SRP-IMAGE-Logo

Nearly $1B in expected spending on health care for noncitizens adds to state budget pressures

By JERRY NOWICKI
Capitol News Illinois
jnowicki@capitolnewsillinois.com

SPRINGFIELD – The state estimates an expansion of state-sponsored health care to individuals who are ineligible for Medicaid based on their citizenship status is expected to cost $990 million in the upcoming fiscal year, far outpacing the original price tag cited when the measures became law.

In 2020, Illinois made noncitizens aged 65 and older eligible for Medicaid-type coverage, becoming the first state to do so. The Health Benefits for Immigrant Seniors program is open to individuals whose income is below the federal poverty level.  

It’s a cost born entirely by the state because the individuals are not eligible for the Medicaid program that is split roughly 50-50 between the state and the federal government.

The expansion was inserted into a late draft of what’s known as the budget implementation bill in the pandemic-shortened 2020 session. It was an initiative of the Illinois Legislative Latino Caucus and sponsored in the House by Rep. Delia Ramirez, D-Chicago, who has since moved on to the U.S. Congress.

She and other advocates said providing health care, especially preventative care, to immigrant populations would be cheaper than making them dependent on emergency room visits.

“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 Springfield State Journal-Register at the time.

Ramirez pegged the program’s Fiscal Year 2021 cost at $2 million, according to the newspaper.

The source of the initial estimate is unclear, although Gov. JB Pritzker’s administration said it had not prepared its own estimate before the program became law because it was a lawmaker-driven initiative. Republicans noted at a Thursday news conference that it was not thoroughly vetted in committee before being added to the budget.

The actual cost of the program far exceeded that estimate, and the program exceeded its FY 2021 appropriation within the first month of implementation, according to a closed-door presentation by the Illinois Department of Healthcare and Family Services to lawmakers last month.

The cost of care for the 65 and over age group was nearly $188 million between March 2022 and February 2023, per that presentation.

Since the program’s initial passage, lawmakers have expanded it twice, lowering the age limit to 55 in 2021 and 42 a year later. The expanded program is known as Health Benefits for Immigrant Adults.

 

Outpacing estimates

As the expansion was to be implemented in 2021, IDHFS brought in its own consultant to try to get a clearer picture of what it would cost. For the current fiscal year that concludes June 30, the actuarial firm Milliman estimated the total program costs would be about $222 million.

But the actual cost for all three age groups was $410 million from March 2022 through February 2023, according to the department.

Milliman’s estimates used American Community Survey data and “assumed…enrollees would not cost more than Medicaid enrollees,” the department noted in its presentation. But IDHFS noted actual program spending “reflects higher enrollee costs than the traditional Medicaid population due to more untreated chronic conditions and higher hospital costs.”

While the presentation laid out higher-than-expected costs for the program, it also noted per-enrollee costs for those age 65 and older are stabilizing because enrolled individuals are getting chronic conditions under control. For all groups, initial costs were higher due to the number of long-untreated conditions now receiving care.

Milliman also underestimated the number of enrollees in the immigrant community, a notoriously difficult population to track. Its estimate of 33,500 total enrollees was exceeded by more than 18,000 with four months to go in Fiscal Year 2023. The number is expected to grow to nearly 99,000 next fiscal year as enrollees in the 42-54 range continue to grow by about 10 percent each month.

When the program’s expansion to the population aged 42-54 passed one year ago, Republicans noted in Senate floor debate that it was tacked onto a bill that had otherwise been agreed to by working group members of both parties.

Milliman’s cost estimate of $68 million for the age 42-54 group was cited in floor debate, but thus far over $104 million in claims has been paid out. That number is expected to grow to $460 million in the upcoming fiscal year for that age group.

All told, the estimated $990 million price tag for the upcoming year represents a $768 million increase over the faulty initial current-year estimate. The Pritzker administration said IDHFS could cover about $300 million of the cost difference within its budget as proposed by the governor, while the rest would be subject to ongoing budget negotiations.

Another Democrat-sponsored bill that remains in committee would add 19-41-year-olds to those covered under the Medicaid-style program. Milliman’s estimate projected that expansion would cost $280 million, but whether it ends up in the final budget remains to be negotiated.

 

Republicans call for pause

House Republicans called for a “pause” and “audit” on the existing program at a Statehouse news conference Thursday.

“We haven’t seen the full magnitude of what the liability could be for this program,” Rep. Ryan Spain, R-Peoria, said at the news conference. “And you know, this is a large country where people are moving to different areas based on what benefits may be available to them. So we’re just scratching the surface of what could be our future unfunded liability in this area.”

While Republicans have long criticized spending state funds on noncitizens, Democratic backers of the proposals note that individuals pay sales, income and other taxes as Illinois residents, even if they’re not U.S. citizens.

The House GOP on Thursday said the program’s funding could be reallocated to other “drastically underfunded” programs and agencies, such as the Department of Children and Family Services and to cut down on wait lists for people most in need of substantial state care.  

“The $990 million could be used to support services to the developmentally disabled…to address the substantial workforce shortages within our nursing homes across the state,” Rep. Norine Hammond, R-Macomb, said.

Sen. Omar Aquino, a Latino Caucus member and Democratic Caucus Chair in the Senate, responded to the GOP criticism saying the larger-than-expected enrollment in the program “only reflects a great need for health care options in underserved communities.”

“As usual, some lawmakers on the other side of the aisle treated the needs of large communities as cold-hearted unfinished statistics to score political points,” Aquino said in a statement.

The Pritzker administration noted the higher-than-expected costs represent just another variable in budget negotiations, and it asserted its fiscal track record of credit upgrades, long-term savings and debt retirement.

“To be clear, the only lawmakers with a proven record of balancing the budget and improving state finances are Gov. Pritzker and the Democratic supermajority in the General Assembly,” Pritzker spokesperson Jordan Abudayyeh said in a statement. “The governor just proposed another balanced budget that invests in education, health care, and communities.”

 

Other spending pressures

Along with the spending pressures outlined by Hammond Thursday, providers at community facilities serving developmentally disabled individuals are seeking a funding increase beyond what Pritzker has proposed, municipalities are seeking a roughly $250 million increase in state aid for the upcoming fiscal year, and some lawmakers are advocating for a permanent child tax credit.

Various Republicans have called for decreasing or eliminating the estate tax, creating a child care tax credit, making permanent a sales tax exemption for groceries, exempting prescription drugs and medical devices from the state sales tax, doubling a senior income tax exemption and paying energy rebates to downstate utility customers.

The long list of funding requests comes amid a backdrop of surging state revenues. The nonpartisan legislative Commission on Government Forecasting and Accountability in early March increased its revenue projection for the upcoming fiscal year to about $465 beyond what the governor had projected.

But March saw the first year-over-year revenue decline of any month in the current fiscal year, and a recent report from the commission projects slow revenue growth over the next three years among increased spending pressures. April, however, is the most important month for revenue projections, as Illinoisans file their taxes and the scope of available funding becomes more clear. The April revenue update is due in early May.

Pritzker’s office didn’t rule out any new spending measures or further expansion of health care to noncitizens but said the governor and lawmakers “will continue on the proven track of working together to ensure state spending does not exceed revenues.”

 

Capitol News Illinois is a nonprofit, nonpartisan news service covering state government. It is distributed to hundreds of newspapers, radio and TV stations statewide. It is funded primarily by the Illinois Press Foundation and the Robert R. McCormick Foundation, along with major contributions from the Illinois Broadcasters Foundation and Southern Illinois Editorial Association.

Leave a Comment





Local News

Richard Chavez, 24, of Oak Park, was charged with first-degree murder in the death of Charisma Ehresman of Forest View. (Booking photo)

Oak Park man charged in Forest View woman’s murder

Spread the love

Spread the love By Carol McGowan and Bob Bong A 24-year-old Oak Park man has been arrested and charged in the strangulation death last month of 20-year-old Charisma Ehresman, of Forest View. Richard Chavez, of the 600 block of South Maple Street in Oak Park, was arrested on February 18 at Cook County Jail where…

Kathy Headley

Years later, he still takes the cake

Spread the love

Spread the loveBy Kathy Headley Your correspondent in Chicago Lawn and Marquette Manor 6610 S. Francisco • (773) 776-7778 In the past I’ve started columns dated Feb. 25 by giving a shout out to former Beatle George Harrison, who would have celebrated his 79th birthday today. Today is no different. He was my favorite of…

Joan Hadac

Laff-Jam coming to St. Bede, no foolin’

Spread the love

Spread the loveBy Joan Hadac GSWNH Columnist At-Large joan.hadac@gmail.com Once again this week, it’s my privilege and pleasure to write the Greater Southwest News-Herald’s column for Greater Ashburn (the Wrightwood, Ashburn, Parkview and Scottsdale neighborhoods). As usual, there are plenty of interesting things happening in this special, vibrant part of Chicago. St. Bede School’s athletics…

Mary Stanek

Best of all, spring is coming

Spread the love

Spread the loveBy Mary Stanek Your correspondent in Archer Heights and West Elsdon 3808 W. 57th Place •  (773) 284-7394 Mardi Gras, Paczki Day, Fat Tuesday and the start of the Lenten season all happen this coming week. But the absolute best part is, March is here. Spring is just around the corner (we can…

Peggy Zabicki

A sweet treat, right on 63rd Street

Spread the love

Spread the loveBy Peggy Zabicki Your correspondent in West Lawn 3633 W. 60th Place •  (773) 504-9327 Hi neighbors! Today is Chocolate Covered Nuts Day. Celebrate wisely. I suggest a trip to Villa’s Nuts and Candy, 4635 W. 63rd St. They have scrumptious chocolate-covered everything and so much more. Call them for information on days and hours at (773) 581-8313.…

Olympic Silver Medalist Abbey Murphy was welcomed back to her home block on 92nd and Ridgeway Avenue in Evergreen Park Thursday night. She stands here alongside Evergreen Park Mayor Kelly Burke (left). (Photos by Kelly White)

Warm homecoming on cold, snowy night for Olympian Abbey Murphy

Spread the love

Spread the loveBy Kelly White Streets lined with residents welcomed back USA Olympic Silver Medalist Abbey Murphy Thursday night to Evergreen Park. The Evergreen Park community has been cheering on 19-year-old Murphy as she and Team USA battled in the women’s hockey tournament at the Winter Olympics in Beijing. Countless residents have decorated their houses…

The late CPD Officer Ella French. --Supplied photo

St. Patrick’s Day parade dedicated to Officer Ella French

Spread the love

Spread the loveHeroism, sacrifice to be honored By Tim Hadac A 29-year-old woman remembered as a hero and martyr among many—in Chicago and elsewhere—will be saluted at the Archer Avenue St. Patrick’s Day parade, set for Saturday, March 12. The late Chicago Police Officer Ella French, shot to death during a traffic stop near 63rd…

CRRNH_EagleScoutCongrats_022322

Eight years later, an Eagle takes flight

Spread the love

Spread the loveBy Joan Hadac Your correspondent in Clearing and Garfield Ridge (708) 496-0265 • joan.hadac@gmail.com Hi everyone. I want to tell you about the eight-year journey of one young man, which started in fourth grade at Kinzie School and ended just recently. His journey took him from Cub Scout Pack 3625 at Kinzie School through…

CRRNH_StDanSpiritDay_022322

A crazy fun day

Spread the love

Spread the love Dahlia Walkosz and Olivia Lopez, fifth graders at St. Daniel the Prophet School, were among many having fun during Crazy Hat Day–part of St. Dan’s efforts to promote good spirit during this year’s Catholic Schools Week. Parents looking for a school for their children for the 2022-23 school year are invited to…

Amelia Garcia

Naz teacher earns Golden Apple nomination

Spread the love

Spread the loveFrom staff reports A teacher at Nazareth Academy in La Grange Park has been named a Golden Apple Award Finalist for Excellence in Teaching. Amelia García is one of just 30 finalists for the prestigious award. Hundreds of high school teachers across the state were nominated. Winners will be announced this spring—surprised individually…

Neighbors

Mary Stanek

Looks like March may go out like a lion

Spread the love

Spread the love. By Mary Stanek Your correspondent in Archer Heights and West Elsdon 3808 W. 57th Place •  (773) 517-7796. . March comes in like a lamb – it goes out like a lion! A sneak peek at the weather forecast for the next 10 days does show some mild days. So, we welcome…

Kathy Headley

Weather cooperated for Marine’s return

Spread the love

Spread the love. By Kathy Headley Your correspondent in Chicago Lawn and Marquette Manor 6610 S. Francisco • (773) 776-7778 . After the surprising snow coming down like a blizzard for a while last Friday night, I was especially glad to see the sun Saturday morning, for Patrick Downs (St. Rita High School class of…

Peggy Zabicki

Slam the brakes on reckless drivers

Spread the love

Spread the love. By Peggy Zabicki Your correspondent in West Lawn 3633 W. 60th Place •  (773) 504-9327 . The most popular topic of conversation in our neighborhood lately is the problem of speeding drivers. There are car accidents every single day due to drivers who break the law. I hope the city will add even more…

Hon. Koula Fornier

Fournier resigns from TTO to become judge

Spread the love

Spread the loveFrom staff reports The Lyons Township Trustees of Schools is accepting applications for a vacancy on their board, after Trustee Koula A. Fournier resigned earlier this month after being sworn-in as a Judge of the Cook County Circuit Court. Fournier was appointed by the Illinois Supreme Court to fill the Maloney vacancy of…

SRP-IMAGE-Logo

Boys Hoops Wrap | Curie, Rice and Marist among area regional champs

Spread the love

Spread the loveBy Xavier Sanchez Correspondent The original March Madness got underway last week across Illinois, and several area teams were crowned regional champions. Teams still alive in Class 4A are Marist and Curie, and in Class 3A are Brother Rice, De La Salle, Evergreen Park and Mount Carmel.   CLASS 4A Marist (29-4) cruised…

Evergreen Park senior Tre Dowdell crosses over a Hillcrest defender during the Class 3A Evergreen Park Regional championship game on Feb. 23. Photo by Xavier Sanchez

Boys Basketball Class 3A Playoffs | Evergreen Park tops Hillcrest for first regional title since 1974

Spread the love

Spread the loveBy Xavier Sanchez Correspondent Some Evergreen Park players have deep roots in the community, but it was a newcomer that carried the Mustangs to a monumental win. Senior guard Tre Dowdell put up a game-high 30 points and Mustangs rolled to a 74-60 win over Hillcrest in the Class 3A Evergreen Park Regional…

SeatGeek Stadium in Bridgeview could be the site for Northwestern football games in 2024. Photo by Jeff Vorva

College Football | Northwestern football may play at SeatGeek

Spread the love

Spread the loveBy Jeff Vorva Correspondent It appears that Chicago’s Big Ten team will be Bridgeview’s Big Ten team for at least one day. Maybe more. Northwestern has released its 2024 football schedule, but where the Wildcats will play their seven home games is unknown. Their home stadium, Ryan Field in Evanston, is undergoing a…

Nazareth senior Amalia Dray fight through a Kenwood defender during the Roadrunners’ 50-37 win in the Class 4A Mother McAuley Sectional title game. Photo by Xavier Sanchez

Girls Basketball | Nazareth tops Homewood-Flossmoor, heads to Illinois Final Four for fifth time in past six seasons

Spread the love

Spread the loveBy Xavier Sanchez Correspondent Nazareth head coach Ed Stritzel has built his Roadrunners into a powerhouse program with a defense-first philosophy that is carrying the reigning Class 3A state champions through another deep postseason run. Four nights after Nazareth held Kenwood to a season-low 37 points in the Class 4A Mother McAuley Sectional…

Mount Carmel's wrestling team celebrates a Class 3A championship. Photo courtesy of Mount Carmel High School

Postseason Roundup | Mount Carmel wrestling wins fifth state title

Spread the love

Spread the loveBy Jeff Vorva Correspondent During the regular season, only one wrestling team from Illinois beat Mount Carmel in a dual meet. Joliet Catholic got the better of the Caravan with a 38-27 victory on Jan. 18. That came two days after Mount Carmel lost to Crown Point (Indiana). The Caravan will be unable…

St. Laurence's Kathleen Martin gets off a shot against Hinsdale South in the Class 3A St. Ignatius Sectional on Feb. 22 in Chicago. Photo by Jeff Vorva

Area Sports Roundup | St. Laurence girls hoops has benchmark season

Spread the love

Spread the loveBy Jeff Vorva Correspondent The St. Laurence girls basketball team’s historic season came to a close with a 42-29 loss to Hinsdale South at the Class 3A St. Ignatius Sectional on Feb. 22, but the Vikings hit some milestone’s in former Marist and Saint Xavier star Claire Austin’s first year as coach. The…