{"id":3656,"date":"2025-02-28T14:57:39","date_gmt":"2025-02-28T20:57:39","guid":{"rendered":"https:\/\/thexradio3.com\/news\/?p=3656"},"modified":"2025-02-28T14:58:15","modified_gmt":"2025-02-28T20:58:15","slug":"audit-finds-illinois-non-citizen-health-care-programs-far-outstripped-original-cost-estimates","status":"publish","type":"post","link":"https:\/\/www.thexradio.com\/news\/local-news\/3656-audit-finds-illinois-non-citizen-health-care-programs-far-outstripped-original-cost-estimates\/","title":{"rendered":"Audit Finds Illinois’ Non-Citizen Health Care Programs Far Outstripped Original Cost Estimates"},"content":{"rendered":"
\"image_print\"Print<\/span><\/a><\/div>

 <\/p>\n

By HANNAH MEISEL
Capitol News Illinois
hmeisel@capitolnewsillinois.com<\/a><\/p>\n

SPRINGFIELD \u2013 A pair of health care programs that benefit noncitizens \u2013 one of which is already on Gov. JB Pritzker\u2019s budgetary chopping block \u2013 far outstripped its original estimated price tag and cost the state of Illinois $1.6 billion through last summer, according to a new audit of the programs published Wednesday.<\/p>\n

The report also found more than 6,000 people enrolled in the state-funded programs were classified as \u201cundocumented\u201d despite actually having social security numbers. Some of those people were green card holders who would have instead qualified for health coverage like Medicaid or traditional insurance.<\/p>\n

The audit<\/a>, which lawmakers requested in late 2023, comes one week after Pritzker delivered his annual budget proposal to the General Assembly. The governor\u2019s plan would defund the newer of the two programs, which is aimed at noncitizens aged 44 to 64, while leaving in place the smaller program for noncitizen seniors aged 65 and older.<\/p>\n

Asked about the audit at an unrelated Chicago news conference Wednesday, Pritzker defended the Department of Healthcare and Family Services\u2019 work on redeterminations in the program<\/a> over the last year, which has brought down total enrollment in addition to the administration\u2019s freezes on enrollment in the programs in 2023.<\/p>\n

\u201cIt’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,\u201d Pritzker said after reiterating his support for universal health care coverage. \u201cAnd I think that’s a sad state of affairs in our society.\u201d<\/p>\n

Republicans, who\u2019ve long criticized both the programs\u2019 ballooning costs and what they\u2019ve characterized as a lack of transparency, said the audit proves them right about Illinois\u2019 first-in-the-nation programs.<\/p>\n

\u201cWe’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,\u201d Senate Minority Leader John Curran, R-Downers Grove told reporters Wednesday at the Capitol. \u201cThat’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.\u201d<\/p>\n

Vastly underestimated costs<\/strong><\/p>\n

When progressive lawmakers first pushed for the creation of the Health Benefits for Immigrant Seniors, or HBIS, program for noncitizens aged 65 and older in the first few months of the COVID-19 pandemic, officials relied on advocates\u2019 $2 million cost estimate for the program\u2019s first year. Though that projection was later doubled to $4 million as the program was being set up in the latter half of 2020, the actual cost ended up at more than $67 million after HBIS began accepting enrollees in December of that year.<\/p>\n

But while actual costs for the seniors\u2019 program in its first three years \u2013 $412 million \u2013 ended up being 84% higher than original estimates, the price tag for the expanded program for adults aged 44 to 64 was many times larger.<\/p>\n

The Health Benefits for Immigrant Adults, or HBIA, program covered noncitizen adults age 55 to 64 and was later expanded to cover those as young as 44. It cost $485.3 million over its first two years \u2013 roughly 284% more than the combined original estimate for both programs.<\/p>\n

The programs were designed with the same income eligibility thresholds as Medicaid. But since federal Medicaid dollars can\u2019t be spent on many types of non-citizens, the state has had to foot the bill itself instead of receiving a roughly 52% federal match<\/a> like it does for traditional Medicaid coverage.<\/p>\n

The audit noted that HFS began seeking federal reimbursement for some emergency services last year, which would be retroactive to mid-2022. But Pritzker last week said part of the reason he was proposing axing the program for adults \u2013 which would save an estimated $330 million next year \u2013 was due to the Trump administration signaling it would soon halt that reimbursement.<\/p>\n

Read more:<\/strong> Pritzker calls $55.2B budget \u2018responsible and balanced\u2019 \u2013 but warns Trump policies could upend it<\/a><\/p>\n

Enrollment has also far outstripped original estimates, especially in the program for adults aged 44 to 64. For fiscal year 2023, nearly 54,000 adults enrolled in the program \u2013 about twice the original projection of 26,800.<\/p>\n

In 2023, after the Pritzker administration acknowledged the programs\u2019 cost had grown to $1.1 billion, the governor asked the General Assembly for authority to impose spending controls. After lawmakers followed his request, Pritzker quickly paused enrollment in the program for adults in July of 2023, followed by a pause in the program for seniors in November of that year.<\/p>\n

Read more:<\/strong> Expected cost for Illinois\u2019 noncitizen health care program grows to $1.1 billion<\/a> | Pritzker quickly wields expanded authority to freeze noncitizen health care enrollment<\/a> | State to pause enrollment in health care program for immigrant seniors as spending again outpaces estimates<\/a><\/p>\n

The programs have not accepted any new enrollees since those pauses and redetermination efforts<\/a> have decreased their headcounts in the last year. The audit cited an enrollment decline in the adults\u2019 program from a high of 53,936 in fiscal year 2023 to 41,537 in fiscal year 2024, which ended June 30.<\/p>\n

The day after the second enrollment pause in November 2023, lawmakers approved a resolution calling for an audit of the programs, which authorized Auditor General Frank Mautino\u2019s office to begin work on the report published Wednesday.<\/p>\n

Pritzker last week proposed defunding the program for adults, telling reporters that those aged 44 to 64 are still of working age and could get jobs with health care coverage. <\/p>\n

Axing the program renews a disagreement between the governor and progressive members of the General Assembly\u2019s Latino Caucus, who opposed enrollment pauses and efforts to require co-pays<\/a> for program participants.<\/p>\n

But the governor framed his proposal as one of shared sacrifice.<\/p>\n

\u201cIf you come to the table looking to spend more, I\u2019m going to ask you where you want to cut,\u201d the governor told lawmakers in his Budget Address. \u201cI have made difficult decisions \u2013 including to programs I have championed, which is hard for me, just as I know some of the difficult decisions you will have to make will be hard for you.\u201d <\/p>\n

Mis-enrollments<\/strong><\/p>\n

The audit also found inconsistencies in enrollment data, sometimes relying on misreporting from program participants.<\/p>\n

Of the 6,098 enrollees with social security numbers who\u2019d been mislabeled as undocumented, nearly 400 people had been in the U.S. for the five years it takes for legal permanent residents to qualify for Medicaid, according to the audit. Meanwhile, other green card holders who hadn\u2019t yet reached that five-year threshold but were enrolled in the state-run programs would have been eligible to purchase health coverage from the Affordable Care Act\u2019s insurance marketplace. <\/p>\n

HFS last spring issued new rules clarifying that those noncitizens were not eligible for the state health coverage programs, and the agency\u2019s redetermination process has identified and disenrolled many.<\/p>\n

Others who had social security numbers are in the U.S. legally but are not eligible for green cards. The HBIA and HBIS programs were designed to cover them but were not intended to cover asylum-seekers who\u2019ve been sent to Illinois from southern border states in recent years.<\/p>\n

Those mis-enrollments, which also included nearly 700 people who received coverage under the program for noncitizens 65 and older despite being too young to qualify, drove some of the ballooning costs in the health care initiative. But the audit points to the Pritzker administration relying on vastly underestimated figures when setting up the programs in 2020, 2021 and 2022.<\/p>\n

\u201cActual enrollment and actual costs exceeded the initial program estimates for both the HBIS and HBIA program,\u201d the audit said.<\/p>\n

Jade Aubrey contributed.<\/p>\n

Capitol News Illinois<\/a> is a nonprofit, nonpartisan news service that distributes state government coverage to hundreds of news outlets statewide. It is funded primarily by the Illinois Press Foundation and the Robert R. McCormick Foundation.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

  By HANNAH MEISELCapitol News Illinoishmeisel@capitolnewsillinois.com SPRINGFIELD \u2013 A pair of health care programs that benefit noncitizens \u2013 one of which is already on Gov. 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