Illinois health care program for noncitizens, including illegal immigrants, balloons to $1.1B

The initial cost to provide healthcare to noncitizens was predicted to be $220 million

An Illinois program to provide health care coverage to noncitizens, including illegal immigrants, will cost the state $1.1 billion for the upcoming fiscal year, officials said this week, an enormous increase from the $220 million initially earmarked for the benefit.

The health care program provides state-funded health care to immigrants age 42 and older who would otherwise qualify for Medicaid if it weren’t for their citizenship status. That includes those who are here legally on a green card for fewer than five years, and illegal immigrants. The state began providing Medicaid-like benefits to those 65 and over in 2020 and expanded it to those 42 and over last year.

Democratic Gov. JB Pritzer’s budget included a $220 million estimate for the program for the upcoming fiscal year. But The State Journal-Register reports that a top state health official briefed the Senate’s appropriations committee and said the new estimate is a staggering $880 million above that.


The outlet reported that the current-fiscal year estimate for the program was $220 million as well, but it has cost over $400 million with two months still to go of fiscal year 23.

Officials said that both the cost of care and the number of those enrollees have dramatically exceeded their estimates. The state had previously estimated 98,500 enrollees, but now says there will be over 120,000 signed up in FY24.

Despite the exorbitant costs, the Chicago Tribune reports that some Democratic lawmakers are pushing to further expand the coverage to adults over 19 — which the governor’s administration says would slap another $380 million onto the price tag in the first year alone.

A photo of J.B. Pritzker

J.B. Pritzker, governor of Illinois, speaks during an interview in Chicago, Illinois, US, on Thursday, Feb. 23, 2023. Pritzker discussed paying down debt, the state getting a credit upgrade, crime, and Citadels Ken Griffin moving his firm out of state.  (Christopher Dilts/Bloomberg via Getty Images)

Republicans meanwhile, have called for a moratorium on new enrollments into the program. The Tribune notes that the extra $880 million would more than wipe out the estimated $303 million surplus that was estimated in Pritzker’s initial budget.

A spokesperson for the governor told the outlet that the administration is working with the General Assembly to discuss a path forward on the initiative

"Every balanced budget that has passed is negotiated with the General Assembly and includes priorities the governor lays out in his budget address and the priorities of lawmakers in the General Assembly…As the program was implemented and real costs were calculated it became clear the program was going to cost much more than what the advocates had predicted," they said.


The controversy comes amid a broader debate across the country about which benefits, if any, should be extended to those in the country illegally — and as the U.S. continues to face a historic migrant crisis at its border, which  Republicans have said is driven in part by migrants being attracted by benefits programs that serve as a magnet.

This week, the University of California regents green-lit a move to allow illegal immigrants to be hired on campus. The state is also considering a bill to provide unemployment benefits to illegal immigrants.

In New York City, officials have warned that the Big Apple is at "breaking point" as they deal with a continuing surge of migration from the border into the self-described "sanctuary city."

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