Widespread Avoidance of Healthcare Linked to Immigration Concerns

Immigration-related anxieties are strongly suspected to be causing undocumented immigrants to forego essential medical treatment, according to recent observations from health officials.

In Dallas County, this fear is believed to have contributed to a noticeable decrease in vaccination rates during 2025, stated the county's leading health official.

Declining Hospital Utilization in Texas

Data obtained from Texas hospitals reveals a substantial drop in service usage by undocumented individuals. Hospital visits by this group fell by 32% between November 2024 and August of the following year.

Specifically, visits dropped from approximately 30,000 in November 2024 to just 20,345 by last August. Conversely, hospital visits from individuals legally residing in the U.S. increased by 14% during the same period.

It is important to note that these figures only reflect patients who self-identified their undocumented status; many may decline to answer questions regarding their immigration background.

Vaccination Rates Drop in Dallas County

Fears surrounding immigration enforcement are also cited as a likely cause for lower childhood vaccination rates administered by the Dallas County health department before the school year commenced in August.

Vaccinations administered totaled 16,412 in 2024, but this number fell to 9,578 clinics in August 2025. Dr. Huang noted that while overall vaccination rates dipped, the most significant declines were observed among Hispanic populations.

Huang emphasized that community outreach teams are hearing these immigration concerns expressed more frequently. He stressed that delaying care or vaccination by any segment of the population endangers everyone, as lower herd immunity coverage makes the entire community vulnerable to infectious diseases.

National Trends and Enforcement Fears

Surveys indicate a broad pattern of avoidance. Drishti Pillai, director of immigrant health policy at KFF, reported that substantial portions of immigrants admit to avoiding care due to immigration fears.

A KFF survey found that nearly 50% of likely undocumented immigrants surveyed had avoided medical attention because of these concerns. Furthermore, one in seven adult immigrants, including those with legal status, reported avoiding care over immigration-related fears.

These fears are exacerbated by past enforcement actions, including reported instances of ICE operations in sensitive locations such as schools, daycares, and medical centers.

Texas Focus on Healthcare Cost Reporting

Texas Governor Abbott issued an Executive Order requiring the Texas Health and Human Services Commission (HHS) to track and report healthcare expenditures for undocumented immigrants.

Abbott stated that Texans should not bear the financial responsibility for this medical care. Public hospitals in Texas reported costs exceeding $1 billion associated with treating undocumented immigrants in 2025.

The Governor asserted that Texas will seek reimbursement from the Biden-Harris Administration for these costs, attributing them to federal border policies. However, HHS reports may not fully capture the picture, as they exclude recouped costs and do not account for expenses related to uninsured U.S. citizens.

Community clinics are not mandated to inquire about immigration status when serving uninsured and underinsured families. Despite this, residents are still questioning why basic demographic information is being collected, according to Huang.