Uploaded August 2026 | Updated September 2026, 3 weeks ago
What is mass illegal immigration actually costing Texas hospitals — and who's really footing the bill? In this episode of Spotlight, host Selene Rodriguez is joined by Texas State Representative and practicing anesthesiologist Dr. Tom Oliverson and TPPF Policy Scholar Brooke Garner for a frank conversation on the financial strain that both legal and illegal immigration is placing on Texas's healthcare system.
From birth tourism to uncompensated care, Dr. Oliverson draws on his firsthand experience in labor and delivery and the Texas legislature to break down the federal mandates, state programs, and systemic loopholes driving billions in unreimbursed costs for Texas taxpayers. Brooke walks through emerging legislative solutions — including sponsor repayment enforcement — that could help Texas claw back dollars lost to fraud and abuse.
In this episode:
- Why Governor Abbott's executive order on healthcare cost tracking matters
- How EMTALA creates an unfunded mandate on every hospital in America
- Birth tourism: from the Rio Grande Valley to Houston to China
- The CHIP Perinatal program and its lack of a citizenship requirement
- Sponsor repayment legislation and what Texas could do first in the nation
- Surrogacy as an overlooked birth tourism loophole
- The real human cost of strained emergency services in border communities
- Why fixing this system actually helps American citizens who depend on Medicaid
Timestamps:
0:00 – Introduction
1:44 – Governor Abbott's executive order explained
2:11 – EMTALA: The federal law driving uncompensated care
4:42 – What is uncompensated care, and why should Texans care?
5:13 – Birth tourism: A growing crisis across Texas
8:18 – Tracking the costs: Over $1 billion and counting
9:05 – Legislative solutions: What Texas can do
12:02 – Sponsor repayment enforcement
13:05 – The CHIP Perinatal program loophole
17:04 – How fixing fraud improves Medicaid for Americans who need it
21:23 – "Suicidal empathy" and the cost of compassion without accountability
27:09 – Surrogacy: The next frontier in birth tourism
28:09 – Emergency services and the human cost in border communities
The Texas Public Policy Foundation’s mission is to promote and defend liberty, personal responsibility, and free enterprise in Texas and the nation by educating and affecting policymakers and the Texas public policy debate with academically sound research and outreach.
Funded by thousands of individuals, foundations, and corporations, the Foundation does not accept government funds or contributions to influence the outcomes of its research.
The public is demanding a different direction for their government, and the Texas Public Policy Foundation is providing the ideas that enable policymakers to chart that new course.
Website: texaspolicy.com
X: twitter.com/tppf
Facebook: facebook.com/texaspolicy
Instagram: instagram.com/texaspolicy
LinkedIn: linkedin.com/company/texas-public-policy-foundation
What is mass illegal immigration actually costing Texas hospitals — and who's really footing the bill? In this episode of Spotlight, host Selene Rodriguez is joined by Texas State Representative and practicing anesthesiologist Dr. Tom Oliverson and TPPF Policy Scholar Brooke Garner for a frank conversation on the financial strain that both legal and illegal immigration is placing on Texas's healthcare system.
From birth tourism to uncompensated care, Dr. Oliverson draws on his firsthand experience in labor and delivery and the Texas legislature to break down the federal mandates, state programs, and systemic loopholes driving billions in unreimbursed costs for Texas taxpayers. Brooke walks through emerging legislative solutions — including sponsor repayment enforcement — that could help Texas claw back dollars lost to fraud and abuse.
In this episode:
- Why Governor Abbott's executive order on healthcare cost tracking matters
- How EMTALA creates an unfunded mandate on every hospital in America
- Birth tourism: from the Rio Grande Valley to Houston to China
- The CHIP Perinatal program and its lack of a citizenship requirement
- Sponsor repayment legislation and what Texas could do first in the nation
- Surrogacy as an overlooked birth tourism loophole
- The real human cost of strained emergency services in border communities
- Why fixing this system actually helps American citizens who depend on Medicaid
Timestamps:
0:00 – Introduction
1:44 – Governor Abbott's executive order explained
2:11 – EMTALA: The federal law driving uncompensated care
4:42 – What is uncompensated care, and why should Texans care?
5:13 – Birth tourism: A growing crisis across Texas
8:18 – Tracking the costs: Over $1 billion and counting
9:05 – Legislative solutions: What Texas can do
12:02 – Sponsor repayment enforcement
13:05 – The CHIP Perinatal program loophole
17:04 – How fixing fraud improves Medicaid for Americans who need it
21:23 – "Suicidal empathy" and the cost of compassion without accountability
27:09 – Surrogacy: The next frontier in birth tourism
28:09 – Emergency services and the human cost in border communities
The Texas Public Policy Foundation’s mission is to promote and defend liberty, personal responsibility, and free enterprise in Texas and the nation by educating and affecting policymakers and the Texas public policy debate with academically sound research and outreach.
Funded by thousands of individuals, foundations, and corporations, the Foundation does not accept government funds or contributions to influence the outcomes of its research.
The public is demanding a different direction for their government, and the Texas Public Policy Foundation is providing the ideas that enable policymakers to chart that new course.
Website: texaspolicy.com
X: twitter.com/tppf
Facebook: facebook.com/texaspolicy
Instagram: instagram.com/texaspolicy
LinkedIn: linkedin.com/company/texas-public-policy-foundation
