A Texas Public Policy Foundation report suggests that expanding data collection to better measure immigration’s fiscal and operational effects on public schools, health care, and emergency services will improve state lawmakers’ policy decisions.
TPPF’s Selene Rodriguez argued that Texas needs a standardized, statewide data-collection framework to reveal immigration-related strains on education and health care.
“The absence of consistent, statewide data limits the states’ ability to distinguish between contributing factors, evaluate where system strain is encumbered, and plan accordingly,” said Rodriguez.
Rodriguez identified health care, public safety, and education as areas heavily influenced by immigration yet wrought with data gaps.
County Indigent Health Care Programs cover low-income individuals ineligible for Medicaid, but Rodriguez writes that they do not verify immigration status before providing care.
Rodriguez argued that providers should be reimbursed for care delivered to illegal aliens under these programs to prevent financial strain.
Federal law requires medicare-participating hospitals to deliver emergency care to illegal aliens, but “unpaid costs are ultimately passed along to Texas taxpayers through higher insurance rates, public hospital funding, and other publicly funded health programs,” wrote Rodriguez.
Citing the Texas Health and Human Services Commission’s fiscal year 2025 report, Rodriguez identified 313,742 visits by patients illegally present in the United States, representing approximately $1.05 billion in total health care costs, not solely uncompensated care.
Gov. Greg Abbott’s Executive Order GA-46 requires hospitals to ask patients about citizenship status. However, patients may decline to answer, and the report notes that the information is self-reported without a formal verification mechanism.
Rodriguez suggested codifying the order into statute and requiring responses during intake while maintaining compliance with federal emergency care requirements.
Public safety infrastructure has also seen increasing strains from immigration.
El Paso spent $300,000 per day in 2022 in response to the influx of illegal aliens in the city, according to a report cited by Rodriguez. A city representative said 50 firefighters were working at an immigrant welcome center, unavailable to respond to emergencies.
Eagle Pass Fire Chief Manuel Mello said the city added a fifth ambulance “strictly to treat migrants” in 2023.
Rodriguez suggested expanding emergency medical services reporting, where legally permissible and operationally feasible, to include patient demographic information, uncompensated response costs, changes in call volume, ambulance utilization, staffing demands, and resource diversion during immigration surges.
She further argued the education system has also felt the increasing weight of immigration.
The U.S. Supreme Court ruling Plyler v. Doe in 1982 overruled a Texas law that denied illegal alien children free public education and required them to pay tuition.
The Office of Refugee Resettlement (ORR) reported that between 2015 and 2020, 31,635 unaccompanied aliens were released into Texas; between 2021 and 2025, 67,271; and so far in 2026, 81.
While it is unknown if every one of these minors entered the public school system, Texas spends around $12,000 per student.
Since no state agency tracks student immigration status, Rodriguez argued that the information gap affects fiscal planning and the ability to provide for students with unique needs, language barriers, and limited prior schooling.
She recommended school districts collect and report data including immigration status, country of origin, and interrupted formal education history.
Additionally, Rodriguez recommended the Texas Education Association “publish annual statewide and regional impact assessments identifying high-growth districts, emerging bilingual population trends, ESL staffing needs, and other operational pressures tied to rapid demographic change.”
Public safety, health care, and education are not the only areas to see financial and infrastructural strains from illegal immigration.
According to a paper from the Federal Reserve Bank of Dallas, illegal immigration “can explain about 30 percent of the total growth in house prices and 20% of total growth in rents over the boom period for the average local market.”
A 2023 report by the U.S. House Committee on Homeland Security also examined the financial burden of illegal immigration, with costs including law enforcement, welfare benefits, and damage to private property.
Rodriguez contended that better data collection will not solve immigration’s challenges but could help policymakers move from reactive decision-making to informed planning.
“While a more accurate measurement will not eliminate strain, it will allow the state to respond with greater precision, accountability, and sustainability,” she wrote.
