University of Chicago UOC Physicals 8 17
SRP-IMAGE-Logo

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

By JERRY NOWICKI
Capitol News Illinois
[email protected]

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

SRP-IMAGE-Logo

High School Football Wrap: Week 4 | St. Laurence has Ball in win over Providence

Spread the love

Spread the loveBy Mike Walsh Correspondent Providence has won 10 state championships and finished runner-up four times, including last season in Class 4A. So how did St. Laurence’s student body celebrate the Vikings’ second-ever victory over the Celtics, 31-24, last Friday night in Burbank? With an old-fashioned field-storming. St. Laurence senior Aaron Ball scored the…

SRP-IMAGE-Logo

Sandburg shreds Lockport defense, block last-second FG attempt to secure win

Spread the love

Spread the loveBy Randy Whalen Correspondent Anthony Shelton burst on the scene a year ago in a big Sandburg win over Lockport. The Eagles junior last week solidified himself as a top quarterback in the South Suburbs with another win over the Porters. Shelton threw for 300 yards and a pair of touchdown passes as Sandburg…

SRP-IMAGE-Logo

Chicago Bears honor Stagg’s Nero, Gilmore

Spread the love

Spread the loveBy Mike Walsh Correspondent The Chicago Bears named Stagg head football coach Colt Nero and Chargers senior Lebarion Gilmore as the Chicago Bears Coach of the Week and the Chicago Bears High School All-Star for Week 3 of the 2023 season. The honors came after Stagg defeated visiting Belleville West 24-0 in a…

Richards freshman running back Ladarrius Foster runs past the Oak Lawn defesne during the Bulldogs’ 27-2 win on Sept. 15. Photo by Xavier Sanchez

Richards downs Oak Lawn in crosstown clash

Spread the love

Spread the loveBy Xavier Sanchez Correspondent Merriam Webster defines a rivalry as “one of two or more striving to reach or obtain something that only one can possess.” In sports, that makes both sides of any competition rivals, but the term is often reserved for a special matchup, of sorts. One of those is Oak…

Summit Police Chief Mel Ortiz (from left), Officer Alberto Valadez, and Officer Jihovanny Correa at the Summit Neighborhood Watch meeting last Thursday night. (Photo by Carol McGowan)

Man dies in Markham shootout after robbing Summit phone store

Spread the love

Spread the loveBy Carol McGowan The man who robbed an AT&T store in Summit on Thursday morning was later found dead in a house in Markham after shots were exchanged between the man and police. The incident started when a man – identified as Jeremy Kelly, 28, of Markham – robbed the AT&T store at…

new bedford park sign

26 hurt in Bedford Park tent collapse

Spread the love

Spread the loveFrom staff reports More than two dozen people at an event in Bedford Park last week were injured when the tent they were meeting in collapsed. Bedford Park Police said they responded to assist the Bedford Park Fire Department at 10:44 a.m. on Thursday, September 14, in the 5600 block of West 73rd…

Mario DePasquale

Former McCook police chief pleads guilty to extortion

Spread the love

Spread the loveBy Bob Bong Mario DePasquale, former police chief of McCook pleaded guilty last week to conspiring with the village’s former mayor to extort two businessmen out of tens of thousands of dollars. DePasquale, 49, pleaded guilty to one count of conspiracy to commit extortion during a brief hearing before U.S. District Judge Elaine…

AERO opened its new school last week in Burbank. (Supplied photos)

AERO opens new facility in Burbank

Spread the love

Spread the loveBy Bob Bong When Queen of Peace High School in Burbank announced it was closing in 2018, the good folks at AERO special education co-op saw a golden opportunity. They purchased the school’s 13-acre site at 7659 S. Linder Ave. in August 2019 for $3.2 million. The plan was to retrofit the high…

reporter st. gianna fest

St. Gianna Fest (formerly Queen of Martyrs Fest) kicks off fall activities

Spread the love

Spread the loveBy Joe Boyle Fall begins this week but there is no shortage of activities occurring this month and next in Evergreen Park. Mayor Kelly Burke reminded residents during the Evergreen Park Village Board meeting Monday night that the St. Gianna Fest (formerly Queen of Martyrs Fest) Family Carnival will take place Friday, Sept. 22,…

Tom Phelan

Oak Lawn village manager Tom Phelan receives pay raise

Spread the love

Spread the loveBy Joe Boyle Oak Lawn Mayor Terry Vorderer is pleased with the overall contributions of Village Manager Tom Phelan, who will receive a merit-based pay increase. Phelan will see a 5 percent increase in pay after village trustees approved a resolution as part of the consent agenda during the Oak Lawn Village Board…

Neighbors

DVN JCs Restoration House Ad
SRP-IMAGE-Logo

High School Football Wrap: Week 4 | St. Laurence has Ball in win over Providence

Spread the love

Spread the loveBy Mike Walsh Correspondent Providence has won 10 state championships and finished runner-up four times, including last season in Class 4A. So how did St. Laurence’s student body celebrate the Vikings’ second-ever victory over the Celtics, 31-24, last Friday night in Burbank? With an old-fashioned field-storming. St. Laurence senior Aaron Ball scored the…

SRP-IMAGE-Logo

Sandburg shreds Lockport defense, block last-second FG attempt to secure win

Spread the love

Spread the loveBy Randy Whalen Correspondent Anthony Shelton burst on the scene a year ago in a big Sandburg win over Lockport. The Eagles junior last week solidified himself as a top quarterback in the South Suburbs with another win over the Porters. Shelton threw for 300 yards and a pair of touchdown passes as Sandburg…

SRP-IMAGE-Logo

Chicago Bears honor Stagg’s Nero, Gilmore

Spread the love

Spread the loveBy Mike Walsh Correspondent The Chicago Bears named Stagg head football coach Colt Nero and Chargers senior Lebarion Gilmore as the Chicago Bears Coach of the Week and the Chicago Bears High School All-Star for Week 3 of the 2023 season. The honors came after Stagg defeated visiting Belleville West 24-0 in a…

Richards freshman running back Ladarrius Foster runs past the Oak Lawn defesne during the Bulldogs’ 27-2 win on Sept. 15. Photo by Xavier Sanchez

Richards downs Oak Lawn in crosstown clash

Spread the love

Spread the loveBy Xavier Sanchez Correspondent Merriam Webster defines a rivalry as “one of two or more striving to reach or obtain something that only one can possess.” In sports, that makes both sides of any competition rivals, but the term is often reserved for a special matchup, of sorts. One of those is Oak…

Summit Police Chief Mel Ortiz (from left), Officer Alberto Valadez, and Officer Jihovanny Correa at the Summit Neighborhood Watch meeting last Thursday night. (Photo by Carol McGowan)

Man dies in Markham shootout after robbing Summit phone store

Spread the love

Spread the loveBy Carol McGowan The man who robbed an AT&T store in Summit on Thursday morning was later found dead in a house in Markham after shots were exchanged between the man and police. The incident started when a man – identified as Jeremy Kelly, 28, of Markham – robbed the AT&T store at…

new bedford park sign

26 hurt in Bedford Park tent collapse

Spread the love

Spread the loveFrom staff reports More than two dozen people at an event in Bedford Park last week were injured when the tent they were meeting in collapsed. Bedford Park Police said they responded to assist the Bedford Park Fire Department at 10:44 a.m. on Thursday, September 14, in the 5600 block of West 73rd…

Mario DePasquale

Former McCook police chief pleads guilty to extortion

Spread the love

Spread the loveBy Bob Bong Mario DePasquale, former police chief of McCook pleaded guilty last week to conspiring with the village’s former mayor to extort two businessmen out of tens of thousands of dollars. DePasquale, 49, pleaded guilty to one count of conspiracy to commit extortion during a brief hearing before U.S. District Judge Elaine…

AERO opened its new school last week in Burbank. (Supplied photos)

AERO opens new facility in Burbank

Spread the love

Spread the loveBy Bob Bong When Queen of Peace High School in Burbank announced it was closing in 2018, the good folks at AERO special education co-op saw a golden opportunity. They purchased the school’s 13-acre site at 7659 S. Linder Ave. in August 2019 for $3.2 million. The plan was to retrofit the high…

reporter st. gianna fest

St. Gianna Fest (formerly Queen of Martyrs Fest) kicks off fall activities

Spread the love

Spread the loveBy Joe Boyle Fall begins this week but there is no shortage of activities occurring this month and next in Evergreen Park. Mayor Kelly Burke reminded residents during the Evergreen Park Village Board meeting Monday night that the St. Gianna Fest (formerly Queen of Martyrs Fest) Family Carnival will take place Friday, Sept. 22,…

Tom Phelan

Oak Lawn village manager Tom Phelan receives pay raise

Spread the love

Spread the loveBy Joe Boyle Oak Lawn Mayor Terry Vorderer is pleased with the overall contributions of Village Manager Tom Phelan, who will receive a merit-based pay increase. Phelan will see a 5 percent increase in pay after village trustees approved a resolution as part of the consent agenda during the Oak Lawn Village Board…

House Ad Subscription2
CRR NH Fireside Realty House Ad