H.B. No. 2587 introduces a new requirement for the Health and Human Services Commission to prepare an annual report detailing the financial impact on hospitals providing uncompensated care to individuals not lawfully present in the United States. The bill adds Section 525.0304 to the Government Code, defining key terms such as "financial impact," "hospital," and "person not lawfully present." It mandates that hospitals include a question about a patient's citizenship or immigration status on their intake forms, while ensuring that responses do not affect the care provided, in compliance with federal law. Hospitals are also required to submit quarterly reports on emergency room visits and inpatient discharges for these patients, along with the associated financial impacts.

The bill stipulates that the first report is due by November 1 of each year, covering the preceding state fiscal year, and the initial report is not required until December 1, 2026. The executive commissioner is tasked with adopting necessary rules for implementation, and the reports must exclude any personal identifying information. This legislation aims to provide transparency regarding the costs incurred by hospitals in caring for individuals who may not have legal status, thereby informing state policy and resource allocation. The act is set to take effect on September 1, 2025.

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