Texas Republican Gov. Greg Abbott on Thursday ordered hospitals in the Lone Star State to ask patients about their immigration status in order to ascertain the costs of providing medical care to people living in the U.S. illegally.

Through an executive order, Abbott directed Texas hospitals to compile data on inpatient discharges and emergency visits by immigrants living in the U.S. without authorization, as well as on the costs of providing medical services to this population.

Abbott instructed the Texas Health and Human Services Commission to require hospitals to start collecting the information on Nov. 1 and to provide regular reports to state authorities.

To justify the move, Abbott cited the record levels of migrant apprehensions at the U.S.-Mexico border in recent years, claiming that Texas was shouldering the economic burden of providing medical services to migrants entering the country illegally.

“Due to President Joe Biden and Vice President Kamala Harris’ open border policies, Texas has had to foot the bill for medical costs for individuals illegally in the state,” Abbott said in a statement.

Abbott’s directive said hospitals should tell patients the new information collection “will not affect patient care.” He noted in his order that federal law requires hospitals to provide emergency treatment to any individual, irrespective of their immigration status.

Still, Abbott’s order is likely to be decried by immigration rights advocates, who have said similar policies have had a chilling effect on immigrants, discouraging them from accessing medical care out of fear of legal repercussions.

In his order, Abbott suggested Texas would seek to get the federal government to reimburse the state for these expenses, though it is unclear how, or if, that would happen.

Thursday’s action by Texas is the latest example of Republican-led states enacting stricter immigration laws and measures. Last year, Florida’s Republican Gov. Ron DeSantis signed a harsh immigration state law that, among other things, requires hospitals to collect information on patients’ immigration status.

Led by Texas, several red states have also passed laws that seek to criminalize unauthorized immigration at the state level and empower state officials to prosecute suspected violators. Those state laws have been challenged in federal court by the Justice Department, which has noted that immigration policy has long been the responsibility of the federal government.

At Abbott’s direction, Texas has mounted an aggressive political and legal challenge to the Biden administration on immigration. The state, for example, has filed lawsuits against virtually every major immigration action by President Biden. 

Abbott has also ordered state officials to bus tens of thousands of migrants to Democratic-led cities, tasked the state National Guard with fortifying the banks of the Rio Grande with razor wire and instructed state troopers to arrest migrants on trespassing charges.