How can it happen that an annual program would cost 94 times times what Illinoisans were told it would cost just three years ago — $188 million in its first year? With subsequent extensions it now costs nearly $1 billion per year and growing, money the state doesn’t have.
A better question: How could it not happen, given the abject disregard for cost of the program and Illinois’ routinely scandalous budget process?
And wait ’till you hear the excuse for the fiasco from Gov. J.B Pritzker’s administration.
Ramirez (D-Chicago)
| Wirepoints
Here’s what happened: In May 2020 Illinois, became the first state to provide Medicaid for undocumented seniors. The coverage was “tucked in near the end of the 465-page budget implementation bill that passed the Illinois General Assembly late Saturday night,” as reported by the State Journal-Register at the time. That’s how Illinois’ budget is routinely implemented. A budget plus an implementation bill, usually totaling at least a thousand pages, is put up for a vote with only hours of review.
The program would cost just $2 million per year, the bill’s sponsor said at the time. That’s Delia Ramirez, a Chicago Democrat in the Illinois House at the time. Pritzker signed the bill without any cost estimate by his office. That’s all we knew at the time.
But the cost of the program blew though the appropriation for it even within the first month of implementation and soared beyond all subsequent estimates and appropriations. That’s according to a closed-door presentation by the Illinois Department of Healthcare and Family Services to lawmakers last month that became public last week.
For the year from March 2022 through February 2023, cost of care for the 65 and over age group was nearly $188 million, which is 94 times what Ramirez claimed.
Since then, the state expanded the program twice, lowering the age limit to 55 in 2021 and 42 a year later. The cost estimates of those expansions also shatter estimates made along the way. Now, the expanded program is estimated to cost $990 million for the fiscal year that starts July 1. That’s an increase of $768 million over this year, which was the first full year under the expanded program.
No portion of that cost is reimbursable by the federal government.
More details are reported in a particularly good column by Capital News Illinois
The problem and the cost uncertainty are still growing, largely because nobody really knows how many illegal immigrants are here and millions more enter the country every year.
Undeterred, House Democrats recently filed House Bill 1570 to further expand free health benefits for undocumented immigrants by adding ages 19-41 to the program.
Why was the report exposing this discussed only behind closed doors last month in the General Assembly?
I have found no excuse.
Is anybody being held accountable?
Certainly not Ramirez. She got a promotion from voters who elected her to the United States House of Representatives in 2022.
How about Pritzker?
Pritzker’s office has given two answers, the first of which is to blame legislators. His office says they didn’t prepare their own cost estimates before the program became law because it was a lawmaker-driven initiative. Republicans have complained that the program was never vetted in committee before being added to the budget, but that apparently didn’t concern Pritzker.
Pritzker’s second answer is a doozy, essentially saying, “How dare you you question us about budgeting. We Democrats are great with budgets.” Specifically, here’s what Pritzker’s press spokesman, Jordan Abudayyeh, told CapitolFax:
The Republicans said it’s time we have some adults in the room when it comes to budgeting. To be clear, the only lawmakers with a proven record of balancing the budget and improving state finances are Governor Pritzker and the Democratic supermajority in the General Assembly. The Governor just proposed another balanced budget that invests in education, healthcare, and communities. The credit ratings agencies have so much trust in his track record that after his proposal the state received two credit upgrades.
Let’s review some history. Who eliminated the bill backlog that reached $16 billion left by the Republican governor? Democrats. Whose prudent fiscal decisions led to eight credit upgrades? Democrats. Who paid additional pension payments? Democrats. Who invested hundreds of millions of dollars to rebuild our human services infrastructure after the Republican budget impasse? Democrats. Who rebuilt the rainy day fund to nearly $2 billion? Democrats. Who balanced the budget four years in a row? Democrats.
The budget, of course, isn’t remotely close to being balanced for other reasons, as we’ve often explained.
But even if it were, the Pritzker Administration apparently wants us to accept that unbudgeted spending should be overlooked because of its supposed budget prowess.
Pritzker’s office says there is about $300 million available to cover the $768 million increased cost for the coming year over the current year. Where the difference will come from remains to be seen.
Illinois House Republicans, at a Thursday press conference, called for a moratorium and an audit on the program. They complained bitterly about how the program and each extension were slipped into other legislation with no review. “Zero transparency, zero accountability, zero public input,” said Assistant Republican Leader C.D. Davidsmeyer (R-Jacksonville),
The Republicans noted that the additional pressure on Medicaid from the program and its expansions is happening at the same time the state is expected to lose $760 million in special Medicaid federal funding for its own citizens that was provided to states during the pandemic.
Davidsmeyer indicated that he fears the pending, further expansion of the program to younger age groups will again be stuck into a budget bill or some other massive omnibus bill at the end of this legislative session, without real review.
“The sad fact is Illinois has become a sanctuary state for undocumented immigrants,” he said. “The State of Illinois gives them free healthcare benefits, driver’s licenses, mortgage and renters’ assistance, as well as other taxpayer-funded benefits. All I can say is ‘If you build it, they will come.’”
And “cost be damned,” he might have added.