Greg Abbott just told Texas hospitals, doctors, and nurses that they have a new job: helping him police immigration. And if they don't play along, the state can come after their licenses.
What the order does
On July 21, 2026, Abbott signed an executive order directing a long list of state agencies to investigate and stamp out what he calls "birth tourism schemes" in Texas health care. The agencies pulled into it include:
- The Texas Health and Human Services Commission
- The Department of State Health Services
- The Texas Medical Board
- The Texas Board of Nursing
- The Texas Department of Licensing and Regulation
The order says "any licensed healthcare provider involved" can be punished — including having their license revoked or suspended, being barred from state contracts, or losing state benefits.
Abbott's statement: "Texas will not tolerate the exploitation of our immigration laws by individuals traveling to the United States illegally or under false pretenses to give birth and secure citizenship for their child."
Turning caregivers into immigration cops
Strip away the "birth tourism" branding and look at what this actually does. Abbott is aiming the state's medical-licensing agencies — the bodies that decide whether a doctor or nurse can practice — at hospitals that treat pregnant patients. The threat is clear: get involved in enforcing the governor's immigration priorities, or risk your license.
That's a dangerous thing to do to health care. When you tell hospitals that treating the wrong pregnant woman could cost them their license, you make providers hesitate — and you make pregnant women, citizen and non-citizen alike, afraid to seek care. One hospital named in the reporting, Mission Regional Medical Center, responded that it had simply shared standard healthcare information "like hospitals across the country," and that the materials in question are no longer even in use.
Fighting a right the Supreme Court just upheld
There's also the small matter of the Constitution. Birthright citizenship — the guarantee that a child born on U.S. soil is a citizen — comes from the 14th Amendment, and the Supreme Court just reaffirmed it. Abbott's order is part of a broader Republican effort to chip away at that right anyway, this time by leaning on hospitals instead of the courts.
A state that already fails women and children
Here's the cruelest irony. Abbott is picking this fight in a state that already treats pregnant women and kids worse than almost anywhere in America. Under his leadership, Texas ranks #49 of 50 for women's health, #44 for child well-being, and #43 for teen birth rate.
He signed a six-week abortion ban with no exceptions for rape or incest. Now he's adding a new layer of fear to the maternity ward. A governor genuinely worried about mothers and babies in Texas would be trying to improve those rankings — not scaring hospitals away from delivering care.
Part of a pattern
Using state power to target immigrants and minorities is a defining feature of Abbott's tenure:
- His Operation Lone Star strung razor wire and floating barriers along the Rio Grande, and a state trooper-medic described migrants — including children — being pushed back into the river.
- He declared a planned Muslim community near Dallas would "never see the light of day" and unleashed state investigations that found no wrongdoing.
- He moved to bar Muslim civil-rights groups from owning land, prompting a religious-discrimination lawsuit.
The birth-tourism order is the same playbook: pick a group to target, wrap it in tough-sounding language, and expand state power to go after them.
The bottom line
Doctors and nurses take an oath to care for patients — not to check immigration paperwork under threat of losing their careers. Greg Abbott's executive order turns Texas hospitals into an arm of his immigration crusade, in a state that already ranks near the bottom for the health of women and children. That's not protecting Texas. It's using the sick and the pregnant as props.
Source
This post is based on reporting from CBS News Texas.
