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Pritzker administration on defense over rising healthcare costs for undocumented immigrants

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Illinois

* I’ve been telling subscribers about this budget hole all week. Click here for the HFS report. Press release…

Illinois House Republican leaders are calling for a moratorium on expansion and a State audit of Illinois’ billion-dollar health benefits program for undocumented immigrants.

At a Capitol press conference Thursday, Deputy Republican Leaders Norine Hammond (R-Macomb) and Ryan Spain (R-Peoria), along with Assistant Republican Leader C.D. Davidsmeyer (R-Jacksonville), highlighted a bombshell State report detailing the massive cost and enrollment expansions of Illinois’ health benefits program for undocumented immigrants.

Hammond, who serves as chief budgeteer for the House Republican Caucus, laid out in detail the dramatic growth in undocumented immigrant participation, which will require nearly a billion dollars in general revenue funds to support the program in Fiscal Year 2024.

“In FY24, Illinois’ program of health benefits for undocumented immigrants is estimated to cost $990 million, which is a $768 million increase (346%) over FY23,” Rep. Hammond said. “Undocumented immigrants are ineligible for any federal Medicaid match, resulting in State GRF being used to pay for the entirety of services provided. These ballooning enrollments and costs are unsustainable and could lead to the loss of funding and services for Illinois’ most vulnerable citizens.”

A recent report from the Department of Healthcare and Family Services (HFS) shows that HFS and its contracted actuarial firm, Milliman, repeatedly underestimated actual enrollees and costs.

FY24 estimates now show growth in healthcare benefits coverage for eligible undocumented immigrants totaling 108,400 over original FY23 estimates, and enrollees totaling 31,500 over original FY23 estimates, a 202% and 94% increase respectively.

“Year after year, we saw the majority party continue to double down on these expansions, which are not eligible for federal matching funds. The Medicaid program in the State of Illinois is our biggest area of spending,” said Deputy House Republican Leader Ryan Spain in discussing House Resolution 220, which he filed to audit and pause new enrollees in the program. “This billion dollar hole, which is just the beginning, requires the General Assembly to exercise fiscal responsibility in both the short-term and long-term to ensure state budget sustainability.”

The additional Medicaid pressure for these expansions is happening at the same time the State is expected to lose $760 million in additional federal funding through the enhanced Federal Medical Assistance Program (FMAP) that was provided to states during the pandemic.

Several important State programs are still drastically underfunded and could greatly benefit from the $990 million in GRF that would go to HFS to continue to provide medical services to undocumented immigrants.

Assistant Republican Leader C.D. Davidsmeyer discussed the process by which these expansions of health benefits to undocumented immigrants were enacted into law and the absolute lack of accountability and transparency for this program.

“During the 2020 pandemic-shortened House session, Democrats slipped health benefits for undocumented immigrant seniors into the FY21 Budget Implementation (BIMP) bill. This new benefit was included in the BIMP at the last minute, without a committee hearing, public input, or debate. We had virtually no time to review the massive BIMP and budget bills that were passed at the end of that special session,” said Rep. Davidsmeyer.

“In 2021, Democrats again slipped expanded health benefits for undocumented immigrants for ages 55-64 into the FY22 BIMP bill. This was again included at the last minute, with no committee hearing and almost no time to debate the bill.

“Last year, Democrats blew up an agreed Medicaid Omnibus bill by yet again adding a last-minute expansion of health benefits for undocumented immigrants for ages 42-54 at the end of session. Zero transparency, zero accountability, zero public input.”

Illinois Democrats recently filed House Bill 1570, which would complete the expansion of health benefits for undocumented immigrants by adding ages 19-41 to the program. HB 1570 has not been debated and no stand-alone vote has been taken on this benefit expansion. Davidsmeyer suggested that if recent history is any guide, the Democrats will again, for the fourth time, add this expansion to the upcoming FY24 BIMP bill or some other massive omnibus bill at the end of the General Assembly’s spring session.

“The sad fact is Illinois has become a sanctuary state for undocumented immigrants,” Rep. Davidsmeyer said. “The State of Illinois gives them free healthcare benefits, driver’s licenses, mortgage and renters’ assistance, as well as other taxpayer-funded benefits. All I can say is ‘If you build it, they will come.’”

The administration has said there’s enough money in the budget to pay for at least half of the coming fiscal year’s shortfall.

* From Jordan Abudayyeh…

The Republicans said it’s time we have some adults in the room when it comes to budgeting. To be clear, the only lawmakers with a proven record of balancing the budget and improving state finances are Governor Pritzker and the Democratic supermajority in the General Assembly. The Governor just proposed another balanced budget that invests in education, healthcare, and communities. The credit ratings agencies have so much trust in his track record that after his proposal the state received two credit upgrades.

Let’s review some history.

Who balanced the budget four years in a row? Democrats.
Who eliminated the bill backlog that reached $16 billion left by the Republican governor? Democrats.
Who rebuilt the rainy day fund to nearly $2 billion? Democrats.
Who paid additional pension payments? Democrats.
Whose prudent fiscal decisions led to eight credit upgrades? Democrats.
Who invested hundreds of millions of dollars to rebuild our human services infrastructure after the Republican budget impasse? Democrats.

Just this week Senate Republicans outlined hundreds of millions of dollars in new spending and did not offer a plan to pay for it. Budget challenges and spending constraints are nothing new to Democrats who have done the hard work to balance the budget year after year. The Governor and the General Assembly will continue on the proven track of working together to ensure state spending does not exceed revenues setting the state up for even more success moving forward.

posted by Rich Miller
Friday, Apr 21, 23 @ 10:35 am

Comments

=These ballooning enrollments and costs are unsustainable and could lead to the loss of funding and services for Illinois’ most vulnerable citizens.”=

That would be meaningful if it came from just about anyone else. We have receipts on how much Hammond cares about people.

Comment by JS Mill Friday, Apr 21, 23 @ 10:42 am
==The administration has said there’s enough money in the budget to pay for at least half of the coming fiscal year’s shortfall.==

In other words, not enough money.

Comment by City Zen Friday, Apr 21, 23 @ 10:46 am
==Republican leaders are calling for a moratorium==

Unlike Republicans, viruses don’t discriminate.

Comment by Jocko Friday, Apr 21, 23 @ 11:00 am
===In other words, not enough money. ===

Correct, but not as much of a shortfall as it may appear for now.

Comment by Rich Miller Friday, Apr 21, 23 @ 11:02 am
The Governor’s office statement says the proposed budget is balanced but that they have enough cash for half the shortfall. If there is a shortfall how is it balanced?

Comment by Hoping for Rational Thought Friday, Apr 21, 23 @ 11:16 am
Remember it was a “Republican budget impasse”

Democrats who controlled the co equal branch of government for the entire 4 years of a Republican Governor’s term shared no responsibility.

They passed a budget 7 billion out of balance and left town but don’t let facts get in the way of a good story.

Comment by Lucky Pierre Friday, Apr 21, 23 @ 11:24 am
Pritzker Admin sure takes a lot of credit for the income tax increase that passed that broke the budget impasse under Rauner.

Comment by Phenomynous Friday, Apr 21, 23 @ 11:34 am
I could do with less framing of the issue, but the issue is clearly significant.

Balancing budgets requires as much information as possible going into the process. It would appear from Hammond’s argument, that there was not enough forethought going into this process of including access to medical care for immigrants.

Ignoring some of the rhetoric on both sides (but especially the harsh rhetoric from Davidsmeyer), we need to recognize that this shortfall will continue going forward unless it is addressed this year.

Comment by H-W Friday, Apr 21, 23 @ 11:38 am
I sure got a good chuckle out of Rep. Davidsmeyer going on and on about “promises made” during the budget discussion at the Capitol.

Pretty rich from a guy who sat through the Rauner years and watched the state held hostage from inside the house.

Comment by Cool Papa Bell Friday, Apr 21, 23 @ 11:42 am
=Remember it was a “Republican budget impasse”=

Yes, as in the republican governor refused to approve a budget until some republicans joined with the democrats to do so.

But, as a previous poster (lol) stated, don’t let facts get in the way of a good story.

Comment by JS Mill Friday, Apr 21, 23 @ 11:43 am
===Remember it was a “Republican budget impasse”===

For the 5,744th time…

“I’m frustrated too but taking steps to reform Illinois is more important than a short term budget stalemate”

- The Owl

It was an admitted Republican thing.

Comment by Oswego Willy Friday, Apr 21, 23 @ 11:48 am
Words matter

An impasse is by definition a disagreement between two parties

Of course the propagandists in the Pritzker administration ignores this as well as other basic facts about the hole in the budget

Comment by Lucky Pierre Friday, Apr 21, 23 @ 11:50 am
=We have receipts on how much Hammond cares about people.=

@JS - The opening question to Norine should have been “Who deserves health in this state”

Comment by Cool Papa Bell Friday, Apr 21, 23 @ 11:51 am
@Cool Papa Bell- I see what you did here and I like it.

Comment by JS Mill Friday, Apr 21, 23 @ 11:53 am
Frankly, Republicans that keep voting against budgets haven’t funded much of anything by voting “Red” year after year.

It’s not like the Republicans here have a record of funding much of anything, even if a few will show up for photo opportunities.

It’s theatre to the aggrieved

To the honest of the shortfall,

To recalibrate the shortfall, it might behoove the administration to look at how it wants a surplus to a rainy day fund, there’s a honesty to either recognizing paying where there’s a shortfall and touting surpluses.

That will be a messaging challenge now, even after Abudayyeh’s own response in Rich’s post.

Comment by Oswego Willy Friday, Apr 21, 23 @ 11:57 am
“Illinois House Republican leaders are calling for a moratorium on expansion and a State audit of Illinois’ billion-dollar health benefits program for undocumented immigrants”

The “Christian values are under attack” lot isn’t Christian-ing very well. As in healing the least of these and treating the immigrant well.

Comment by Grandson of Man Friday, Apr 21, 23 @ 12:31 pm
===An impasse is by definition a disagreement between two parties===

And in this case, one party declared that there would be no agreement unless unions were gutted.

Just stop it, LP. Seriously. The Republicans had a generational chance to hold significant power in this state and they blew it with Rauner’s ridiculous overreach. A pro-choice, pro-environment, even at times pro-consumer Republican could’ve been reelected here the way Massachusetts supported their GOP gov.

But no. Kill the unions or no budget.

What a disaster, and you keep clownishly defending it years after it was abundantly clear the damage he did. “Hang in there,” indeed.

Go back to shilling for the Bears.

Comment by Rich Miller Friday, Apr 21, 23 @ 12:40 pm
Is this amount of money the state is going to pay a one time thing or is it going to repeat every year?

Comment by DuPage Friday, Apr 21, 23 @ 1:06 pm
===Is this===

Clicking the provided link would’ve answered your question, so try doing that.

Comment by Rich Miller Friday, Apr 21, 23 @ 1:10 pm
My mistake(s). I thought the feds paid part of this. Illinois politicians need to get busy and lobby the feds to help pay the costs for this. Otherwise, it may well require tax increases or other things like shorting the state pensions again or other bad things. Ask our federal reps. and senators to add this into the overall massive federal budget.

Comment by DuPage Friday, Apr 21, 23 @ 1:57 pm
A self-employed family of two which makes 400.001% of the federal poverty level, $78,880, and is less than 65yo, has a healthcare premium of around $20,000 per year. (Bronze)

Seems like this is all reasonable. /s

(Illinois needs to allow for long term catastrophic health plans with high deductibles to protect small business entrepreneurs)

Comment by 40,000 ft Friday, Apr 21, 23 @ 3:05 pm
=Illinois politicians need to get busy and lobby the feds to help pay the costs for this.=

@DuPage - While I agree, do you think the House is ready to pass a federal match for Medicaid for the undocumented?

Comment by Cool Papa Bell Friday, Apr 21, 23 @ 3:33 pm
The feds should pay the state the costs . It’s a federal issue immigration. States shouldn’t get stuck with the bill.

Comment by Tinman3 Monday, Apr 24, 23 @ 8:28 am
It seems to me that taxing retirement income in Illinois would cover this extra expense and still have money left over to further pay down the pension debt. Is this issue off the table?

Comment by Earl Hickey Tuesday, Apr 25, 23 @ 11:48 am