I wouldn’t be surprised if many people claim they are illegal when they are not so they don’t have to have insurance, give an address or social security number or get billed.
There isn’t really anyone ‘hiding in the shadows’ it is a marketing ploy.
I would bet that if Texas were to start sending bills to the country the patient belongs to, and IF our fed gov were to back it up.
We’d see a LOT less illegals from those countries.
I’d suggest adding in the cost of education.