Debate Over Expansion of Health Care Program for Undocumented Residents, Green-Card Holders Slows State Budget Talks

Illinois state legislators are unlikely to meet their self-imposed deadline of a Friday adjournment, given that as of Wednesday evening there was no agreement on a budget and no spending plan formally teed up to vote on in the next few days.

One roadblock has been a set of programs in which Illinois provides health care coverage to green-card holders and undocumented residents.

Thanks to our sponsors:

View all sponsors

Glo Choi looks back to when his mom, who is undocumented, got sick.

“I don’t know what we were more afraid of: That her health was failing, or that we weren’t able to afford the cost,” said Choi, a community organizer with the Hana Center. “And no one in Illinois should have to question: can I afford to stay alive? Can I afford to keep working?"

These days, his mom is covered by Illinois’ Health Benefits for Immigrant Seniors. It works a lot like Medicaid, the government health insurance program for the poor.

Those who would be covered by Medicaid but not for their immigrant status are covered under the relatively new state program.

At first, it was only for seniors.

Then the program expanded to non-citizen adults age 42 and older, with the Health Benefits for Immigrant Adults program.

Now, advocates want everyone (because youth have coverage elsewhere, that means adults 19 on up, per House Bill 1570) to be eligible.

The Healthy Illinois Campaign estimates that will cost roughly $200 million.

“This isn’t breaking the state budget and to say so is just blatantly anti-immigrant when we’re talking about 0.4% of the state budget,” said the group’s director, Tovia Siegel.

But a report commissioned by the state projects an expansion would cost nearly double that figure, at $380 million. 

Illinois’ Department of Healthcare and Family Services (HFS) says it stands by its numbers, which were prepared by an actuary.

Advocates’ previous cost estimates for the current programs were wildly low.

The agency estimates that this fiscal year, coverage for the two programs will cost $690 million – an amount flagged by Republicans, who have bemoaned Illinois’ sanctuary state status as “unsustainable.” They’ve called for an audit on the programs, and a moratorium on new enrollments (House Resolution 220).

While Gov. J.B. Pritzker touted the program previously, he has not put his support behind the expansion. The governor has insisted the new budget must be balanced.

“When we hear politicians say that there’s not enough money for extending coverage this year, we’re hearing that they’re OK with leaving 100,000 people behind,” Siegel said. “We’re hearing that they’re okay with leaving 100,000 people to get sick, to not being able to access the care that they need, the care that we all deserve.”

Advocates are putting on pressure on Pritzker, and say its “inhumane” for those who have pledged that “health care is a right” to not figure out a way to pay for health care for all.

“I urge the General Assembly, the governor’s office, HFS to keep working to figure out a way how to do this and stop using us as a scapegoat for not being able to close the (budget) gap,” said Esther Corpuz of Alivio Medical Center, a federally qualified health center that offers bilingual services and primarily serves Mexican Americans.

Members of the Healthy Illinois Campaign say the state’s cost estimates are flawed, and don’t take into account that while there are initial cost surges as individuals who’ve long had neglected needs finally get them taken care of, the spike evens out.

“Somebody needs oral surgery in order to be able to work and be out of pain, but then they transition into normal dentistry once or twice a year. That’s a kind of a low-scale example of how there’s kind of a spike in cost, and then it settles back down,” said John Bouman of Legal Action Chicago at a statehouse press conference on Wednesday.

Negotiations on the spending plan continue, with many Latino lawmakers insisting that the expansion of the health care program be part of a final deal.

Other legislators are upset the growing costs would eat up money they say go to other deserving programs.

Thanks to our sponsors:

View all sponsors

Thanks to our sponsors:

View all sponsors