The U.S. Department of Health and Human Services (HHS) has issued a sweeping new policy that bans undocumented individuals from accessing a wide range of federally-supported health and social service programs. In Texas, where millions rely on these services as critical safety nets, the consequences will be immediate and far-reaching.
A sweeping denial of care undermining decades of care access
The HHS decision formally rescinds a longstanding 1998 interpretation of the Personal Responsibility and Work Opportunity Act. It reverses policies that previously allowed undocumented individuals to access care funded through federal programs.
The change means people living in our communities — many of them workers, parents, and neighbors — will now be barred from:
- Community Health Centers (CHCs) – Community-based health providers that offer primary care services like vaccines, check-ups, and cancer screenings.
- Certified Community Behavioral Health Clinics – Clinics that provide comprehensive mental health and substance use services to people of all ages, with a focus on timely access and care coordination.
- Title X family planning services – Federally-funded programs that offer confidential reproductive health care, including birth control and disease testing, primarily for low-income individuals.
- Mental health and substance use treatment programs – Public programs that deliver counseling, medication, and recovery support for people experiencing mental health conditions or substance use disorders.
- Federal block grants for community services – Flexible federal funding streams provided to states and local agencies to support a wide range of essential health and social services in underserved communities.
While federal law (42 USC 254b(a)(1)) still requires CHCs to serve “all residents of the area served by the center,” this policy shift undermines that obligation. In Texas, it could further destabilize the already strained safety-net infrastructure that serves millions, regardless of immigration status.
Costly consequences for Texas communities
Denying people preventive and primary care does not stop them from getting sick. It only delays treatment and increases the likelihood of serious illness. That drives them to emergency rooms and puts added pressure on hospital systems already stretched to the brink.
This decision undermines public health, drives up costs, and adds to the crisis facing Texas hospitals and clinics. The burden will fall on families already facing barriers to care and will strain health systems that are already doing more with less.
By turning away people in need, HHS is creating a public health crisis with ripple effects that will be felt by all Texans, not just those directly impacted. When our health system breaks, it breaks for all of us.
A call to restore health and health care for all
EHF believes health is not a privilege reserved for a few. It is a right that should extend to every person, regardless of immigration status. Policies that remove access to care are not only morally wrong, they are economically unsound and medically dangerous.