* Tribune reporters Jeremy Gorner and Dan Petrella…

Gov. JB Pritzker’s administration vastly underestimated the cost and popularity of a pair of health insurance programs for immigrants who are not citizens that has ended up costing the state $1.6 billion since the initiative began in 2020, according to an audit report released Wednesday.

Aside from inaccurate projections of the programs’ cost and the number of people who would enroll, the audit uncovered more than 6,000 people enrolled in the programs who were listed as “undocumented” despite having Social Security numbers, and nearly 700 who were enrolled in the program for people 65 and older despite being younger than that. In addition, almost 400 people were enrolled in the programs but appeared to have been in the country long enough to qualify for Medicaid, which is jointly funded by the federal government.

The report from Illinois Auditor General Frank Mautino’s office was published a week after Pritzker proposed eliminating funding for the program that provides Medicaid-style insurance coverage for people younger than 65 who are in the country without legal permission or are in the U.S. legally but have not yet qualified for a green card. The cut, estimated to save $330 million, was part of Pritzker’s plan to close a budget hole once pegged at more than $3 billion.

The cost overruns were particularly pronounced in the program for younger recipients, with the actual expenditure of $485 million through the three years ending June 30, 2023, coming in at nearly four times the estimated cost of $126 million, according to the audit.

* From the Auditor General’s Health Benefits for Immigrant Seniors and Adults audit…

Key Findings:

Actual enrollment and actual costs exceeded the initial program estimates for both the HBIS and HBIA programs. Regarding estimated number of enrollees, in FY23:

- for HBIS (65+), the initial estimated number of enrollees was 6,700,
while the actual number enrolled was 15,831;
- for HBIA (55-64), the initial estimated number of enrollees was 8,000, while the actual number enrolled was 17,024; and
- for HBIA (42-54), the initial estimated number of enrollees was 18,800, while the actual number enrolled was 36,912.

Regarding the initial cost estimates for all three fiscal years 2021, 2022, and 2023:

- for HBIS (65+) the total estimate was $224.0 million, while the actual total cost was $412.3 million or 84 percent higher;
- for HBIA (55-64) the total estimate was $58.4 million, while the actual total cost was $223.1 million or 282 percent higher; and
- for HBIA (42-54) the total estimate was $68.0 million, while the actual total cost was $262.2 million or 286 percent higher.

In FY21, 6,884 individuals were enrolled in HBIS (65+). HBIS (65+) enrollment increased to 11,362 in FY22, 15,831 in FY23, and decreased to 11,464 in FY24. The HBIA (55-64) enrollment increased from 6,675 in FY22, to 17,024 in FY23, before decreasing to 13,596 in FY24. The HBIA (42-54) enrollment increased from 5,823 in FY22, to 36,912 in FY23, before decreasing to 27,941 in FY24. According to HFS officials, the FY24 numbers exclude those who have been removed from the
program due to redetermination or due to the change in eligibility that removed legal permanent residents from the program.

Click here for the full report.

…Adding… Governor Pritzker was asked about the audit during an unrelated press conference…

Reporter: Governor, there was an audit released this morning that showed that your administration underestimated the cost and the popularity of the immigrant healthcare programs that have been discussed in recents years. I’m wondering what happened to cause those estimates off, particularly for program for people under 65?

Pritzker: So I think the thing that is missing from the reporting, and what I would point out to you, is that number one people’s immigration status changes during the course of a year. You’ve got people who were eligible for the program, who became uneligible for the program. So even though you expect that people will move on because, well, it may be their immigration status, it may be because they got a job that has health care coverage associated with it. But you expect them to move on, and maybe they didn’t move on either because they didn’t know they could, should. But that happens, I hate to tell you, on Medicaid as well.

It’s why we do every year redeterminations, and we did it with this program as well. One of the reasons that we even know about some of those people is because of the redeterminations. So people get removed from the program as a result of the redeterminations. But before they got redetermined to not be eligible, they were still on the program and that cost taxpayers money. So that’s a lot of I think what I would say about that.

But the broader context is people need to get healthcare. I am in favor of universal healthcare however that comes together. And we can talk about the myriad ways that we could do that. But people don’t go get healthcare [or] get treated when they don’t have a problem. And so it’s some evidence 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. And I think that’s a sad state of affairs in our society.

Reporter: For redeterminations, the issue is on the cost estimates?

Pritzker: No, I’m saying, I think when you look at who’s covered, how much it costs to cover them. Some of those people become ineligible mid-year, and you’re still paying for them because we don’t know and maybe they don’t know that they’re no longer eligible for that program. We find out when we do redeterminations. We did that for the larger Medicaid population, as you know, in the state of Illinois, which we were kept from doing for three years because of COVID, but we also did it in this program to determine who’s no longer eligible for it. So the program is became a lot less expensive as a result of the work that we did and and as you know, you know we’re no longer operating, or we will no longer operate that earlier the 42-63 cohort, and instead focus on the most vulnerable, who are the seniors that are covered by that program.

Please pardon all transcription errors.

…Adding… House Minority Leader Tony McCombie…

“House Republicans warned about the costly expansion of this program when it was first exposed last year. We could not afford it then, and we cannot afford it now. Yet, Democratic leadership forced taxpayers to shoulder the burden of this reckless spending for non-citizens, pushing our state’s finances to the brink.

“Beyond the overwhelming cost, reports of fraud and abuse make it even clearer that this program must end. There is no need to wait until the next fiscal year—immediately shut it down and protect Illinois taxpayers.”

…Adding… Senate Republicans…

A new report from the Illinois Auditor General confirms significant mismanagement in Gov. Pritzker’s taxpayer-funded free healthcare program for noncitizens, revealing thousands of potentially ineligible enrollees and costs far exceeding initial projections. At a capitol press conference, Illinois Senate Republican Leader John Curran (R-Downers Grove) and Senator Chapin Rose (R-Mahomet) highlighted the audit’s findings, calling for more financial transparency from the Pritzker Administration and stronger oversight to prevent further misuse of taxpayers.

“The audit’s findings show the shocking misuse and mismanagement of taxpayer dollars by the Pritzker Administration,” said Curran. “The governor’s overspend on his free healthcare for non-citizens program and gross mismanagement increases costs on all Illinois taxpayers and crowds spending on education and other core services.”

Auditors found that more than 6,000 enrollees classified as “undocumented” actually had Social Security Numbers, raising serious concerns about the integrity of the enrollment process and failure to properly verify eligibility. Senate Republicans voiced concerns that the lack of oversight not only erodes public trust but also leaves taxpayers on the hook for the Pritzker Administration’s failure to manage the program responsibly. Curran and Rose said that Illinoisans deserve transparency and accountability—not more bureaucratic incompetence.

The audit also exposed massive cost overruns, with spending on some age groups running nearly 300 percent over budget. The most extreme overrun came in the 42-54 age group, where costs surged to nearly triple what was projected.

These staggering miscalculations highlight a complete failure of fiscal planning, forcing taxpayers to cover the shortfall, Senators explained.

“Once again, the governor has proven himself unreliable, and we’re finding out after the fact that his estimates weren’t even in the ballpark,” said Senator Rose (R-Mahomet). “If it were up to me, we’d get rid of these programs entirely. Illinois taxpayers shouldn’t be footing the bill for illegal immigrants.”

Senate Republicans have long criticized Gov. Pritzker’s decision to spend billions of taxpayer dollars on non-citizen programs while Illinois families struggle with skyrocketing property taxes, grocery bills, and healthcare costs. Instead of prioritizing hardworking citizens, the Democratic Majority have funneled taxpayer dollars into a program riddled with waste, mismanagement, and a lack of transparency.

The audit’s findings have renewed calls for accountability. Leader Curran reintroduced Senate Bill 1699, which requires detailed annual reports on a range of taxpayer-funded programs for noncitizens—not just healthcare, but also housing, legal aid, and other services. The reports would include total expenditures, specific appropriations, the number of recipients, funding sources, and awarded contracts. To ensure transparency and prevent further misuse of taxpayer dollars, this information would be made publicly available online.

Illinois taxpayers deserve transparency and fiscal responsibility. This audit confirms that mismanagement in Gov. Pritzker’s program has resulted in massive cost overruns and wasted taxpayer dollars. With accountability long overdue, Senate Republicans will continue fighting for reforms that put hardworking families first, demand transparency, and end reckless spending.

The full press conference can be viewed at this link: https://youtu.be/VEL04XfYoGE

* Related…

* Sun-Times | Pritzker’s $55.2 billion budget has no new taxes, cuts health care for adults lacking legal status: Pritzker’s budget plan excludes funding for health care for immigrant adults who lack legal status and are between the ages of 42 and 64. Last year, the Democratic governor included $629 million to provide health care benefits to immigrants without legal status 42 and up, and seniors who would otherwise qualify for Medicaid. The governor’s office called that intentional omission a reflection of difficult decisions being made to bring the proposal into balance. The office, however, said funding for health care for seniors who lack legal status will be maintained. The program for adults will end June 30, the end of the fiscal year.