Under the executive order that Abbott announced in August, hospitals are required to ask patients whether they are U.S. citizens and whether they are in the country legally.

Patients have the right to withhold information, and hospital staff must tell them that their response will not affect their care, as required by federal law.

Hospitals do not need to submit reports to the state until March. The first draft of the spreadsheet prepared by state health officials to track the data does not include fields to submit patient names or personal information.

Providers will complete a transcript of inpatient and urgent care patient visits and document whether these patients are in the country legally, are citizens, or are legally present in the United States.

The reports will also include costs for those covered by the Children’s Health Insurance Program, known as Medicaid or CHIP, and costs for patients who are not covered by that program.

“Texans should not have to shoulder the burden of subsidizing medical care for illegal immigrants,” Abbott said when he announced the policy.

Florida enacted a similar law last year. Health advocates argue that the law scares immigrants who need emergency medical care, leading to fewer people seeking help even from facilities not subject to the law.

Florida’s preliminary data is limited by the state’s own admission. Data is self-reported. Anyone can refuse to answer, an option chosen by about 8 percent of people admitted to the hospital and about 7 percent of people going to the emergency room from June to December 2023, according to a Florida state report. Less than 1 percent of people who went to the emergency room or were hospitalized reported being in the U.S. “illegally.”

Immigrant and healthcare advocates have tried to educate Texas residents about their rights. In Florida, groups used text messages, posters and emails to get the word out. But advocates there said they haven’t seen the fears ease in nearly a year.

Healthcare providers received directives from the state and guidance from the Texas Hospital Association.

“The bottom line for patients is that this does not change hospital care. Texas hospitals remain a safe place to get needed care,” said Carrie Williams, a spokeswoman for the hospital association.