Illinois Considers Cuts to Immigrant Health Coverage Amid Budget Shortfall

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