Illinois Noncitizen Health Care Programs Exceed Initial Cost Estimates: What the Latest Audit Reveals

SPRINGFIELD – Two health care programs for noncitizens in Illinois have exceeded their initial budget estimates, costing the state $1.6 billion by last summer. A recent audit revealed these surprising figures and noted discrepancies in enrollment data.

The audit found that over 6,000 enrollees were incorrectly labeled as “undocumented.” Many of these individuals actually had Social Security numbers, including some green card holders who could qualify for Medicaid instead of state-funded programs.

Governor JB Pritzker had proposed cutting funding for one of these programs focused on noncitizens aged 44 to 64 while keeping the program for seniors 65 and older. At a recent news conference, he discussed the enrollment issues, citing the need for transparency and proper management of these programs.

“There are many in need of coverage who aren’t getting it, which is a sad reality,” Pritzker stated, reiterating his support for universal health care.

Critics, especially from the Republican party, argued that the audit underscores their concerns about the growing costs and lack of oversight in these programs. They claim this situation is straining the state budget and impacting funding for education and other essential services. Senate Minority Leader John Curran pointed out the financial burden on Illinois taxpayers, emphasizing the need for strict audits and controls.

The Health Benefits for Immigrant Seniors (HBIS) program was initially estimated to cost $2 million per year when it launched during the COVID-19 pandemic. However, the actual first-year expenditure soared to over $67 million, a significant jump from projections. Similarly, the Health Benefits for Immigrant Adults (HBIA) program far exceeded initial costs, ballooning to $485.3 million, well above the original estimates.

These programs are designed similarly to Medicaid, but because federal funds cannot be used for many noncitizens, the state bears the full financial responsibility. Enrollment numbers also greatly surpassed expectations. Nearly 54,000 adults enrolled in the adult program for fiscal year 2023, double the initial estimate.

In light of escalating costs, Governor Pritzker sought authority from the General Assembly to implement spending controls and paused enrollment in both programs in 2023. Since then, enrollment numbers have decreased through a redetermination process, reducing costs somewhat.

The audit revealed misclassifications in enrollment data. Over 6,000 individuals who held Social Security numbers were incorrectly categorized as undocumented. This confusion contributed to the rising costs of the programs, highlighting the need for better oversight and clear guidelines. Misreporting and misclassifications have complicated the administration of these health care initiatives, resulting in unintended enrollments.

As discussions continue about how to manage these programs and their funding, the issues raised in the audit serve as a critical reminder of the complexities involved in providing health care to marginalized populations.

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