Illinois Proposes Ending Health Benefits for Immigrant Adults Amid Budget Constraints

Illinois is facing a potential termination of the Health Benefits for Immigrant Adults (HBIA) program, which provides state-funded health insurance for low-income noncitizens between ages 42 and 64 without legal immigration status. The program, launched in 2022, currently covers approximately 32,000 noncitizens but is proposed to be defunded in Governor JB Pritzker's 2026 budget due to fiscal concerns. The Health Benefits for Immigrant Seniors program, covering those over 65, will continue operation despite the adult program's proposed elimination.

The HBIA and senior programs are costly, with combined expenditures significantly exceeding original estimates. An audit revealed the senior program spent $412 million in its first three years, 84% over budget, while the adult program cost $485.3 million over two years, 284% over initial projections. Enrollment issues were also noted, with some participants classified as undocumented despite holding social security numbers or legal status that may qualify them for Medicaid or other insurance.

The proposed budget cuts have sparked public demonstrations and advocacy from immigrant rights organizations and healthcare advocates. Protesters highlighted the importance of the program in providing essential healthcare access to millions who would otherwise face barriers, including catastrophic medical debt and unmet healthcare needs.

The Illinois Department of Healthcare and Family Services (IDHFS) indicated that individuals losing coverage might still access some primary and preventive care through Federally Qualified Health Centers and free charitable clinics, which serve uninsured and underinsured people regardless of immigration status. This partial safety net, however, does not fully replace the comprehensive insurance benefits offered by the HBIA program.

Governor Pritzker emphasized the importance of balancing the state budget, signaling limited flexibility for increased spending. Lawmakers remain engaged in negotiations, exploring potential solutions to funding challenges in the state health insurance programs serving immigrant populations. The outcome will impact coverage access, fiscal planning, and healthcare delivery dynamics within Illinois' diverse communities.