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* The Tribune has a story about the governor’s proposal to do away with state health coverage for non-citizens aged 42-64…
“When an individual doesn’t have health insurance coverage, since they’re more likely to forgo primary and preventive health care, it’s possible that health conditions that are fairly easy to treat can go undetected for a long time and ultimately become more complex and expensive to treat, which can raise the costs of uncompensated care,” [Drishti Pillai, director of immigrant health policy at KFF, a nonprofit, nonpartisan health policy organization] said. “It can also lead to worse economic outcomes due to productivity losses, with immigrants playing a key role, especially in certain professions such as health care, agriculture, transportation.”
That’s similar to the argument Pritzker made nearly two years ago when he signed a state budget deal that preserved the program.
“We save money when we invest in health care for undocumented immigrants,” Pritzker said in June 2023, just a few weeks before his administration closed enrollment for immigrants under 65 to help control the programs’ costs. “Because you know what happens if they don’t get health care, basic health care: They end up in an emergency room. We all end up paying for that at a much higher cost than if we have preventative care.”
In response to the recent audit, Pritzker’s Department of Healthcare and Family Services, which administers the programs, also pointed to the prevalence of untreated chronic conditions and high rates of hospitalization among participants as key factors in driving the cost overruns.
* From a March 3rd Pritzker op-ed…
For Illinois families of all backgrounds and across the state, health care isn’t an afterthought — it’s a lifeline. Since becoming governor, I have made it a top priority — eliminating the Medicaid backlog, passing the Healthcare Protection Act, expanding Medicaid access and coverage, erasing hundreds of millions of dollars in medical debt, and investing in safety net and rural health systems.
Unfortunately, congressional Republicans passed a budget that will mean stripping away health care from working families to finance tax cuts for a privileged few, taking from low- and middle-income families to benefit the rich. From day one, Donald Trump and JD Vance’s administration has put health care on the chopping block.
* Even if spending money reduces state costs down the road, the short-term state costs have been unexpectedly huge…
There are three separate programs known as the Health Benefits for Immigrant Senior and Adults (HBIS) for the following age groups: 42-to-54; 55-to-64; and 65 and older. The first two age groups are facing dissolution.
The report, which was requested by lawmakers and conducted by the Office of the Auditor General, found that HBIS (55-64) was estimated to cost $58.4 million in the first three years while the actual cost was $262.2 million, or 286% higher than initial projections.
The cost of the 42-to-54 program saw similar numbers.
Your thoughts?
…Adding… Thanks to a commenter for this link to a 2022 press release…
The Illinois Department of Healthcare and Family Services is expanding the Health Benefits for Immigrant Adults program to now provide health care coverage to undocumented immigrant adults and certain legal permanent residents aged 42 and over.
Building on the first-in-the-nation Health Benefits for Immigrant Seniors program, Illinois in March launched the Health Benefits for Immigrant Adults program for qualifying individuals aged 55 to 64. The Illinois General Assembly authorized the expansion to include those aged 42 and up as part of Medicaid omnibus legislation this spring that Gov. JB Pritzker signed into law in May. Qualifying individuals aged 42 to 54 will be eligible for services through the Health Benefits for Immigrant Adults program beginning July 1, 2022.
“From day one of my administration, equity has been—and will always be—our north star,” said Governor JB Pritzker. “Everyone, regardless of documentation status, deserves access to holistic healthcare coverage. I am proud to expand the Health Benefits for Immigrant Adults program to include more Illinoisans in need of care. We are leading the nation in health equity—and creating a healthier, happier Illinois in the process.”
…Adding… Another reader sent this…
WATCH | Gov. JB Pritzker on the Health Benefits for Immigrant Seniors/Adults programs: “It saves money if we keep people out of emergency rooms and keep people out of hospitals. It actually saves taxpayers money and that is what this program really does.” pic.twitter.com/QQHlIDBMNi
— Healthy Illinois (@Healthy_ILL) February 29, 2024
posted by Rich Miller
Monday, Mar 17, 25 @ 12:35 pm
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Jb more than argued for these programs - he called them his “Northstar”
“”From day one of my administration, equity has been—and will always be—our north star,” said Governor JB Pritzker. “Everyone, regardless of documentation status, deserves access to holistic healthcare coverage. I am proud to expand the Health Benefits for Immigrant Adults program to include more Illinoisans in need of care. We are leading the nation in health equity—and creating a healthier, happier Illinois in the process.”
But remember that what the government giveth the government may taketh away. Elections and election cycles have consequences
https://www.illinois.gov/news/press-release.25189.html
Comment by Donnie Elgin Monday, Mar 17, 25 @ 12:44 pm
A thorny issue no doubt, don’t want hospitals going belly up anywhere. Have to come to terms with how such programs can be seen as magnet though.
Comment by Macon Deliberations Monday, Mar 17, 25 @ 12:48 pm
The Tribune story was brutal. The reality is people will be impacted by this decision. Was the money saved worth that human cost? What does it mean politically? In California, Governor Newsom chose to borrow billions rather than kicking undocumented people off their insurance plans. The horrible back room convos with the HSF Director havent helped JB and his team either.
I expect this story to blow up on the national stage down the line, all it takes is one person who had coverage taken away and either chose to avoid seeking help or piled on debt unto their family, likely US citizens, that changed their lives.
Comment by When Will It Stop Monday, Mar 17, 25 @ 12:53 pm
In this case, it’s not a question of policy, it’s stewardship of dwindling resources caused by an external source. How JB triages the budget is up to him.
Comment by Give Us Barrabbas Monday, Mar 17, 25 @ 12:55 pm
==A thorny issue no doubt, don’t want hospitals going belly up anywhere.
This is really the challenge. Combine this with reductions in Medicaid and I’m very worried about rural hospitals and some urban hospitals that serve lower income folks disproportionately. The Governor has a lot of not good options.
Comment by ArchPundit Monday, Mar 17, 25 @ 12:58 pm
You can vehemently support a policy and still not have enough money to provide for it. That’s actually what the definition of pragmatic progressivism is. This population got healthcare during a worldwide pandemic, now we can no longer afford it and these are people who are working age that will have to find another solution. It’s not ideal, but this is what responsible governing looks like.
Comment by LOL Monday, Mar 17, 25 @ 1:03 pm
JB should bear in mind the context of “North Star”
when using it for PR, it should mean a certain permanence. From Shakespeare’s Julius Ceasar…
“”I am constant as the northern star, / Of whose true-fixed and resting quality / There is no fellow in the firmament; / The skies are painted with unnumbered sparks, / They are all fire and every one doth shine; / But there’s but one in all doth hold his place.”
Comment by Donnie Elgin Monday, Mar 17, 25 @ 1:03 pm
How did anyone believe the $2 million estimate? State employee health insurance premiums that year were just under $25 thousand, which would cover 80 people. IF the program participants only cost 20%, that would be 400 people. Any figures from the advocates, going forward, should be looked at with suspicion.
Comment by Anyone Remember Monday, Mar 17, 25 @ 1:12 pm
I think everything that is said in this post is true. Multiple things can be true at the same time. Advocates and Rep. Ramirez pushed this program touting its very obvious policy advantages but priced it at $2 million with an absurdly low estimate for uptake. And they put it in the BIMP where no one saw it. Then they did it again to add another age bracket– again in the BIMP.
The language itself is a mess with different standards applying to different populations and different levels of statutory authority granted. And if you tried to pass this enormously expensive policy in a bill on its own you would not come anywhere close to 60/30. You probably couldn’t even get it out of a committee.
That doesn’t mean that the policy merits are untrue. Healthcare is good, and people should have it. But states are different than the federal government, and providing a Medicaid product with little to no federal match at the state level is not a sustainable proposition. It’s why the trigger language exists to eliminate the ACA Medicaid expansion in the event the feds reduce the match. The state cannot pay for costs like this in a sustainable way because unlike the feds, we don’t print money and can’t run deficits.
Terrible choices are made when budgets get tight– choices that hurt people. In this case, you have a poorly researched policy idea with cost implications and political consequences its backers did not anticipate. It’s a huge chunk of money in a year where there is a real money problem, and as a result it’s not sustainable to continue the program.
Comment by Who else Monday, Mar 17, 25 @ 1:29 pm
Only points out the larger issue of illegal immigration and its consequences for the State’s fiscal health. This is major money when the state will be facing budget deficits for several years under current projections.
Comment by Mason County Monday, Mar 17, 25 @ 1:33 pm
= governor’s proposal to do away with state health coverage for non-citizens aged 42-64+
JB (channeling John Kerry) …”I was for it before I was against it”
Comment by Donnie Elgin Monday, Mar 17, 25 @ 1:44 pm
If it is truly important, taxes should be raised to cover the costs. The choice to end the subsidy is a political choice.
Comment by Chicagonk Monday, Mar 17, 25 @ 1:47 pm
“I expect this story to blow up on the national stage…”
Tell me you are misreading both the politics of the moment and of the man in one sentence. If it gets asked on the national stage JB will say - “healthcare is my Northstar. I think everyone should have it. But governing is about making the hard choices when no one else can or will and I will do that every time to balance the budget even when it involves cutting things I like” and the audience will clap and the political press will praise him for a pragmatic answer and everyone will move on to the next thing.
It’s not a flip flop to say “I really like this thing and want to be able to do it but we can’t afford it at this time so I have to make the difficult decision to cut back.”
Comment by Howie Bird Monday, Mar 17, 25 @ 3:59 pm
The HFS and DHS Agency Directors need to resign or be fired.
Comment by Dpiman Monday, Mar 17, 25 @ 4:07 pm
=== - Who else - Monday, Mar 17, 25 @ 1:29 pm:
“Advocates and Rep. Ramirez pushed this program touting its very obvious policy advantages but priced it at $2 million with an absurdly low estimate for uptake. And they put it in the BIMP where no one saw it. Then they did it again to add another age bracket– again in the BIMP.”
Ok THIS right here. THIS is where it should have came to a full stop. Lobbyists are not financial experts, but come on. This numbers are pure fiction & just embarrassing. Yes undocumented should get healthcare. They should also get work permits & citizenship but our immigration system is BROKEN. Illinois does not have the capacity to carry the duties of our federal government. Under a different administration yeah we could have saved it. Now with a possible recession, NO!
Ramirez herself put fighting for a ceasefire precedent over the families in her district. She also did not stomp or fundraise for Kamala. So there it is. Unfortunately, those who would lose healthcare will be the husbands, wives, mothers, fathers, etc, the very people who voted her in. Good luck to her in 2026. AIPAC won’t be the only ones gunning to get her out of her seat. FAFO
Comment by Trinity Monday, Mar 17, 25 @ 4:17 pm
Don’t worry. Delia Ramirez is in Congress now. I’m sure she’s working on a Medicaid expansion that will cover these adults. Best guess is an estimated $2 billion nationally, give or take.
Problem solved?
Comment by 47th Ward Monday, Mar 17, 25 @ 4:18 pm
“Everyone, regardless of documentation status, deserves access to holistic healthcare coverage”
*So long as everyone else is forced to foot the bill to pay for my paternalistic moralizing
Comment by JB13 Monday, Mar 17, 25 @ 4:53 pm
=== The HFS and DHS Agency Directors need to resign or be fired. ===
For carrying out the governor’s objectives and the law?
Hahahaha. Nope.
Government is where moral idealism and political reality collide.
J.B. Pritzker is correct: health care is a fundamental human right, whether you are a citizen of this country or not. And providing residents with affordable access to care also makes economic sense.
Presidential candidate Pritzker is also right: there is no stomach in Springfield for funding this program, especially after Latinos voted for Trump so loudly, and on top of that even enrolling in the program probably puts undocumented immigrants in danger of being deported by ICE. The immgrant health care funding would dog every budget debate this session, and haunt Pritzker on the Presidential campaign trail.
Comment by Thomas Paine Monday, Mar 17, 25 @ 4:56 pm