Audit finds Illinois vastly underestimated cost of noncitizen heathcare on taxpayers

SPRINGFIELD, Ill. (WTVO) — An investigation has revealed that Gov. JB Pritzker’s administration greatly underestimated the cost of providing healthcare to undocumented migrants, costing the state $1.6 billion since 2020.

The audit, conducted by Auditor General Frank Mautino, found that: more than 6,000 people enrolled in the program were listed as “undocumented” despite having Social Security numbers; 700 were enrolled in a program for those 65 and older despite being younger; and 400 were enrolled in the program but were found to have been in the country long enough to qualify for Medicaid.

Covered services include doctor and hospital visits, lab tests, physical and occupational therapy, mental health, substance abuse disorder services, dental and vision services, and prescription drugs.

The program is similar to Medicaid but is funded by the state since migrants aren’t eligible for federal coverage.

Without federal match dollars for treating immigrants as part of the state’s Health Benefits or Immigrant Adults program, Illinois taxpayers were left to pick up the tab.

The report was published a week after Pritzker delivered his annual budget address to the General Assembly, in which he proposed cutting funding to a newer program that gives Medicaid-style health coverage to noncitizens between ages 44 and 65, but leaving another program, which caters to noncitizen seniors over 65, in place.

The state had estimated the cost of the program for younger people at $126 million, but the actual cost to taxpayers came in at $485 million over three years, the audit found.

The Health Benefits for Immigrant Seniors program, on the other hand, was budgeted at $2 million for the first year, but that estimate ballooned to $4 million while the program was being set up in 2020, and actually cost taxpayers more than $67 million by December 2020.

In three years, the program cost the state $412 million — 84% higher than the original estimates.

“If they don’t get healthcare, basic healthcare, they end up in an emergency room and we all end up paying for that at a much higher cost than if we have preventative care and regular care for people,” Pritzker said in 2023.

As of December, there 54,000 adults had enrolled in both programs, although the state had estimated 26,800.

In 2023, Pritzker pumped the brakes on the program after enrollments came in at a rate “more rapidly than people had anticipated when the program was put in place.”

“It’s some evidence, anyway, that there are an awful lot of people out there who need coverage, who aren’t getting it, or who will do anything to get it,” Pritzker said at an unrelated event on Wednesday. “And I think that’s a sad state of affairs in our society.”

The Governor also said that some migrants of working age in the 42-65 program were later able to find a job “that has health care associated with it.”

Republicans have been critical of the program since its inception.

“We’re the only state that puts this burden on Illinois tax on their own state taxpayers taking this on and to not run it properly and to have these large cost overruns, that’s how you end up with a budget deficit,” Senate Minority Leader John Curran (R-Downers Grove) said Wednesday. “That’s what’s crowding out spending on education. That’s what’s crowding out spending on other components of the state budget. That’s why we need an audit.”