Illinois Moves to Cut Thousands of Non-Citizens From Taxpayer-Subsidized Health Care

Illinois Gov. J.B. Pritzker speaks in Chicago, Ill., on Aug. 4, 2021. Scott Olson/Getty Images

Illinois officials are moving to stop providing taxpayer-subsidized health care to thousands of non-citizens, including many illegal immigrants, in a bid to rein in soaring costs.

The Illinois Department of Healthcare and Family Services said in a recent statement it will start annually verifying the eligibility for two programs—Health Benefits for Immigrant Adults (HBIA) and Health Benefits for Immigrant Seniors (HBIS)—after enrollment was paused due to budget concerns.

“This process will mirror the redetermination process used in the traditional Medicaid program to ensure those enrolled remain eligible,” the agency said.

The plans include closing cases for people who are enrolled who make over a certain amount or who otherwise are no longer eligible for the program in which they’re enrolled. Officials also plan on removing legal permanent residents who qualify for Medicaid, which is a federal program.

“The redetermination process ensures that those who are enrolled remain eligible for coverage,” Illinois Department of Healthcare and Family Services spokesperson Jamie Munks told WBEZ. “If an individual loses coverage through the redetermination process, it is because they no longer meet eligibility requirements, or they are required to respond or submit additional information to prove their continued eligibility, but they do not do so.”

The processes are estimated to reduce the number of enrollees in the state programs by about 6,000 people, state Sen. Don DeWitte, a Republican, told the Center Square after hearing from state health officials. Those removals would result in savings of $14 million.

HBIS, launched in 2020, provides taxpayer-funded health care for seniors who would receive Medicaid coverage but can’t get it due to their immigration status. HBIA, introduced in 2022, provides the same state benefits for people aged 42 to 64. Illegal immigrants are among the approximately 63,000 covered.

“Everyone, regardless of documentation status, deserves access to holistic healthcare coverage,” Illinois Gov. J.B. Pritzker, a Democrat, said in one of his statements in support of the programs.

Many Republicans have opposed the programs, noting that some citizens still lack health care.

The costs of the programs have increasingly sparked concern among lawmakers of both parties.

Each person aged 55 or older costs about $1,168 a month, while the rest cost about $750 a month, according to the Illinois Department of Healthcare and Family Services. Total monthly costs soared to $71 million in August 2023. Illinois paused enrollment in 2023 after projecting it would cost $831 million for fiscal year 2024 and spike to $1.1 billion if no restrictions were implemented. Lawmakers had only approved $550 million for the programs for the fiscal year.

Health officials said the growing costs stemmed in part from covered populations suffering from “untreated chronic conditions.”

Mr. Pritzker, in his recently submitted fiscal 2025 budget, asked for $629 million in funding for the program.

Fees Introduced

The Illinois Department of Healthcare and Family Services said in 2023, as it paused enrollment, that it would also be imposing co-pays for certain hospital services that were not eligible for federal money.

The new fees included $250 for an inpatient hospitalization, $100 for a visit to an emergency room, and 10 percent of what the department would pay providers for non-emergency outpatient services.

The agency said at the time that the changes would help bring down costs while describing the programs as “a vital resource for individuals who would otherwise be eligible for Medicaid but for their immigration status.”

The agency later rolled back the emergency room visit co-pay, under pressure from activists.

The rollback came after officials said they checked with the U.S. Centers for Medicare & Medicaid Services, which conveyed that states can ask for reimbursement for all emergency room visits, regardless of the patient’s immigration status.

“This decision will keep Illinoisans safer and allow them to seek the healthcare they need in emergencies,” Tovia Siegel, director of the Healthy Illinois Campaign, an activist group, said in a statement.

The other co-pays were kept in place. The agency said they would help ensure costs came down. Ms. Siegel said they would be “a significant burden on both providers and patients, limiting access to healthcare for Illinois’ immigrant community.”