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Sen. Cristina Castro, D-Elgin, and Rep. Eva-Dina Delgado, D-Chicago, question representatives of the Illinois Department of Healthcare and Family Services about proposed changes to programs that offer health care benefits to noncitizens in Illinois. (Andrew Adams / Capitol News Illinois)
Concerns Raised Over Lack of Public Input on Proposed Changes to Health Care Programs for Noncitizens
Members of a state rulemaking oversight committee have expressed concerns regarding the lack of public input in Governor J.B. Pritzker’s plan to cap enrollment in Medicaid-like health care programs for noncitizens.
Controversy Surrounding Health Benefits for Immigrant Adults and Health Benefits for Immigrant Seniors Programs
The controversy centers around the Health Benefits for Immigrant Adults and Health Benefits for Immigrant Seniors programs, which provide health care benefits to low-income noncitizens who would qualify for Medicaid benefits if not for their citizenship status. The Pritzker administration exercised its authority to cap program spending through emergency rulemaking in late June, which included freezing enrollment in HBIA and setting a cap for enrollees in HBIS. These changes also reduced reimbursement rates for public hospitals, introduced copayments and coinsurance for some services, and transitioned some enrollees into the Medicaid managed care program to reduce costs.
Rationale Behind the Proposed Changes
The Illinois Department of Healthcare and Family Services (IDHFS) defended the rules, stating that they were designed to limit costs for the program. According to IDHFS officials, without these changes, the program would be underfunded by hundreds of millions of dollars. The General Assembly allocated $550 million while granting the administration the authority to cap costs.
Emergency and Permanent Rules
The administration proposed the changes through both emergency and permanent administrative rules. While emergency rules are typically valid for 150 days, the law allows the administration to refile emergency rules once they expire. Therefore, unless the Joint Committee on Administrative Rules (JCAR) votes to suspend the rules by a three-fifths majority, they will remain in place for at least the next two years.
Concerns Raised by Committee Members
Both Democratic and Republican members of JCAR expressed concerns about the lack of stakeholder engagement in the development of the rules. State Sen. Cristina Castro, a member of the Illinois Legislative Latino Caucus, criticized the department for not consulting with advocates from the immigrant advocacy community. State Rep. Eva-Dina Delgado called for immediate action to engage stakeholders and advocacy groups before implementing the proposed rules. State Rep. Steven Reick voiced his opinion that the rules should have been considered in legislation rather than administrative policy.
Committee Frustrations and Future Discussions
State Sen. Bill Cunningham, co-chair of JCAR, expressed frustration at the lack of stakeholder engagement from various agencies and stated that the committee will likely have another discussion about the health care rules next month. He hopes that the department will collaborate more closely with the stakeholder groups.
Capitol News Illinois is a nonprofit, nonpartisan news service covering state government. It is distributed to hundreds of print and broadcast outlets statewide. It is funded primarily by the Illinois Press Foundation and the Robert R. McCormick Foundation, along with major contributions from the Illinois Broadcasters Foundation and Southern Illinois Editorial Association.
