Greg Abbott ordered the Texas Health and Human Services Commission (HHSC) to investigate hospitals over alleged "maternity tourism" packages offered to foreign women who would travel to Texas to give birth.
According to the governor's official statement, the initial investigation points to Mission Regional Medical Center, which Abbott accuses of promoting birth packages for foreign women and profiting from a practice he describes as exploitation of the healthcare system and American citizenship.
What Texas is investigating
Abbott's order calls on the HHSC to conduct an immediate and thorough investigation. If violations are found, the agency must refer them to the attorney general for civil action and to the relevant district or county prosecutor for potential criminal charges. It may also impose administrative sanctions and fines on the hospital under investigation.
The governor argues that thousands of foreign women come to the United States under "false pretenses" to give birth and secure American citizenship for their children. Under this interpretation, the investigation seeks to determine whether state-regulated institutions facilitated or promoted such practices.
The Texas Tribune explained that state actions have not focused on directly investigating foreign women who gave birth in Texas. Instead, the focus is on healthcare providers or care centers accused of encouraging, organizing, or profiting from birth trips, possibly through illegal mechanisms.
The case follows a prior lawsuit by Attorney General Ken Paxton against De'Ai Postpartum Care Center, a Houston-area facility accused of facilitating travel by Chinese citizens to give birth in Texas. Paxton alleged that the center promoted its services on Chinese platforms, claimed to have assisted in the birth of more than 1,000 American babies, and provided instructions on how to conceal the purpose of the trip.
What this means for immigrants
The legal point is important: giving birth in the United States as a foreign national is not illegal, and so-called "birth tourism" is not illegal in and of itself. What can constitute a crime is committing immigration fraud — for example, obtaining a visa under false pretenses, concealing relevant information, or participating in commercial schemes designed to deceive the federal government.
The Texas Tribune also noted that a child born on American soil is a citizen under the Fourteenth Amendment, regardless of their parents' citizenship or immigration status.
The concern among immigrant advocates is that these measures will create fear around seeking medical care. Texas has required since 2024 that hospitals ask patients about their immigration status, though patients may decline to answer and hospitals must provide care regardless of citizenship.
Abbott's order does not in itself alter birthright citizenship or make it a crime to give birth in Texas. But it does increase pressure on hospitals, postpartum care centers, and providers who treat pregnant foreign women.
For immigrant communities, the practical risk is that fear of being singled out may ultimately drive pregnant women away from necessary medical care.
