SPRINGFIELD, Ill. — Gov. JB Pritzker’s plan to maintain Illinois as a sanctuary state is facing challenges as the state grapples with a budget shortfall for the upcoming fiscal year. His proposed $55.2 billion budget includes cuts to a health coverage program for some immigrants regardless of their legal status.
Illinois is one of only seven states and the District of Columbia offering such programs, which provide Medicaid-style benefits to low-income immigrant adults and seniors.
What Is Being Cut?
- Enrollment in the program for immigrant adults aged 42 to 64 will end on June 30.
- The immigrant seniors’ program (65 and older) will continue for current enrollees but will not accept new applicants.
- The adult program costs an estimated $404 million this year.
- Together, the programs cover over 43,000 people at a cost of around $538 million annually.
Why These Programs Matter
Supporters say the programs:
- Help tens of thousands of families who would otherwise lack access to health care.
- Reduce emergency room visits by encouraging preventive care and chronic illness management.
- Save Illinois hospitals money; a recent study found a 15% reduction in bad debt for hospitals due to the programs, equal to about $1.5 million per hospital per year.
- Are funded in part by immigrant households paying $8.6 billion annually in state and local taxes.
Political Debate and Challenges
- Democrats, who control the legislature, support continuing the program but face budget constraints.
- Republicans criticize the program’s cost and argue it may attract more undocumented immigrants.
- Federal budget cuts to Medicaid add pressure to state budgets, raising questions about sustainability.
- California and other states offering similar programs are facing similar funding shortfalls.
Broader Context
- Illinois began its immigrant health coverage programs in 2020 for seniors and expanded in 2021 to adults aged 42–64.
- Other states like California, New York, Minnesota, Oregon, and Washington D.C. offer varying forms of coverage for immigrants regardless of status.
- Illinois has an estimated 400,000 undocumented immigrants, many of whom remain ineligible or unenrolled due to lack of awareness or barriers.
What’s Next?
- Lawmakers continue budget negotiations before the legislative session ends May 31.
- Advocates urge Pritzker and the General Assembly to “hold the line” on immigrant health coverage amid political pressures.
- The debate highlights the broader tension between fiscal realities and social policy goals in sanctuary states.
Source Attribution
Information sourced from:
- Illinois state government budget proposals
- National Immigration Law Center
- University of Chicago and University of Illinois studies
- Statements from Illinois lawmakers and immigrant advocacy groups