Original reporting by JERRY NOWICKI of Capital News Illinois; Analysis by Fox Valley Magazine
One wonders whether to laugh or cry. The State of Illinois’ Medicaid policy regarding noncitizens is both an hilarious tale of government incompetence and a tragic tale of the cost of such incompetence.
In 2020, Illinois made noncitizens aged 65 and older eligible for Medicaid-type coverage, becoming the first state to do so. The Health Benefits for Immigrant Seniors program is open to individuals whose income is below the federal poverty level.
It’s a cost born entirely by the state because the individuals are not eligible for the Medicaid program that is split roughly 50-50 between the state and the federal government.
The expansion was inserted into a late draft of what’s known as the budget implementation bill in the pandemic-shortened 2020 session. It was an initiative of the Illinois Legislative Latino Caucus and sponsored in the House by Rep. Delia Ramirez, D-Chicago, who has since moved on to the U.S. Congress.
Ramirez pegged the program’s Fiscal Year 2021 cost at $2 million, according to the newspaper.
The actual cost of the program far exceeded that estimate, and the program exceeded its FY 2021 appropriation within the first month of implementation, according to a closed-door presentation by the Illinois Department of Healthcare and Family Services to lawmakers last month.
Between March 2022 and February 2023, the cost of care for the 65 and over age group was nearly $188 million.
Oops.
Since the program’s initial passage, lawmakers have expanded it twice, of course, lowering the age limit to 55 in 2021 and 42 a year later. The expanded program is known as Health Benefits for Immigrant Adults.
As the expansion was to be implemented in 2021, IDHFS brought in its own consultant to try to get a clearer picture of what it would cost. For the current fiscal year that concludes June 30, the actuarial firm Milliman estimated the total program costs would be about $222 million.
But the actual cost for all three age groups was $410 million from March 2022 through February 2023, according to the department.
Oops, again.
All told, the estimated $990 million price tag for this upcoming year represents a $768 million increase over the faulty initial current-year estimate, and a $988 million expenditure for a program that began with that $2 million original estimate.
Regardless of what one thinks about providing state-funded healthcare for noncitizens, one has to marvel at the ingenuity of our government officials, elected and unelected, in taking a program that was originally estimated to cost a mere $2 million to a program that will cost nearly $1 billion a mere few years later.
For some reason, we don’t really feel like laughing.
