Gov. JB Pritzker’s administration dramatically underestimated the actual price tag of a controversial healthcare program for adult immigrants who lack legal status, costing the state $1.6 billion since 2020, a state auditor general’s report revealed Wednesday.
The investigation by Illinois Auditor General Frank Mautino was already underway when Pritzker decided to nix the program beginning July 1 — and the new report is giving fire to Republicans who want to see the program end immediately.
The Democratic governor last week excluded in his budget proposal funding for the Health Benefits for Immigrant Adults program, which provided health care for immigrants who lack legal status, aged 42 to 64. Last year, Pritzker included $629 million to provide health care benefits to immigrants without legal status 42 and up, and seniors who would otherwise qualify for Medicaid.
Mautino’s report, prompted by a Legislative Audit Commission resolution in November 2023, reveals that the initial cost estimates for the program for seniors was estimated at $224 million for 2021, 2022 and 2023 — but actually cost the state $412.3 million or 84% more.
For the program for adults ages 55 to 64, initial estimates for those years ran $58.4 million, but actually cost the state $223 million, or 282% more. For the program for those aged 42-54, the cost estimate was $68 million but ultimately cost the state $262 million.
Enrollment was also vastly underestimated, the report found. For the program for seniors 65 and older, the initial estimated number of enrolled was 6,700, while the actual number was more than double: 15,831.
For the program for people ages 42-54, the estimated number of enrollees was 18,800, while the actual number enrolled was 36,912. For the program for ages 55-64, the initial estimate was 8,000 but actual number of those enrolled was 17,024.
The report also found glaring errors, including that 478 people enrolled had two or more recipient identification numbers; and 6,098 people enrolled were designated as “undocumented” but had a Social Security numbers. Auditors also found 688 enrollees who were designated to the program for seniors, but were not 65 or older.
At a news briefing in Chicago Wednesday, Pritzker bypassed some of the report’s errors and focused on the fleeting nature of immigration status. He also spoke of his support for universal health care.
“I think the thing that is missing from the reporting, and what I would point out to you, is that number one, people’s immigration status changes during the course of a year. You’ve got people who were eligible for the program, who became ineligible for the program,” Pritzker said.
“So even though you expect that people will move on because, well, it may be their immigration status, it may be because they got a job that has health care coverage associated with it,” Pritzker added. “But you expect them to move on, and maybe they didn’t move on either because they didn’t know they could [or] should.”
The governor said the redetermination process is expected to weed out those who are ineligible. But he acknowledged that those people have still cost the state money.
“People get removed from the program as a result of the redeterminations,” Pritzker said. “But before they get redetermined to not be eligible, they were still on the program and that cost taxpayer money.”
Illinois House Republican Leader Toni McCombie, R-Savanna, is urging Pritzker to end the program now, instead of waiting until July 1.
“Beyond the overwhelming cost, reports of fraud and abuse make it even clearer that this program must end,” McCombie said in a statement. “There is no need to wait until the next fiscal year — immediately shut it down and protect Illinois taxpayers.”
Illinois Senate Republicans also criticized the program and are proposing legislation to audit all spending of programs for immigrant adults lacking legal status.
“This program cost taxpayers of Illinois millions upon millions of dollars, dollars that’s never should have been spent on people ineligible for coverage, both not properly in the program or not getting federal reimbursements when they were eligible,” said Illinois Senate Republican Leader John Curran, R-Downers Grove.
“…This really highlights this is the largest portion,” Curran continued, “but one portion of the spending on the undocumented immigrant population that the state of Illinois is taking upon itself, upon the taxpayers of Illinois, without providing any transparency.”