committee: 5/5/25

Caption

Relating to an annual report on the financial impact on hospitals for providing certain uncompensated care.

Summary

HB 2587 requires the Health and Human Services Commission to produce an annual report on the financial impact to hospitals that provide uncompensated care to patients who were not lawfully present in the United States. The report must be submitted to the governor and legislature each year and cover the preceding fiscal year. To support the report, the bill directs the executive commissioner to require hospitals to add a citizenship or immigration-status question to patient intake forms, along with a statement that the answer will not affect care, and to submit quarterly data on emergency room visits, inpatient discharges, and the associated uncompensated costs for such patients. The bill defines key terms such as “financial impact,” “hospital,” and “person not lawfully present,” and it requires that no personal identifying information be included in the reports. It also delays the initial HHSC report until December 1, 2026, even though the act would take effect on September 1, 2025. The measure is framed as a data-collection and reporting bill rather than a direct change to eligibility for care or reimbursement rules.

Impact

HB 2587 would add a new reporting requirement to Chapter 525, Government Code, and would indirectly affect hospitals licensed under Chapter 241, Health and Safety Code, that provide acute care and participate in Medicaid or CHIP. It would require HHSC to collect quarterly hospital data and publish an annual statewide report on uncompensated care costs associated with patients who are not lawfully present, while also requiring hospitals to modify intake procedures to ask about citizenship or immigration status. The bill does not change federal or state obligations to provide emergency or other required care, but it does create a new administrative burden and a new state-level data collection framework related to immigration status and hospital finances.

Sentiment

Based on the bill text and the absence of recorded committee testimony or votes in the provided materials, the bill appears to have been treated as a policy and reporting measure rather than a highly debated floor issue. Its structure suggests an interest in quantifying hospital costs and informing lawmakers with statewide data. The return to committee on May 13, 2025 indicates the measure did not advance at that point, but no recorded vote or transcript is available here to show direct support or opposition.

Contention

The main point of contention is likely the requirement that hospitals ask patients about citizenship or immigration status on intake forms, even with a federal-law disclaimer that care cannot be affected by the response. Supporters would likely view the bill as a way to measure the fiscal burden of uncompensated care on hospitals and state health programs, while critics may see it as invasive, potentially chilling to patients, and administratively burdensome for hospitals. Another likely concern is whether collecting immigration-related information could discourage care-seeking or create privacy and trust issues, despite the bill’s prohibition on personal identifying information in the reports.