From State Rep. Dan Ugaste:
Audit shows Pritzker Administration vastly underestimated the cost of immigrant healthcare program.
On Wednesday, the Illinois Auditor General released the results of an audit of the Health Benefits for Immigrant Seniors and Adults programs, (HBIS and HBIA or Medicaid for non-citizens) which showed that the State of Illinois has already spent over $1.6 billion in taxpayer funds on health benefits for undocumented immigrants.
According to the Auditor General’s report released on February 26, Governor Pritzker’s administration vastly underestimated the actual cost and actual enrollment of the HBIS and HBIA programs.
Regarding the initial cost estimates for all three fiscal years 2021, 2022, and 2023:
- for HBIS (65+) the total estimate was $224.0 million, while the actual total cost was $412.3 million or 84 percent higher;
- for HBIA (55-64) the total estimate was $58.4 million, while the actual total cost was $223.1 million or 282 percent higher; and
- for HBIA (42-54) the total estimate was $68.0 million, while the actual total cost was $262.2 million or 286 percent higher.
The total cost for these programs since inception was just over $1.6 billion (for FY21-FY24). Fiscal Year 2025 has an estimated cost of $629 million, which was not included in the audit, bringing the total estimated cost of the programs to $2.2 billion.
Regarding the estimated number of enrollees, in FY23:
- for HBIS (65+), the initial estimated number of enrollees was 6,700, while the actual number enrolled was 15,831;
- for HBIA (55-64), the initial estimated number of enrollees was 8,000, while the actual number enrolled was 17,024; and
- for HBIA (42-54), the initial estimated number of enrollees was 18,800, while the actual number enrolled was 36,912.
Last week, Governor Pritzker proposed ending the HBIA program for illegal immigrant adults aged 42-64 in his proposed Fiscal Year 2026 budget. The State of Illinois has already spent nearly $1 billion on health benefits for this age group, with actual costs being 282 to 286 percent higher than the administration’s initial estimates. Gov. Pritzker only proposed eliminating this program for adults aged 42-64, while keeping the HBIS program intact for those aged 65+.
Background on Health Benefits for Illegal Immigrant Seniors and Adults. On November 7, 2023, the Legislative Audit Commission adopted Resolution Number 165, which directed the Office of the Auditor General to conduct a performance audit of the Illinois Department of Healthcare and Family Services’ (HFS) administration of the program of Medicaid services and coverage provided to undocumented immigrants from FY21-FY23.
In 2020, Illinois began to expand healthcare coverage to noncitizen immigrants. The first expansion, the Health Benefits for Immigrant Seniors program (HBIS), began in December 2020, and covered adult seniors 65 years of age and older. The second expansion began in May 2022 and covered immigrant adults between the ages of 55 and 64. The most recent expansion began in July 2022 and covered immigrant adults between the ages of 42 and 54. These two expansions are both part of the Health Benefits for Immigrant Adults program (HBIA).
SB 1298/P.A. 103-102 (FY24 Medicaid Omnibus) included a provision that allowed HFS to implement emergency rules to provide for the expeditious and effective ongoing implementation of HBIA/HBIS. In the following months of 2023, the Pritzker Administration implemented enrollment caps and other cost saving measures.
House Republicans again call for end of taxpayer-funded health benefits for illegal immigrants.
House Minority Leader Tony McCombie released the following statement in response to the Illinois Auditor General’s report on the state run HBIA/HBIS program for undocumented immigrants, which far exceeded enrollment and cost estimates:
“House Republicans warned about the costly expansion of this program when it was first exposed last year. We could not afford it then, and we cannot afford it now. Yet, Democratic leadership forced taxpayers to shoulder the burden of this reckless spending for non-citizens, pushing our state’s finances to the brink.
“Beyond the overwhelming cost, reports of fraud and abuse make it even clearer that this program must end. There is no need to wait until the next fiscal year—immediately shut it down and protect Illinois taxpayers.”
Assistant Minority Leader C.D. Davidsmeyer called the audit findings shocking and again demanded that the State immediately end the massively expensive program.
“As the chief sponsor of House Bill 1456 to end taxpayer-funded health benefits for illegal immigrants, I already knew that this program was running way over the initial cost estimates,” Rep. Davidsmeyer said. “But even I was shocked by audit findings that showed cost overruns of up to 286 percent higher than the Pritzker administration’s initial estimates. At a time when our State is facing a multi-billion-dollar budget deficit, we simply cannot afford to spend over $1.6 billion on this giveaway to illegal immigrants.”
Representative Davidsmeyer discussed the secretive nature of how these programs were initially created and expanded in Illinois.
“The HBIS and HBIA programs were never fully debated and have never received stand-alone votes by the General Assembly. The initial HBIS program, along with the HBIA expansions, were slipped into several different Budget Implementation bills and a Medicaid Omnibus bill. I strongly believe that these massively expensive programs would never have passed as stand-alone bills,” said Davidsmeyer.
State Representative Amy Elik released the following statement in response to the Illinois Auditor General’s report on the state-run HBIA/HBIS program for undocumented immigrants, which far exceeded enrollment and cost estimates:
“Last year, I, through the Legislative Audit Commission, directed the Auditor General to conduct an audit of the Health Benefits for Immigrant Seniors and Adults (HBIA/HBIS), and the results were released today and are alarming. As House Republicans predicted, the audit found astounding differences in the estimates of the program versus the actual enrollment and expenses. We must do better. Now is the time and this is the opportunity to work for taxpayers, not promote fraud and overspending.”
State Representative Dennis Tipsword issued a statement following the Health Benefits for Immigrant Seniors and Adults audit report that was released this week by the Illinois Auditor General’s Office.
“House Republicans repeatedly warned the Democrats and Governor Pritzker that providing free healthcare benefits to illegal immigrants was unsustainable and unfair to the taxpayers and residents of Illinois. Not only did the Auditor General find out that the state egregiously overspent on healthcare benefits, but there were also thousands of improper enrollments in the program.
