With costs soaring, Gov. J.B. Pritzker to close enrollment for many in insurance program for immigrants
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Gov. J.B. Pritzker’s administration will close enrollment for a state-funded health insurance program for immigrants under 65 who are in the country without legal permission, and cap enrollment for those 65 and older, after ballooning costs forced last-minute compromises on the state budget.
The move drew a swift rebuke from Latino legislators and an immigrant health care advocacy group that blasted it as “immoral and fiscally short-sighted.”
The budget proposal Pritzker introduced in February included $220 million for the program, but by early May projections had swelled to $1.1 billion for the coming year as enrollment continued to outstrip expectations.
To close the deal on the state’s $50.4 billion budget, Pritzker struck a deal with the Democratic-controlled General Assembly that allocated $550 million for the program and gave his administration “tools” to control its cost. The second-term Democratic governor essentially agreed to assume the political liability for restricting access to the program after declaring a year ago that “everyone, regardless of documentation status, deserves access to holistic health care coverage.”
The changes, which take effect with the start of the state’s new budget year July 1, also include copays for emergency room and inpatient services when the state can’t receive matching funds from the federal government.
Those already enrolled in the program will continue to receive coverage, the administration said.
The Illinois Department of Healthcare and Family Services, which administers the program, announced the changes Friday after Pritzker earlier in the day signed into law a measure that granted the agency the authority to make changes to the program to rein in costs.
Healthcare and Family Services referred to the action taken Friday as a “pause” in new enrollments and said it “hopes to resume new enrollments as soon as fiscally possible.”
State Rep. Edgar Gonzalez of Chicago, who represents the Little Village neighborhood and serves as Latino Caucus whip for the House Democrats, said he was “extremely disappointed in this course of action.”
“It doesn’t just affect Latinos — it affects all of Illinois,” Gonzalez, who voted in favor of the measure that gave the Pritzker administration the power to make changes to the program, said in a text message. “You would think after years in a global pandemic that the state would understand firsthand what lack of health care does to vulnerable populations.”
The Illinois Legislative Latino Caucus issued a statement Friday urging those who are currently eligible for the program to sign up before the rolls are closed next month.
Created in 2020, the program originally provided Medicaid-style coverage to immigrants 65 and older who are in the country without legal permission or who have green cards but haven’t completed a five-year waiting period and are therefore ineligible for the traditional health insurance program for the poor, which is jointly funded by the federal government.
Since then, the program has been expanded twice, and it now covers those 42 and older.
Advocates and some Democratic lawmakers pushed during the spring legislative session to further expand the program to cover those 19 and older, though legislators put that effort on hold as it became clear that there were concerns about whether the state could afford to fund the existing program at its current level.
A statewide coalition that pushed for the program and its expansion denounced the changes in a statement Friday, saying the governor “is turning his back on the communities he claims Illinois welcomes and aligning himself with anti-immigrant Republicans around the country.”
“Because of Gov. Pritzker’s decision, there are people who will be forced to forgo cancer treatment, diabetes care, mental health care, and countless other kinds of necessary medical treatment,” Healthy Illinois said in a statement. “Today’s move is immoral and fiscally short-sighted.”
The group pointed to remarks Pritzker made after signing the state budget earlier this month in which he said, “We save money when we invest in health care for undocumented immigrants.”
The Latino Caucus on Friday made clear that its members have not given up on further expansion.
“We were proud to fight to make Illinois the first state in the nation to offer Medicaid-like benefits to these communities,” the group’s statement said. “However, this backslide is disappointing.
“We will continue to fight for health care for all Illinoisans. Latino Caucus members have not given up — and will pursue closing the gap in coverage until we achieve health care for all residents.”
Pritzker’s office did not immediately respond to a request for comment on the criticism.
As of June 7, there were 63,255 people enrolled in the program, including 14,594 people 65 or older, according to Healthcare and Family Services. There were 32,612 participants ages 42 to 54, the group that just became eligible last July 1.
Under the rules introduced Friday, sign-ups will be closed for those 65 and older if enrollment for the age group reaches 16,500.
People enrolled in the program will be on the hook for copays of $250 for inpatient hospitalizations and $100 for emergency room visits if the services they receive aren’t eligible for reimbursements from the federal government. There also will be a 10% coinsurance charge for outpatient services at hospitals or ambulatory surgery centers.
Among other changes, the new rules will require the Cook County Health and Hospital System, which has been paid through the program at higher rates than other providers, to reimburse the state for the difference “in a method and amount as determined by the department.”
From its launch in 2020 until June 7 of this year, the state spent a total of $726 million on the program, with more than $328 million, or about 45% of the total cost, going to the county health system, according to the state agency.
Cook County Health did not respond immediately to a request for comment.
Chicago Tribune’s A.D. Quig contributed.
