Two states, Florida and Texas, have implemented laws that require hospitals to ask patients about their legal status in the United States. The Florida law took effect in 2023 as part of Governor Ron DeSantis’ immigration policies, while the Texas law will go into effect on November 1. Both states have high immigrant populations, ranging from undocumented individuals to those with pending asylum cases. Despite the higher rates of uninsured individuals in these states compared to the national average, research shows that immigrants tend to use less and spend less on healthcare.

Republican leaders in Florida and Texas argue that these laws are necessary due to what they perceive as lax enforcement of immigration policies by the Biden administration. Florida Senator Blaise Ingoglia, who sponsored the hospital bill, claims it is the strongest anti-illegal immigration law at the state level. However, there are concerns that the law creates additional barriers for immigrant patients who already face disparities in accessing healthcare. Immigrant advocate groups in Florida have tried to educate individuals about the law’s limitations, including the fact that individual status will not be reported to authorities.

There have been instances where patients have delayed seeking care due to fears of the law’s implications. In Florida, there have been reports of people leaving the state in search of better healthcare access and employment opportunities due to the impact of the hospital mandate. However, some patients have been persuaded to seek treatment after speaking with advocates who clarify the law’s provisions. Data collection related to the law is expected to be unreliable, as self-reporting may lead to incomplete or inaccurate information, and a significant percentage of individuals chose not to answer the status question.

People who are not legally in the U.S. cannot enroll in Medicaid in Florida and Texas, except in cases of a medical emergency. This lack of insurance coverage can result in higher healthcare costs, especially for individuals with progressive diseases like cancer. Community groups, policymakers, and advocacy organizations in Texas are working to educate individuals about their rights when faced with the status question. Despite a decrease in deportation fears in Florida, concerns remain about the impact and purpose of the law. Healthcare providers and advocates emphasize the need for policies that prioritize access to care for all individuals, regardless of immigration status.

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