House Republicans call for a moratorium, audit of Illinois’ billion-dollar health benefits program for undocumented immigrants

Illinois State Representative Amy Elik (R-Alton) and her House Republican colleagues are calling for a moratorium on expansion and a State audit of Illinois’ billion-dollar health benefits program for undocumented immigrants.

At a Capitol press conference in Springfield, State Representative Amy Elik (R-Alton), Deputy Republican Leaders Norine Hammond (R-Macomb) and Ryan Spain (R-Peoria), along with Assistant Republican Leader C.D. Davidsmeyer (R-Jacksonville), highlighted a bombshell State report detailing the massive cost and enrollment expansions of Illinois’ health benefits program for undocumented immigrants.

Rep. Hammond, who serves as chief budgeteer and Rep. Elik who serves as deputy budgeteer for the House Republican Caucus, laid out in detail the dramatic growth in undocumented immigrant participation, which will require nearly a billion dollars in general revenue funds to support the program in Fiscal Year 2024.

“Illinois’ health benefit program for undocumented immigrants is estimated to cost nearly $1 billion next fiscal year, a 346% increase since last year,” said Rep. Elik. “These costs incurred keep climbing and are not eligible for matching funds by the federal government. The majority party approved this spending without considering the fiscal impact to our general revenue fund. This puts services for our most vulnerable citizens and many other critical programs at risk in future state budgets.”

A recent report from the Department of Healthcare and Family Services (HFS) shows that HFS and its contracted actuarial firm, Milliman, repeatedly underestimated actual enrollees and costs. FY24 estimates now show 108,400 additional eligible documented immigrants over original FY23 estimates.

“Year after year, we saw the majority party continue to double down on these expansions, which are not eligible for federal matching funds. The Medicaid program in the State of Illinois is our biggest area of spending,” said Deputy House Republican Leader Ryan Spain in discussing House Resolution 220, which he filed to audit and pause new enrollees in the program. “This billion dollar hole, which is just the beginning, requires the General Assembly to exercise fiscal responsibility in both the short-term and long-term to ensure state budget sustainability.”

The additional Medicaid pressure for these expansions is happening at the same time the State is expected to lose $760 million in additional federal funding through the enhanced Federal Medical Assistance Program (FMAP) that was provided to states during the pandemic.

Several important State programs are still drastically underfunded and could greatly benefit from the $990 million in GRF that would go to HFS to continue to provide medical services to undocumented immigrants.

Assistant Republican Leader C.D. Davidsmeyer discussed the process by which these expansions of health benefits to undocumented immigrants were enacted into law and the absolute lack of accountability and transparency for this program.

“During the 2020 pandemic-shortened House session, Democrats slipped health benefits for undocumented immigrant seniors into the FY21 Budget Implementation (BIMP) bill. This new benefit was included in the BIMP at the last minute, without a committee hearing, public input, or debate. We had virtually no time to review the massive BIMP and budget bills that were passed at the end of that special session,” said Rep. Davidsmeyer.

“In 2021, Democrats again slipped expanded health benefits for undocumented immigrants for ages 55-64 into the FY22 BIMP bill. This was again included at the last minute, with no committee hearing and almost no time to debate the bill.

“Last year, Democrats blew up an agreed Medicaid Omnibus bill by yet again adding a last-minute expansion of health benefits for undocumented immigrants for ages 42-54 at the end of session. Zero transparency, zero accountability, zero public input.”

Illinois Democrats recently filed House Bill 1570, which would complete the expansion of health benefits for undocumented immigrants by adding ages 19-41 to the program. HB 1570 has not been debated and no stand-alone vote has been taken on this benefit expansion. Davidsmeyer suggested that if recent history is any guide, the Democrats will again, for the fourth time, add this expansion to the upcoming FY24 BIMP bill or some other massive omnibus bill at the end of the General Assembly’s spring session.

Stay up to date on news and legislative action in the Illinois House of Representatives by visiting or contact State Representative Amy Elik’s district office in Alton at 618-433-8046.