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Case 6:23-cv-00007 Document 305 Filed on 03/08/24 in TXSD Page 14 of 31

to emergency medical conditions, including childbirth and labor, to aliens living in the United States. (Id. at 51-52).

44. In May 2023, HHSC estimated expenditures for Emergency Medicaid services provided to CHNV nationals. The expenditure calculations reflect the sum of paid amounts on Emergency Medicaid claims for services to individuals with a country of origin listed as one of those four countries, regardless of immigration status. The expenditure calculations are as follows: $207,000 in 2019; $141,000 in 2020; $123,000 in 2021; $178,000 in 2022; and $30,000 in 2023 (as of May 5, 2023). (Id. at 52).

45. CHIP Perinatal provides prenatal care to certain low-income women who do not otherwise qualify for Medicaid. (Id. at 53).

46. In May 2023, HHSC estimated the cost of Texas CHIP Perinatal services provided to aliens from Cuba, Haiti, Nicaragua, and Venezuela. The total estimated cost to Texas for these services was approximately $28,000 in 2019; $37,000 in 2020; $64,000 in 2021; $80,000 in 2022; and $51,000 in 2023 (as of May 5, 2023). (Id. at 54). Further, since October 1, 2022, Texas paid an estimate of $47,500 in services for aliens from Cuba, Haiti, Nicaragua, and Venezuela. (Id.).

47. While these figures are estimates, the Court finds that through these two programs, Texas will inevitably expend some health care resources on CHNV nationals who enter the United States under the Parole Program.

2.

An Increase in CHNV Nationals Entering Texas Would Impose Incarceration Costs on the State.

48.

According to a 2022 figure, the average cost of incarcerating an inmate who qualifies for reimbursement under the federal government’s State Criminal Alien Assistance Program (“SCAAP”) in Texas Department of Criminal Justice (“TDCJ”) facilities is $77.49 per day. (Dkt. No. 263 at 35).

49. From July 1, 2020, to June 30, 2021, TDCJ incarcerated 7,058 eligible inmates for a total of 1,984,597 days. Using the 2022 per-day figure, the estimated cost of incarcerating these inmates for that period was $153,786,422. (Id.).

50. Of that amount, SCAAP reimbursed only $17,364,520. Thus, Texas paid approximately $68.74 per day per criminal alien incarcerated in TDCJ facilities. (Id.).

51. Texas, via TDCJ, also incurs costs to keep aliens in custody or add them to mandatory parole or supervision programs when those aliens are not detained or removed by federal immigration authorities. (Id. at 36). For example, in Fiscal Year 2022, the average per-day cost of these programs for each inmate not detained or removed is $4.69, which would mean total costs of $9,307,760, based on the most recently completed SCAAP application. (Id. at 36).

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