Gov. J.B. Pritzker defends cuts to immigrant health care program as cost to Cook County remains uncertain
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Gov. J.B. Pritzker on Monday defended himself against rebukes from Latino elected officials and others critics over his decision to close enrollment for many people in a health care program for immigrants in the country without legal permission, arguing he did what was necessary to preserve coverage for those who are already enrolled.
At the same time, neither state nor Cook County officials have yet provided an estimate for what the policy shift will cost the county, whose hospital system will have its reimbursement rate for services provided to people in the program cut as a result of the changes announced June 16.
The state has indicated Cook County, which has been paid at a higher rate than other providers under the program that was introduced in 2020, will be expected to repay the amount it received above the standard reimbursement.
The changes came as part of an eleventh-hour budget deal in May that provided $550 million for the program — half of the projected cost for the budget year that begins July 1 — and gave Pritzker the power to make changes to control costs while accepting the political liability for those efforts.
“We need to make sure that we’re living within our fiscal limits within the state of Illinois,” Pritzker said Monday during an unrelated event at Chicago’s Union Station. “That’s something that wasn’t done for a number of years in Illinois.”
The second-term Democrat, who campaigned for reelection as a progressive who supports providing health care and other services regardless of immigration status, pointed to the budget pressures a day after telling reporters at a Pride Parade event that members of the state legislature’s Latino caucus “knew exactly what we were doing.”
“And in fact, what we have done, and it’s in part because of their advocacy, is we’ve saved the program to provide health care for undocumented immigrants,” Pritzker said Sunday. “And it’s a paused program that I hope and intend to expand.”
Among those criticizing the governor’s actions, which include closing enrollment July 1 for people under 65 who are currently eligible and capping enrollment for people 65 and older, was U.S. Rep. Jesus “Chuy” Garcia, a Chicago Democrat. In a statement earlier this month, Garcia said that the moves by Pritzker were “wrong and will have life-and-death consequences.”
“The state is trying to save money by ripping away care from undocumented people — care they were promised and programs that many immigrants have paid into. In the end, defunding preventive care will cost everyone more money and more pain,” said Garcia, who attended Monday’s Union Station event alongside the governor.
Asked about such criticism, Pritzker said: “We’re all working together — and we’re talking about the congresspeople as well as our members of the General Assembly and everybody who cares about this program to provide health care — to provide this program for 63,000 people in the state of Illinois. We’re continuing to do that; in fact, there’s room for a few more within the program and within the budget.”
As for the reimbursement changes for Cook County’s hospital system, Pritzker said the move is simply to bring the county in line with what other providers who care for people in the program are paid.
What exactly the hit will be to the county’s budget remains unclear. A spokeswoman for the state’s Department of Healthcare and Family Services said only that the agency continues to work with the county on the issue. Cook County Board President Toni Preckwinkle, who also attended Monday’s Union Station event, declined to comment.
County County Health spokeswoman Alex Normington said county officials “had a good discussion” with the state on Friday but could not provide an estimate of the cost.
“We are collaborating to bring some items to a resolution, including reimbursement for care provided,” Normington said. “What’s clear is that we continue to share the same goal of providing necessary care and services.”
In addition to closing enrollment for people ages 42 to 64 beginning next month, Pritzker also is capping enrollment in the program for people 65 and older once the total number of participants reaches 16,500.
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. The department did not provide updated figures Monday.
The program also will begin charging 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.
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 have pushed for the program to be expanded to cover people 19 and older.
