Estimated cost of Illinois noncitizen health care program reaches $1.1 billion

SPRINGFIELD — The estimated cost of Illinois continuing to provide medical coverage to noncitizens who are ineligible for Medicaid benefits has been revised upward to $1.1 billion in the next fiscal year.

As of the end of March, the Illinois Department of Health Care and Family Services funded a program that provides state-funded health care to individuals over the age of 42 who qualify for Medicaid if they have not obtained citizenship. We estimate it will cost $990 million to deliver. .

The new estimate, shared Wednesday by IDHFS director Teresa Eagleson in testimony to the Senate Appropriations Committee, shows the $220 million estimate included in Gov. J.B. Pritzker’s February budget proposal now down to $880 million. Exceeded.

IDHFS Chief of Staff Ben Winnick told the commission that the initial estimate was based on data from the Census Bureau’s American Community Survey, estimating the eligible population and assuming that a certain percentage would register.

However, both the cost of providing care and the number of enrolments far exceed estimates.

“Because of the unreliability of that data, our enrollment projections are only focused on monthly growth based on the trends we see, and are not tied to the universe of entitlements. said Winnick.

10% monthly growth rate

Forecasts are currently based on the program’s current monthly growth rate of approximately 10%. Enrollment numbers are expected to exceed 120,000 in fiscal year 2024. Previous estimates put him at 98,500 subscribers.

Winnick said the program currently serves about 56,000 people, and the department oversees health care for about 3.9 million people through various programs statewide.

R-Cherry Valley Senator Dave Syverson expressed concern over the fact that no other state offers the same level of health insurance to noncitizens as Illinois. As a result, enrollment numbers will continue to rise and cost estimates may be revised upwards, he said.

“Illinois is the only state in the country that fully covers health care for illegal immigrants over the age of 42, so if they cross the border and find you have a health condition, they will be able to help you. I know there’s one state that comes in if it’s a health issue,” he said at a press conference Thursday. “Now Illinois is flooded with all the sick people coming here from all over the country because of the state’s policy of being a welcoming state.”

The same Senate committee heard a proposal from Sen. Omar Aquino of the Chicago Democratic Party to further expand Medicaid coverage to noncitizens over the age of 19. IDHFS estimates that it will cost an additional $380 million.

“We are the first[state]in the country to provide care for people over the age of 42 like this. We are a welcoming state and we say it with pride,” said Aquino. rice field.

He said expansion means people who have “lived in the shadows” can now seek care, and the pace of the program’s growth shows that need.

“Some of this highlights many of the untreated medical problems from type 2 diabetes, cancer and more,” he said.

Eagleson noted that per-patient costs for individuals aged 65 and over have leveled off since 2021, when the population was first covered by the state-run health care program.

“I think it’s important to say that people are getting diagnostic services and medications that help them manage chronic conditions and things like that,” Eagleson said. At the stratum, these costs increased fairly quickly in the first few years, then actually declined, and now we have normal inflation, so they start to level off as people get treatment.”

Winnick said the majority of the program’s enrollees live in Cook County, and the results are coming from less dependence on the county-run health care system.

“A lot of it is because these conditions are now under control,” he said. , using its insurance to access a wider range of providers.”

cost burden

As of February, the agency’s total budget request was $37.2 billion, with just over $9 billion from the General Revenue Fund.

The Pritzker administration estimates that the proposed IDHFS budget could cover the higher-than-expected cost of about $300 million.

“The governor’s focus remains on investing in the priorities outlined in his budget speech,” Pritzker spokesperson Jordan Abdaye said in a statement. “His administration is working closely with the General Assembly to ensure that additional priorities fit within a balanced budget framework.”

Department officials said they are also looking at other ways to cover the costs.

Because individuals are not citizens, the federal government does not respond to state contributions to the program. But Eagleson says the federal government’s Medicaid program “funds emergency services for illegal residents.”

“So we’ve already got verbal commitments, which is about $67 million in[federal]matches for the funds we’ve already spent on the program,” she said of the talks with the federal government. I was. “And based on the cost estimates…from $100 million to $120 million, she believes emergency services will cost more.”

Republican senators also said noncitizens are part of a paid Medicaid program, not the Medicaid Managed Care program that most other beneficiaries are enrolled in.

This managed care system uses private insurance companies known as managed care organizations (MCOs) to coordinate the care of Medicaid recipients. The state releases funds to the MCO at the statutory rate. These MCOs are charged an “assessment,” a type of tax on providers designed to bring more federal funding to state Medicaid programs.

Eagleson says that having noncitizen recipients participate in a managed care program doesn’t necessarily reduce costs, but it does increase revenue by allowing recipients to be evaluated through MCOs. It says it will.

Winnick said the reason noncitizens were not included in managed care was because the department expected the group to be much smaller than it actually was.

“Obviously, we are looking at options to expedite the rollout of managed care for this population at a time when enrollment numbers are growing significantly,” he said.

Senator Chapin Rose (Republican Mohammed) said the funds spent on the expansion would be a 20% expansion of the requested hospital Medicaid base rate, or sufficient funds for services provided to individuals with developmental disabilities. He pointed out that it may have been sufficiently funded for

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