Peoria Standard

Illinois’ free Medicaid program for undocumented immigrants is costing the state nearly $1 billion per year. Republican lawmakers want to pause the program and audit it.

“Year after year, we saw the majority party continue to double down on these expansions, which are not eligible for federal matching funds,” state Rep. Ryan Spain (R-Peoria) said in a Thursday press conference. “The Medicaid program in the State of Illinois is our biggest area of spending.”

Spain was joined at the press conference by Rep. Norine Hammond (R-Macomb) and Rep. C.D. Davidsmeyer (R-Jacksonville). 

“This billion dollar hole, which is just the beginning, requires the General Assembly to exercise fiscal responsibility in both the short-term and long-term to ensure state budget sustainability,” Spain said.  

Republican leaders in the General Assembly called for a “pause” to the program until it can be audited. Spain filed House Resolution 220 in that effort. 

According to its synopsis, the resolution “Urges a moratorium on the enrollment of new beneficiaries for Medicaid services under the program for undocumented immigrants and a moratorium on the expansion of Medicaid services and coverage for any new population of undocumented immigrants not already covered; and urges the Auditor General to conduct a performance audit as soon as reasonably possible, and annually thereafter, to assess the Department of Healthcare and Family Services' administration of the program of Medicaid services and coverage provided to undocumented immigrants.”

In 2020 Illinois became the first state to offer free healthcare to noncitizens. The program allowing the undocumented to take advantage of Medicaid has been dramatically expanded without adequate funding to ensure its fiscal health. 

Wirepoints posted a story about this to its website. 

“For the year from March 2022 through February 2023, cost of care for the 65 and over age group was nearly $188 million, which is 94 times what (bill sponsor then- Rep. Delia) Ramirez claimed,” Mark Glennon wrote in Wirepoints. “Since then, the state expanded the program twice, lowering the age limit to 55 in 2021 and 42 a year later. The cost estimates of those expansions also shatter estimates made along the way. Now, the expanded program is estimated to cost $990 million for the fiscal year that starts July 1. That’s an increase of $768 million over this year, which was the first full year under the expanded program.” 

The state has only allocated $300 million of the anticipated cost of $990 million this year. Democrats have sought to now expand the program to those ages 19 and up via HB1570 which is currently being considered. 

The Pritzker administration pointed out previous Democratic budgeting as a defense.

“The Republicans said it’s time we have some adults in the room when it comes to budgeting,” Pritzker spokesman Jordan Abudayyeh told Capitol Fax. “To be clear, the only lawmakers with a proven record of balancing the budget and improving state finances are Governor Pritzker and the Democratic supermajority in the General Assembly. The Governor just proposed another balanced budget that invests in education, healthcare, and communities. The credit ratings agencies have so much trust in his track record that after his proposal, the state received two credit upgrades.”

Abudayyeh said Democrats saved the state. 

"Who eliminated the bill backlog that reached $16 billion left by the Republican governor? Democrats. Whose prudent fiscal decisions led to eight credit upgrades? Democrats. Who paid additional pension payments? Democrats. Who invested hundreds of millions of dollars to rebuild our human services infrastructure after the Republican budget impasse? Democrats. Who rebuilt the rainy day fund to nearly $2 billion? Democrats. Who balanced the budget four years in a row? Democrats.”

The initial program was advocated for by the Illinois Legislative Latino Caucus and former state representative Delia Ramirez, a Chicago Democrat who now serves in Congress representing Illinois' 3rd District.

Ramirez originally said the program would cost only $2 million per year. At the time she said it “is nothing to a $2 billion Medicaid bill.” She bemoaned the plight of immigrants when the first version of the program passed. 

“You can pay taxes, you can do this, you can do that, you can be in this country for 25 years attempting to legalize, but you can’t get this basic health care, basic ability to stay alive, covered. If ever before, this pandemic has shown us how critical that is,” Ramirez was quoted in the State Journal-Register at the time.